Pulled A Calf Muscle?

Calf injury

Pulled A Calf Muscle?

The calf muscles – gastrocnemius and soleus – of the lower leg works across both the knee and ankle joints to plantar flex the foot (point the toes) and flex (bend) the knee. The muscles insert into the Achilles tendon and can often be injured in sports involving running, acceleration & quick halts in movement or changes in direction such as Tennis, Football (all codes), Basketball and Hockey. Injury can also occur through gradual wear & tear, occasionally straining whilst simply walking across the road. Tears to the calf muscle range from a partial tear where there is minimal pain and minimal loss of function, to a complete rupture which may require surgical reconstruction.

Pain that occurs in the calf muscle is often the result of a pulled or torn calf muscle, the most common place to incur this injury is at the muscular tendinous junction of the Gastrocnemius; roughly halfway between the knee and the heel.

A calf strain may also be more likely in athletes who have tight calf muscles.

Signs & Symptoms

  • A sudden sharp pain or pulling sensation at the back of the lower leg during exercise.
  • May feel like you have been hit in the leg and potentially hear a “pop”.
  • Pain on stretching the muscle.
  • Difficulty walking properly or standing on toes.
  • Swelling and bruising may be present.
  • If the rupture is severe a gap in the muscle belly may be felt.

Immediate Management

The immediate treatment of any soft tissue injury consists of the RICER protocol.

  • Rest
  • Ice
  • Compression
  • Elevation &
  • Referral to A Physio

RICE protocol should be followed for 48–72 hours. The aim is to reduce the bleeding and damage in the muscle. The leg should be rested in an elevated position with an ice pack applied for 20
minutes every two hours.

Grade Description Return to play
Grade 1 – Mild Sharp pain (during or after activity), may be unable to continue activity. The muscle is stretched causing some small micro tears in the muscle. Return to play – 10 to 12 days. Full Recovery takes approximately 2 to 4 weeks if you do all the right things.
Grade 2 – Moderate Unable to continue activity. There is partial tearing of the muscle fibres. Return to play – 16-21 days. Full recovery takes approximately 4 to 8 weeks with good rehabilitation.
Grade 3 – Severe Severe pain at junction between Achilles tendon and belly of the muscle. Complete tearing or rupture of the muscle fibres. Full recovery can take 3-4 months and, in some instances, surgery may be needed. Return to play – approx. 6 months if surgery is required.

Immediate Management

A Compression bandage should be applied to limit bleeding and swelling in the injured area. The No HARM protocol should also be applied – no heat, no alcohol, no running or activity, and no
massage. This will ensure decreased bleeding and swelling in the injured area.


  • Keeping calf muscles strong so they can absorb the energy of sudden physical stress.
  • Stretching out calf muscles before physical activity, i.e. calf raises. Gradually including weights or additional resistance over time.
  • Learning the proper technique for exercise and sporting activities. This will decrease stress on all muscles, including calf muscles.
  • Undertaking training prior to competition to ensure readiness to play.
  • Undertaking fitness programmes to develop strength, balance, coordination and flexibility.
  • Gradually increasing the intensity and duration of training.
  • Allowing adequate recovery time between workouts or training sessions.
  • Wearing correct footwear.
  • Drinking water before, during and after play.
  • Avoiding activities that cause pain. If pain does occur, discontinue the activity immediately and commence RICER.

Physiotherapy for calf injuries

Physiotherapy for calf strains & tears is vital to hasten the healing process, ensure an optimal outcome and minimise the likelihood of recurrence.

Treatment may comprise:

  • ice & electrotherapy & taping
  • anti-inflammatory advice
  • the use of heel wedges or crutches
  • stretches
  • dry needling
  • soft tissue massage
  • joint mobilisation
  • exercises to improve strength, flexibility or balance
  • activity modification advice
  • biomechanical correction
  • a gradual return to activity program

Rehabilitation and return to play

As pain decreases, gentle exercise and stretching are added to treatment. Rehabilitation should be conducted with caution.

Depending on the demands of your sport, you will require specific sport-specific exercises and a progressed training regime to enable a safe and injury-free return to sport.

At Lewisham Physio we will discuss your goals, time frames and training schedules to optimise a complete return to sport.

The perfect outcome will have you performing at full speed, power, agility and function with the added knowledge that a thorough rehabilitation programme has minimised your chance of future injury.

Peter Hogg

Have a question? Ask the guru...