• Matthew Corbin D.C

A Definitive Guide To Calf Strain: A Patients Guide.


Most people who are physically active know what a calf strain feels like, maybe a pop, a sharp pain, a dull ache, tightness and even pins and needles. It is very frustrating because it limits our activity or sport or even our job! A calf strain is also not limited to active sports people and happens more often at the age of 40-50. A calf strain is a common sporting injury.

This guide is to walk you through what happens, what to do and when to seek a doctor, professional or someone qualified to treat this issue…….✋


A case study on myself.

Lets roll back to my first calf strain, I was around 10 years old and just finished PE (physical education), we had done a 10 mile cross country run in the cold, rain and generally miserable English winter weather. No pain then. Had a hot shower, no pain then either, but then when walking down a set of steps to go to my next class BOOM! There it was, lancinating pain, pain a samurai warrior would have been proud of. I dropped to the floor holding my left calf and held in my tears (men don’t cry). But I did scream a little, actually like a little girl because my voice had no broken yet (honest). The other kids around me were either laughing or looking at me in disbelief. It was a crap day and a crap few weeks.

So what would have caused my left calf pain? Is it the left as I’m left footed? Did I run too hard or too far? Was there a weakness? Was it a samurai warrior?

Most likely it was that I did too much too quickly, I had never ran 10 miles before, I played lots of football, basketball and short sprints but never a longer distance run like that. I basically loaded my left calf beyond it’s adaptable capacity and something just gave in. While walking down that step I was already fatigued and the extra loading on the calf muscle was too much for me to take so it decided to have a grumble putting me out for what felt like forever. It can also be caused by many jumping sports like basketball and netball, rugby players are also renowned for them during scrums and pushing many time their own body weight.

Anatomy and function:

The medical name for the calf muscle is called the gastrocnemius. This muscle is divided into two main parts, the medial and lateral (left and right). It’s action is to point the foot down (plantar flexion) and also helps with bending the knee. Other muscles help in both actions but is the primary muscle to point the toes down. We could go into neurology here but you might get a bit bored.

Is it a calf strain?

When people get sudden pain in their calf with movement, in most cases it’s likely to be a calf strain. It is very wise to make sure that it is a strain as there are quite a few things that it could also be. When diagnosing a condition we need differentials, we call these differential diagnoses. As follows


- Achilles, sprain, tear, rupture

- Blood clot (DVT)

- Medial tibial stress syndrome

- Extensional compartment syndrome

- Popliteal Artery Entrapment Syndrome (PAES)

- Bakers cyst

- Soleus strain

- Knee osteoarthritis

- Claudication

- Cancer

Think of differentials as backups, when we apply one treatment that does not work then further testing might be used such as MRI, diagnostic ultrasound, bone density scans and nerve conduction tests in severe cases. If there is something very serious like a blood clot or cancer then in most cases something else would have popped up like general to extreme fatigue, unexplained weight loss, swelling and discolouration. A simple calf strain is easy to diagnose in a Chiropractic treatment room without expensive machines. Referrals are done when we find something sinister in the exam or case history.

What is a calf strain and what can we do?

Think of a calf strain as mild, moderate and severe, or grades 1, 2 and 3:

Grade 1: A small tear or over stretch of a few muscle fibres, painful but still full motor strength and gait (walking) is generally unaffected. 7-10 days healing time.

Treatment: Moderate rest for 24-72 hours, elevation and ice (15 to 20 minutes every 2 hours). Gentle movements of the foot help keep everything moving in a safe way. Walking should not be too painful and recommended to keep active. Start a stretching routine making sure it is not causing too much pain. You could take an anti inflammatory but the latest research says this interrupts the healing process. Healing vs pain relief it's up to you.

Grade 2: A partial tear, some loss of strength pain, bruising, limping and may feel a tearing or popping sound. 4-6 weeks healing time.

Treatment: Moderate rest for 24-72 hours, elevation and ice (15 to 20 minutes every 2 hours). Treatments involve muscle manipulation, manual mobilisations, acupuncture, sports tape, shockwave (after care) and home care advice. A rehab course is then needed to get back to normal without further injury.

Grade 3: Complete tear of calf muscle, usually the medial portion, sever pain, loss of lower leg function, bruising, swelling. 6 month healing time.

Treatment: Surgery is usually needed with complete tear of the calf muscle. It is quite rare it gets to that point though. All of the above applies at the different stages of healing.

So in most cases it is a non serious injury but it is the type of injury that can reoccur. Our Chiropractic care in Cardiff can provide everything except the scan but we can refer for them at no extra cost.

Prevention:

Prevention is key, by getting our body to function at it’s best it needs to be trained the best. Balance exercises, loading the calf gradually and safely is your best bet. The body can take a little time to adapt which is why increasing intensity in any exercise should be graded over time. Never stretch before exercise and always warm up with squats, stair climbs or gentle jogging. Stretching can be performed after exercise and a warm down also. Never train through pain unless directed by a professional. Pro athletes often still train when injured but in a way that is not going to affect their injury directly.

I hope this blog has given you an insight and overview of what happens, what to do and how to prevent it. Train safe or a samurai warrior might be around the corner ;)

Research

1. https://www.physio-pedia.com/Calf_Strain#Differential_Diagnosis

2. http://www.hkcem.com/html/publications/Journal/2005-1/P36-41.pdf

3. https://greatist.com/fitness/12-biggest-myths-about-stretching

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351654/

5. https://www.ncbi.nlm.nih.gov/pubmed/28259848

6. https://reference.medscape.com/features/slideshow/weekend-warrior-injuries

#calf #strain #calfpain #cardiffstrain

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