What is a calf strain?

A calf strain or a pulled calf muscle is when the calf muscle is overstretched. The calf muscles are located in the back of your lower leg, from the distal end of the femur to the calcaneus (heel bone). The calf muscle consists of the gastrocnemius and soleus muscles that make up the triceps surae. The calf muscles allow you to bend your ankle and knee. A calf strain can cause pain which may limit your ability to run, jump, and walk. It often occurs when the calf is working eccentrically (working while under stretch) like when coming down from a jump. Can commonly occur with “weekend warriors” when patients do not consistently strengthen and stretch their muscles but play sports on weekends. 

Grades of calf strains

• Grade 1 mild: 

  • Few muscle fibers are injured

  • Strength and range of motion remains full but can be sore

  • May have a feeling of tightness

  • Post activity tightness and/or achiness 

• Grade 2 moderate:

  • Can be very variable

  • Many muscle fibers may be torn

  • Some muscle fibers are intact 

  • Decrease in plantarflexion strength 

  • Limited range of motion bringing foot upwards (dorsiflexion)

  • Pain during muscle testing and when stretching the calf

  • Swelling and bruising are common

  • Unable to continue activity, significant pain with walking after injury 

• Grade 3 severe: 

  • All muscle fibers are completely torn

  • Either the muscle is completely torn into 2 parts or muscle belly is torn from its attachment to the tendon 

  • Severe pain, swelling and bruising 

  • Difficult to generate force during muscle testing 

  • Range of motion is severely limited due to pain

• Depending on the severity of the strain, it may take several weeks to several months before returning to activity 

• Patients with a fully ruptured calf muscle may need surgery 

Physical Therapy

Physical therapy exercises may include pain-free gentle range of motion exercises, isometric exercises, and isotonic exercises. Activity modifications may be necessary in the beginning of recovery. Gradual weight bearing exercises will be progressed into the patient’s course of treatment. Return to sport exercises may be incorporated if the patient wishes to return to a specific sport. 

-Leanne Komoda, PT, DPT