Calf Strain

When an excessive load is applied to the calf muscle, the gastrocnemius or soleus muscles while they are contracting, or if these muscles over stretch as they lengthen the muscle may tear. This will most likely occur on acceleration or decceleration.

Grade 1 Calf Strain

When there is damage to a small number of muscle fibres – usually less than 5% of fibres  this is a considered to be a mild calf strain.

In this case the pain may be sudden onset pain or just tightness in the calf area, the player might be able to play on, the area will become painful and tender later on, there will probably be no visible bruising or swelling, and the player will be able to walk around without limping.

This could take 2 to 3 weeks rest, however sometimes this is more like a micro-tear with minimal damage, and with good early management the player may return to sport after a week.

Grade 2 Calf Strain

When there is more extensive damage, with a large number of muscle fibres involved, but the muscle is still in tact it is known as a grade 2 calf strain or calf tear.

In this case there will be a sudden onset of pain. The player will be unable to play on, there will be a tender mass at the site of injury, there may be bruising which may not appear until the following day, and may be lower than the area of pain. There will be weakness in the muscle and the player may be limping.

The rest period required is usually between 3 and 6 weeks. Good physiotherapy treatment and early management will reduce the recovery period.

Grade 3 Calf Strain

When there is a complete rupture of a muscle it is referred to as a grade 3 calf tear.  There will be a sudden severe onset of pain, and the player may not be able to walk off the pitch.

There will be severe pain in the muscle and severe pain and weakness on resistance. There may be a visible deformity in the muscle where the fibres have recoiled back into a lump. There will be swelling in the area and bruising will be extensive when it appears the following day.

In a sports person this may require surgery to repair the muscle if the fibres have severely recoiled. Even with good physiotherapy and management it may take 3 months to fully recover.

All muscle strains should be rested and allowed to heal. If the patient continues to play, the condition will worsen. If ignored, a grade one strain has the potential to become a grade two strain or even a complete rupture.