The calf muscle is made up of the gastrocnemius muscle, which is the large muscle at the back of the lower leg and the soleus, a smaller one located just below the gastrocnemius. These muscles can become injured or torn due to overstretching or overuse. Calf strains are common in athletes, especially runners.
Symptoms of calf strain are:
- Sudden pain at the back of the leg, approximately midway between the knee and the heel.
- Pain when standing on tiptoe.
- Swelling or bruising along the calf.
- Pain when the muscle is contracted against resistance or pain when the muscle is stretched.
With an acute (sudden) calf strain, the RICE formula works well in the initial stages, (rest, apply ice and compression and elevate the affected area), however physical therapy is needed to help prevent further injury and to restore the previous level of function. Your doctor may prescribe anti-inflammatory medication for the pain and recommend a heel pad to raise the heel and take some of the strain off the calf. Heel pads should be worn in both shoes to avoid leg length discrepancy which can lead to other problems.
Physical therapy treatment involves pain management, stretching and strengthening exercises. We will test the calf muscles and ankle and knee joints for flexibility and assess your balance, which may be impaired after injury. We will then use pain and inflammation relieving modalities such as ice and ultrasound and begin passive stretching exercises. Manual therapy such as massage and trigger point therapy may also be performed to get rid of trigger points and scarring that may have resulted from the calf strain. Acupuncture is also commonly used in physical therapy for calf strains and we may recommend strapping for support.
As the acute symptoms decrease, so begins the next phase of treatment. Specific functional, strengthening exercises such as heel raises, treadmill walking and balance board work are performed to maintain fitness and strengthen the muscles to prevent the recurrence of injury. As you get stronger, you may begin running to build up condition and get ready to return to active sports.
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