Videos in this series about calf pain include: Calf stretch heel cord Yoga heel
stretch, Achilles Tendon heel pain: How to treat (Physical Therapy), Foam Roller: Stretching / massaging the
calf muscles, Stretch to relieve pain & stress, Treating Shin Splints: Physical Therapy... Shin Splints:
What you need to know.
Sudden pain that occurs in the calf muscle during activity may be the result of a pulled
or torn calf muscle. This is called a calf strain or a calf pull. It occurs when part of the muscles of the
lower leg (gastrocnemius or soleus) are stretched beyond their ability to withstand the tension. This
stretching can result in small microtears to the muscle fibers or, in a severe injury, a complete rupture of
the muscle fibers.
Calf Muscle Cramp
A far less severe, but often painful, cause of calf pain is the calf calf muscle cramp or
spasm. This involuntary contraction of a muscle, is short-lived, but in may be so strong that it causes a
Achilles Tendon Tear
A calf strain is similar to an Achilles tendon tear or rupture, but occurs higher up in
the back of the leg. The signs of a calf strain are also similar to that of an Achilles tendon
- you may think you've just been hit in the back of the leg and hear an audible "pop."
There will be sudden, sharp pain in the back of the lower leg, or pain, swelling and even bruising over the
calf muscle. Most calf injuries will make it difficult to tolerate weight on injured side and make it very
difficult to stand on the toes.
Calf Strain Cause and Severity
A calf strain or pull often happens during acceleration or an abrupt change in direction
while running. A torn calf muscle may spasm, and contract forcefully so that the toes will automatically point
downward. Bruises show up over the injured area as well as in the foot and ankle due to pooling of blood from
Calf strains may be minor or very severe and are typically graded as follows:
Grade 1 Calf Strain: The muscle is stretched causing
some small micro tears in the muscle fibers. Full recovery takes approximately two weeks.
Grade 2 Calf Strain : There is partial tearing of muscle fibers. Full recovery takes
approximately 5-8 weeks.
Grade 3 Calf Strain: This is the most severe calf
strain with a complete tearing or rupture of muscle fibers in the lower leg. Full recovery can take 3-4
months and, in some instances, surgery may be needed.
Calf Strains Treatment
The first treatment is R.I.C.E. (rest, ice,
. Wrap the calf to keep the blood from pooling in the foot, and keep it elevated for the
first 24 hours to reduce swelling. Anti-inflammatory medication
may help reduce pain. Eventually, the
muscle reattaches to the tendon; however, and the calf is often shorter than before the injury and prone to
A visit to a physician and or a physical therapist is recommended to ensure in fast
Typical rehab for a calf strain depends upon the severity of the injury, and includes the
Rest the Muscle. Avoid activities that cause pain.
Avoid impact activity or excessive stretching (no running, jumping, or weightlifting). Do not return to
your sport until you are pain-free.
Taping the Calf. Some athletes find that taping the
calf can reduce pain and help protect from further injury. Applying special precut tape, such
asScrip Spidertech Calf Tape, is one way to easily tape the calf
Range of Motion Stretching Exercises. When acute
pain is gone, begin stretching the muscle moderately with passive range of motion stretching. Gently pull
your foot and toes up with legs straight if possible to stretch the calf muscle. Hold for 10 seconds and
repeat 5 to 10 times.
Progressive Calf Stretching Exercises. As you heal, you
can begin using a regular stretching and flexibility program to gain range of motion and prevent future
calf injury. Follow the advice of your therapist when beginning these exercises.
Use a Foam Roller. Performing gentle self-massage with a
foam roller as your calf injury heals can help reduce scar tissue formation and improve blood flow to
Progressive Strengthening Exercises. Start with
exercise tubing or a band and hook it under your toes and press down gently using light resistance. Point your foot down against resistance and then slowly
return to the start position. Do 10 reps, rest and repeat 5 to 10 times. Over time you will progress to
Calf Raise Exercise.
Achilles Tendon Strengthening. Once you have healed and
experience no pain with basic strengthening exercises, consider strengthening your Achilles tendon to
prevent related lower leg injuries.
The goal of rehab is to return to normal activity as quickly as possible without any
long-term effects. If you return too soon, you risk developing a chronic injury. Keep in mind that everyone
recovers at a different rate, and your rehab needs to be tailored to your needs and your progress not the
You can safely return to your
sport when you meet the
You have your physician's "okay."
You are pain-free.
You have no swelling.
You have full range of motion (compared to the uninjured side).
You have full or close to full (90 percent) strength (again, compare with the
You can jog straight ahead without pain or limping.
You can sprint straight ahead without pain or limping.
You can jump on both legs without pain and you can jump on the injured leg without
You are not alone. Aching shins is a very common complaint for new walkers. It can also
be a problem for walkers increasing their speed or distance. Shin pain (generally referred to as shin splints)
is caused from too much stress on weak shin muscles. This pain may be caused by many things including shoes
with too high a heel or inflexible sole, weak shins or calves, tight shins or calves, striding out too far in
front of your body, increasing speed or distance too rapidly, muscle imbalances or gait
Symptoms can include throbbing, tenderness, and aching from
below the knee to the ankle. The pain is normally worse early in the morning and at the beginning of your walk,
and can gradually get better as your walk progresses.
Prevention and treatment:
Warm up by walking at a slower pace at the beginning of each walk. Then perform ankle circles (rotate ankle ten
times in one direction, then ten times in opposite direction) and toe points (point toes, then flex foot - ten
times on each foot) to get your muscles loosened up. Do the ankle circles and toes points several times each
day, or write the alphabet in the air with your toes.
Stretch your calves, shins, and achilles tendon after every walk.
Tight muscles make the shin work harder to lift your foot.
Cross train (biking, swimming, etc.) once or twice a week.
Replace your shoes when needed and choose the right shoe for your foot. Walkers should
always choose flexible shoes with a low heel to produce the rolling motion needed for fitness walking. If
you over pronate be sure to wear shoes that correct for this problem.
Choose a good walking surface. Avoid concrete if at all possible. If you walk on a road with an obvious camber
try walking out and back on the same side of the road to avoid putting too much stress on one leg.
Increase your mileage and speed gradually. The general rule of thumb is to increase mileage at a rate of 10%
Be sure that you are not overstriding.
Perform exercises to strengthen calves and shins.
If you are currently having shin pain you may need to take a day or two of rest and start
back more slowly. Remember RICE: Rest, Ice, Compression andElevation (and Ibuprofen works wonders).
If you are doing all of the above and the problem does not get better see a sports medicine doctor or
Academy of Orthopaedic Surgeons, Sprains and Strains: What's the Difference?
Strain. About.com Symptom Checker
[http://symptomchecker.about.com/od/Diagnoses/muscle-strain.htm]. Last accessed, June 2010.
Noonan TJ, and
Garrett WE, "Muscle strain injury: diagnosis and treatment" J. Am. Acad. Ortho. Surg., Jul 1999; 7: 262 -