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Background & Etiology

A calf strain or pull is an injury to the muscles of the leg. There are three main muscles in the lower leg, two gastrocnemius muscles and the soleus muscle, which run from the knee to the ankle. A strained muscle occurs when the muscle is stretched or pulled beyond its normal range. This can cause small tears in the muscle fibers, or even in severe cases a complete muscle tear.

There are three grades of calf strain:

Grade I – slight pain or discomfort, with a limited impact on physical ability

Grade II – moderate pain or discomfort, and a noticeable impact on physical ability particularly during running or jumping activities

Grade III – severe pain and discomfort that impedes the ability to walk, often accompanied by muscle spasm, swelling, and bruising.

A calf strain is most common in men between 30-50 years of age. These injuries are often acute (sudden onset) characterized by a sharp pain in the back of the leg. The muscle most typically injured in a muscle strain is the medial gastrocnemius. Common causes of calf muscle strain include:

  • Sudden changes in training, particularly in runners
  • Sharp movements that require changing direction quickly to run or jump
  • Pain that makes sleeping difficult
  • Pain that continues while sitting or resting
  • Sudden, sharp pain in the back of the leg
  • Difficulty walking, running, or jumping
  • Swelling along the back of the leg
  • Bruising at the site of the injury
  • Muscle spasm

If an individual suspects they have a calf strain, the initial treatment should consist of avoiding the positions and activities that produce the pain. A course of conservative treatment is usually recommended that would include rest and immobilization, ice, physical therapy and non-steroidal medications to reduce inflammation.

If symptoms persist, treatment by your physician may be necessary. This may include steroidal medication or injections, in conjunction with therapy. Though rare, in severe cases surgical intervention may be needed to reattach the muscle ends to the event of a complete tear.

Physical Therapists are professionals, educated and trained to administer interventions. As stated in The Guide to Physical Therapist Practice, interventions are the skilled and purposeful use of physical therapy methods and techniques to produce changes consistent with the diagnosis, prognosis and goal of the patient or client. Common interventions in the treatment of calf strain include:

  • Manual Therapeutic Technique (MTT): hands on care including soft tissue massage, deep friction massage and joint mobilization by a physical therapist to regain mobility and range of motion of the lower leg.
  • Therapeutic Exercises (TE) including stretching and strengthening exercises to regain range of motion and strengthen the leg and effected muscle.
  • Neuromuscular Reeducation (NMR) to restore stability, retrain the lower extremity, and improve movement technique and mechanics (for example, running or jumping activities) in daily use of the involved lower extremity.
  • Modalities that can include the use of ultrasound, electrical stimulation, ice, cold laser and others to decrease pain and inflammation in the leg.
  • Home program that includes strengthening, stretching and stabilization exercises and instructions to help the person perform daily tasks and advance to the next functional level.

Procedures that your physician may recommend and perform in addition to physical therapy that include:

  • REST and ICE
  • The use of NSAIDS (Non Steroidal Anti-Inflammatory Drugs)
  • Steroidal injections to reduce inflammation
  • Pain medication to reduce the discomfort and allow the patient to perform the recommended exercises
  • Surgery to correct underlying pathology

Prognosis

Most people recover full function following a course of conservative care that includes physical therapy, medication and/or injections. It is important that once the pain and inflammation is reduced, and motion and strength are restored, the patient gradually returns to full activities.

Rate of progress often depends on the severity of the calf strain. Symptoms may subside in several days for a grade I injury, several weeks for a grade II injury, and several months for a grade III injury. Instruction in daily activities or sport performance is helpful for reducing a reoccurrence of calf strain.

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Real People, Real Testimonials.

“After my bilateral hip replacement I had a choice where to do my outpatient therapy. I chose to go to Twin Boro because of the positive experience I had there previously. Every staff person I worked with knew what they were doing, were friendly and contributed to a very positive experience for me.”

Wiken

"After a wrist/hand surgery, I completed 6 months of physical therapy at the TWIN BOROS - DAYTON NJ location with therapist James Battaglia. In the beginning I was in a great deal of pain with very limited range of motion. I was cringing from pain and using safe words lol. From day one, James gave me excellent care! He was very patient and listened to my cues. He crafted a full complement of exercises for me both in the office and also an at-home exercise program. Christa (sp) another therapist - also filled in for James during vacations and worked on my wrist. She too was excellent! The assistants and office staff are all super friendly and address every patient by their first name. You are not just a “patient” here. The staff all genuinely care about you. By the time I “graduated” 6 months later my wrist was doing so much better. I was actually sad to leave. This is a great facility- clean, modern and professional. You won’t be disappointed with this facility at all!"

Starr D.

"The therapists and staff at the Twin Boro in North Brunswick truly place their patients first. My six month experience at this office was outstanding. Coming to Twinboro, I was unsure of my diagnosis, but with the help and dedication of my therapist Ivana, answers were found and exercises were set in place to treat my symptoms. Ivana made coming to therapy an enjoyable experience with her attention to detail, compassion, and sociability. It was evident through the environment Ivana created for that she listens to her patients and makes decisions with the best interest of the patient in mind. If you need to attend physical therapy and are in the area, Twin Boro in North Brunswick is the right choice!"

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