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Calf Muscle Strain Physiotherapy Mississauga

Updated: Nov 13, 2019

Calf strains are common sports injuries seen in physiotherapy and sports medicine clinics. The “calf muscle” consists of three separate muscles (the gastrocnemius, soleus, and plantaris) whose aponeuroses unite to form the Achilles tendon. Calf strains are most commonly found in the medial head of the gastrocnemius. The gastrocnemius is considered at high risk for strains because it crosses two joints (the knee and ankle) and has a high density of type two fast twitch muscle fibers. The combination of excessive stretch and rapid forceful contraction of type two muscle fibers results in strain.

 

Differentiating strains of the gastrocnemius or soleus is important for treatment and prognosis. Simple clinical testing can assist in diagnosis and is aided by knowledge of the anatomy and common clinical presentation. Soleus muscle injury may be underreported due to misdiagnosis as thrombophlebitis or lumping of soleus strains with strains of the gastrocnemius. The classic presentation is of calf tightness, stiffness, and pain that worsen over days to weeks. Walking or jogging tends to increase the symptoms and swelling and disability are generally mild.

How a physiotherapist distinguishes a calf strain to other injuries?

 

The physical exam allows them to isolate the site and severity of injury. To localize strains to the gastrocnemius or soleus, a combination of palpation, strength testing, and stretching is required.

 

Palpation of the calf should occur along the entire length of the muscles. It is necessary to identify tenderness, swelling, thickening, defects, and masses if present. Gastrocnemius strains typically present with tenderness in the medial belly or the musculotendinous junction. In soleus strains the pain is often lateral. A palpable defect in the muscle helps in localization and suggests more severe injury.

 
 

Additional testing that can be used during evaluation of calf strain includes the Thompson test for complete disruption of the Achilles tendon, circumferential calf measurements to quantify asymmetry and functional movements.

 

Careful examination of wrist is required to rule out TFCC. An X-ray may be required depending on the severity of pain and inflammation to check for fractures and other abnormalities. The most reliable imaging test is an MRI, which allows doctors to inspect the tissue and cartilage to see the extent of the injury.

It should be noted that concomitant tears of both the soleus and gastrocnemius are possible. This can complicate the clinical picture. Imaging may also be useful in diagnosis and grading of calf injuries in elite athletes because of unique financial and strategic consequences of return to play decisions. Both can be used to confirm strain, localize the injured muscle and determine extent of injury.

 

Classification of the injuries

 

Grade 1

 

1st degree-mild

 

Symptoms include Sharp pain at time of injury or pain with activity. It’s usually able to continue activity with mild pain and localized tenderness. Mild spasm and swelling

No or minimal loss of strength and ROM

<10% muscle fiber disruption

 

Grade 2

 

2nd degree moderate

 

Unable to continue activity and Clear loss of strength and ROM

>10–50% disruption of muscle fibers

Edema and hemorrhage

 

Grade 3

 

3rd degree severe

 

Immediate severe pain, disability and complete loss of muscle function

Palpable defect or mass. Possible positive Thompson’s test

50–100% disruption of muscle fibers

 
 

How can calf muscle strain be treated by Physiotherapy?

 

Acute physiotherapy treatment is aimed at limiting hemorrhage and pain, as well as preventing complications. Over the first 3–5 days, muscle rest by limiting stretch and contraction, cryotherapy, compressive wrap or tape, and elevation of the leg are generally recommended. Acetaminophen or narcotic pain medication could also be used. Gentle active exercises of the ankle and calf should be started within the limits of pain.

 
 

Following successful acute treatment more active physiotherapy and rehabilitation strategies can be started. Rehabilitative exercises should isolate the soleus and gastrocnemius by varying knee flexion as described above. Passive stretching of the injured muscle at this stage helps elongate the maturing intermuscular scar and prepares the muscle for strengthening. As range of motion returns, strengthening should begin with unloaded isometric contraction.

 

Contractures suggest the presence of painful and restrictive adhesions that can be treated with Hawk or Garston release techniques.

 

Active release technique or Trigger point release is also helpful in treating the calf strains.

 
 

If you are interested to know more about your problem and discuss to find out if there is a way our highly qualified Physiotherapists standing by to help you. Call us today at

905 997 4333 to get started on your recovery from calf strain!! Our registered Physiotherapists believe in using the latest technology to deliver our clients improved, high quality services that contribute to the improvement of your patient’s health.

Sheena John

Registered Physiotherapist

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Calf Muscle Strain Physiotherapy Mississauga

Updated: Nov 13, 2019

Calf strains are common sports injuries seen in physiotherapy and sports medicine clinics. The “calf muscle” consists of three separate muscles (the gastrocnemius, soleus, and plantaris) whose aponeuroses unite to form the Achilles tendon. Calf strains are most commonly found in the medial head of the gastrocnemius. The gastrocnemius is considered at high risk for strains because it crosses two joints (the knee and ankle) and has a high density of type two fast twitch muscle fibers. The combination of excessive stretch and rapid forceful contraction of type two muscle fibers results in strain.

Differentiating strains of the gastrocnemius or soleus is important for treatment and prognosis. Simple clinical testing can assist in diagnosis and is aided by knowledge of the anatomy and common clinical presentation. Soleus muscle injury may be underreported due to misdiagnosis as thrombophlebitis or lumping of soleus strains with strains of the gastrocnemius. The classic presentation is of calf tightness, stiffness, and pain that worsen over days to weeks. Walking or jogging tends to increase the symptoms and swelling and disability are generally mild.

How a physiotherapist distinguishes a calf strain to other injuries?

The physical exam allows them to isolate the site and severity of injury. To localize strains to the gastrocnemius or soleus, a combination of palpation, strength testing, and stretching is required.

Palpation of the calf should occur along the entire length of the muscles. It is necessary to identify tenderness, swelling, thickening, defects, and masses if present. Gastrocnemius strains typically present with tenderness in the medial belly or the musculotendinous junction. In soleus strains the pain is often lateral. A palpable defect in the muscle helps in localization and suggests more severe injury.

Additional testing that can be used during evaluation of calf strain includes the Thompson test for complete disruption of the Achilles tendon, circumferential calf measurements to quantify asymmetry and functional movements.

Careful examination of wrist is required to rule out TFCC. An X-ray may be required depending on the severity of pain and inflammation to check for fractures and other abnormalities. The most reliable imaging test is an MRI, which allows doctors to inspect the tissue and cartilage to see the extent of the injury.

It should be noted that concomitant tears of both the soleus and gastrocnemius are possible. This can complicate the clinical picture. Imaging may also be useful in diagnosis and grading of calf injuries in elite athletes because of unique financial and strategic consequences of return to play decisions. Both can be used to confirm strain, localize the injured muscle and determine extent of injury.

 

Classification of the injuries

 

Grade 1

 

1st degree-mild

 

Symptoms include Sharp pain at time of injury or pain with activity. It’s usually able to continue activity with mild pain and localized tenderness. Mild spasm and swelling

No or minimal loss of strength and ROM

<10% muscle fiber disruption

 

Grade 2

 

2nd degree moderate

 

Unable to continue activity and Clear loss of strength and ROM

>10–50% disruption of muscle fibers

Edema and hemorrhage

 

Grade 3

 

3rd degree severe

 

Immediate severe pain, disability and complete loss of muscle function

Palpable defect or mass. Possible positive Thompson’s test

50–100% disruption of muscle fibers

 
 

How can calf muscle strain be treated by Physiotherapy?

 

Acute physiotherapy treatment is aimed at limiting hemorrhage and pain, as well as preventing complications. Over the first 3–5 days, muscle rest by limiting stretch and contraction, cryotherapy, compressive wrap or tape, and elevation of the leg are generally recommended. Acetaminophen or narcotic pain medication could also be used. Gentle active exercises of the ankle and calf should be started within the limits of pain.

 
 

Following successful acute treatment more active physiotherapy and rehabilitation strategies can be started. Rehabilitative exercises should isolate the soleus and gastrocnemius by varying knee flexion as described above. Passive stretching of the injured muscle at this stage helps elongate the maturing intermuscular scar and prepares the muscle for strengthening. As range of motion returns, strengthening should begin with unloaded isometric contraction.

 

Contractures suggest the presence of painful and restrictive adhesions that can be treated with Hawk or Garston release techniques.

 

Active release technique or Trigger point release is also helpful in treating the calf strains.

 
 

If you are interested to know more about your problem and discuss to find out if there is a way our highly qualified Physiotherapists standing by to help you. Call us today at

905 997 4333 to get started on your recovery from calf strain!! Our registered Physiotherapists believe in using the latest technology to deliver our clients improved, high quality services that contribute to the improvement of your patient’s health.

Sheena John

Registered Physiotherapist

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  • Mississauga Location:
  • Curezone Physiotherapy,
  • 110-812, Britannia Road West,
  • Mississauga, ON, Canada L5V 0A6​
  • (Located in Heartland, the plaza behind Canadian Tire, opposite to Silver Spoon)
  • Open Hours:
  • Mon to Fri: 08:00 AM - 09:00 PM
  • Sat: 10:00 AM - 07:00 PM
  • Sun: 10:00 AM - 03:00 PM
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Our Services

Curezonephysiotherapy inc. © 2020. All Rights Reserved

CONTACT US

  • Mississauga Location:
  • Curezone Physiotherapy,
  • 110-812, Britannia Road West,
  • Mississauga, ON, Canada L5V 0A6​
  • (Located in Heartland, the plaza behind Canadian Tire, opposite Silver Spoon)
  • Open Hours:
  • Monday to Friday : 08:00 AM - 09:00 PM
  • Saturday : 10:00 AM - 07:00 PM
  • Sunday : 10:00 AM - 03:00 PM
Facebook-f Linkedin

Our Services

curezonephysiotherapy inc. © 2020. All Rights Reserved