A common and notorious muscle injury we deal with a lot here at our Newport physio is the calf strain. A strain can be quite debilitating as it greatly affects your ability to walk and exercise. So what causes them? How do you rehab them? Read on to find out!
The calf complex is made out of three muscles; the Gastrocnemius, the Soleus, and the Plantaris. All three muscles come together to form the Achilles tendon which can have its own list of problems. The muscle group crosses two joints and as such acts on both the knee and ankle. A calf strain is when there is damage to these muscle fibres. The degree of the damage is graded based on the number of muscle fibres torn, the amount of bruising present and the level of pain with certain activities/tests. Vaguely speaking Grade 1 is <10% muscle fibres torn with very little bruising and minor pain with activity. Grade 2 is >10% but <50% fibres torn with more pain, bruising and potentially swelling. Whereas grade 3 is a major disruption of the fibres resulting in an inability to contract the calf muscle (often resulting in surgery).
Causes: Most commonly from sporting movements that result in high internal forces and rapid changes in muscle length and contraction type such as sprinting and direction changes in sports such as netball or soccer. They can occur in slow movements as well such as daily life tasks but a common precursor is fatigue or being poorly conditioned.
Rehab: A grade 1 tear you can expect to take 1-3 weeks, grade 2 is 3-6 weeks, and a grade 3 injury is highly individualised but can take many months to return to full activity. During the acute stage the most important thing is to follow the P.O.L.I.C.E. protocol. (Protection, Optimal Loading, Ice, Compression, and Elevation). This assists in the reduction of the bruising and lessening of pain so that a graded exercise program (that focuses on restoration of range and strength and the reduction of pain) can steer you back to activity. SCENAR is also a great tool in accelerating the rehabilitation.
Calf strains have a high recurrence rate and are quite prone to taking longer than expected for rehab. A high profile example of a calf strain recovery gone wrong is Kevin Durant who in last years NBA playoffs rushed his rehab back in order to compete in the finals round and ended up rupturing his Achilles tendon as the complex was not ready for that intensity.
If you have any further questions about calf strains or need to start your rehab journey don’t hesitate to contact us for an appointment with one of our physios!