Maybe you went a little too hard on the pickleball court. Or went a little further than you intended on your weekend run. Whatever the cause, you may have noticed pain or discomfort in your calf during your activity or immediately following. 

This type of calf pain is often due to a calf strain, or a pulled calf muscle. It’s common, and usually resolves on its own, reassures Kristin Vinci, PT, DPT, a physical therapist at Hinge Health. But there are things you can do to help speed your recovery.

Read on to learn more about calf strains, what causes them, and how to treat them, especially with exercises from our Hinge Health physical therapists. 

What Is a Calf Strain?

A calf strain occurs when one or two of the muscles in your calf — the soleus or gastrocnemius — gets stretched to the point that results in a microtear in the muscle, causing pain. Calf strains can vary in severity, ranging from a very small, minor tear to a larger one. “Calf strains often happen when you jump or change directions quickly,” says Dr. Vinci. 

Symptoms of a Calf Strain

Calf strains can cause a variety of symptoms, including: 

• Sudden onset of pain. When you strain your calf, you’ll often know immediately. “There’s usually a very clear moment when you’re doing an activity and feel a sharp sudden pain, or sometimes even just sudden soreness,” says Dr. Vinci. The pain usually improves once you stop the activity.

• Swelling, redness, and/or bruising of your calf muscle. This usually indicates a more significant calf strain, notes Dr. Vinci.

• Pain or soreness when you tense your calf muscles, stand on your toes, point your toes, or flex your ankle.

Calf Strain: A Hinge Health Perspective

Calf strains happen when the calf muscle over extends (or over stretches) and tears. And while hearing that you’ve “torn” something in your body can sound alarming, your muscles — especially the big muscle groups in your legs — are very resilient and designed to recover from these kinds of issues that naturally can happen in the course of everyday activities or during exercise.

If you’re reluctant to move because you think you’ll cause more pain or injury to your calf, know this: Movement is often the fastest way to healing. As our Hinge Health care team says, movement is medicine. The reason: You want your calf muscles to remain flexible and stretched to prevent the muscle tightness that can lead to a calf strain. In order to do that, you need to engage in exercises that support your healing and strengthen your muscles to help prevent future calf injuries.

This is why Hinge Health physical therapists recommend a new pain relief approach that offers a more comprehensive plan than the traditional R.I.C.E. (rest, ice, compression, and elevation) method. Instead of rest, PEACE & LOVE encourages movement as you heal. The PEACE part, which is done for two to three days following an injury, like a calf strain, stands for:

• Protect the injured calf by scaling back on activities that cause pain in the first few days after injury — but don’t avoid movement entirely. 

• Elevate the injured leg above your heart to reduce swelling.

• Adjust anti-inflammatories, like ibuprofen. It’s best to limit their use, as high doses can impact tissue healing. But if you’re in a lot of pain or your symptoms are limiting your function and movement, talk to your doctor about whether it’s safe for you to use them. 

• Compression. If it hurts to move the injured calf, a gentle compression wrap may help for the first few days or weeks after injury. Just make sure you exercise without the wrap as you strengthen the affected area. 

• Education. Listen to your body. It will tell you when an activity is too much for your calf muscles. A physical therapist can help you tune in to these clues, too.

A few days after your calf strain, Dr. Vinci recommends that you work on LOVE:

• Load the injured area by gradually returning to normal activities, using pain as your guide. Know that some pain during or after activity is okay, but your pain should not exceed an acceptable level for you. At the gym, this may look like starting back with less weight when you do certain moves.

• Optimism. It’s natural to get discouraged when you’re injured, but maintaining the belief that you have the capacity to heal and can return to meaningful activities is a critical component of healing. Simply believing that you will get better really does matter.

• Vascularization means increasing blood flow to the injured area by engaging in exercise you can handle. This may even reduce the need for pain medication.  

• Exercise, or an active approach to recovery, restores mobility and strength. You can use pain as a guide to gradually progress your exercise and increase difficulty. For new-onset acute pain, a physical therapist can evaluate you and rule out anything before recommending independent exercise, says Dr. Vinci. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

Calf Strain: Common Causes

Pulled calf muscles are common and can happen to anyone. “We see them often with high-impact activities where you change direction quickly, like running, tennis, soccer, or football,” says Dr. Vinci. Other possible causes of a calf strain include: 

• Age. Research suggests that people over the age of 40, especially men, may be more susceptible to a calf strain. This may just be due to normal age-related changes in the muscle, says Dr. Vinci. If you’ve had a previous calf strain, you’re also more likely to develop one again. While you can’t change your age, there is a lot you can do to address other risk factors by staying active and keeping calf muscles strong.

• Weak muscles. “When you develop a calf strain, it’s often due to the demands of the activity overloading the calf muscle,” explains Dr. Vinci. “Working on calf strength can reduce your risk of a strain when exercising at higher intensities.”

Treatment Options for Calf Strains

Calf strains can be uncomfortable and feel limiting. But an injury doesn’t have to (and shouldn’t) keep you from your usual routine or doing the activities you love. You can take a few steps to help your calf muscles heal:

• Ice. Icing sore calf muscles can help reduce inflammation associated with a calf strain. Ice the calf area for 10 to 20 minutes at a time, around four times a day. After a few days, you might find that heat feels better, which increases circulation and blood flow to the area.

• Elevate. Raise your calf above your heart as much as possible to reduce pain and swelling.

• Stay active. If a specific activity irritates your calf muscle, scale back or use assistive devices to help tolerate the activity better (like one crutch on the non-painful side to help you walk). It’s important to still do activities that keep your calves moving, like some of the exercises in the section below. “You want to get blood flow to the area,” points out Dr. Vinci. As discomfort subsides, you’ll be able to gradually return to normal activities.

• Heel lifts. These are inserts that temporarily go inside your shoes to slightly elevate the heel and decrease the stretch of your calf muscles as you walk, reducing pain.

• Physical therapy. If a calf strain persists or recurs, then a course of physical therapy may be in order. Your physical therapist (PT) can do a gait analysis to see if anything in your walking or running form is contributing to your calf strain, says Dr. Vinci. A PT can also look for muscle imbalances or weaknesses. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

There’s no set calf strain recovery time. Most people recover fully from a minor calf strain within about two to three weeks. A more severe strain may take longer.

Strengthening and stretching calf muscles are important parts of calf pain treatment. The following exercises are recommended by Hinge Health physical therapists. And remember: Because all the muscles in your legs work together, be sure to stretch and strengthen other leg muscles, like the quads and hamstrings, as well.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Ease Into New Footwear

If you’re breaking in a new pair of athletic shoes, Dr. Vinici recommends that you do your exercise routine at a slightly lower intensity than normal. “If you change your workout shoes, it could impact your foot position, which, in turn, may put strain on your calves,” she points out. By starting at a lower intensity, your feet can get used to the new shoes and every part of your body — including your calves — will be happier.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. 

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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2. Green, B., & Pizzari, T. (2017). Calf muscle strain injuries in sport: a systematic review of risk factors for injury. British Journal of Sports Medicine, 51(16), 1189–1194. doi:10.1136/bjsports-2016-097177

3. Kwak, H.-S., Lee, K.-B., & Han, Y.-M. (2006). Ruptures of the medial head of the gastrocnemius (“tennis leg”). Clinical Imaging, 30(1), 48–53. doi:10.1016/j.clinimag.2005.07.004

4. Green, B., Lin, M., McClelland, J. A., Semciw, A. I., Schache, A. G., Rotstein, A. H., Cook, J., & Pizzari, T. (2020). Return to Play and Recurrence After Calf Muscle Strain Injuries in Elite Australian Football Players. The American Journal of Sports Medicine, 48(13), 3306-3315. doi:10.1177/0363546520959327

5. Rainbow, C. R., & Fields, K. B. (2021, August 25). Calf injuries not involving the Achilles tendon. UpToDate. https://www.uptodate.com/contents/calf-injuries-not-involving-the-achilles-tendon