Managing acute calf tears

Written by Tom Goom, senior Physio at The Physio Rooms Brighton. Follow Tom on Twitter.

Calf pain in runners is quite common and can become a persistent nuisance. Fortunately it usually responds well to treatment and there are a lot of simple exercises you can do to help it recover. This is the first of a series of pieces on calf injury and will guide you through early management of a calf tear. Later pieces will examine non-traumatic calf pain and rehab of strength and flexibility.

The calf is made up of 2 large muscles – gastrocnemius and soleus and a smaller muscle called plantaris. Gastrocnemius is the more superficial of the muscles with soleus sitting beneath it. Gastroc. has two heads to it and crosses both the ankle and knee joints – this makes it somewhat vulnerable to injury. Injuries to soleus are far more rare. In one study of 141 cases referred for ultrasound after calf strain just 1 had a soleus tear while 94 had gastroc injuries.

Traumatic calf injury

The calf is usually injured with sudden movements that dorsiflex the ankle (bend it up) while weightbearing. With the gastroc this often happens with the knee straight as the muscle is then stretched over 2 joints. Activities like rapid lunges (common during racquet sports) or acceleration to sprint when running are common causes of calf injury. It may also occur when the muscle is fatigued after distance running.

During a calf injury many people describe a sudden sensation of being struck on the back of the leg. Swelling is common and it can be difficult to walk initially. In more minor calf injuries people can sometimes continue with their sport at the time of the injury but the pain becomes more severe after. Of the two heads of the muscle the medial head (on the inside of the calf) is more commonly injured than the lateral head (on the outside).

Management of acute calf injury involves POLICE (formerly RICE). With muscle injuries anti-inflammatory medications are not currently recommended, especially in the first 48 hours as they are thought to delay healing. As with all injuries RunningPhysio recommends seeing an appropriate health professional. In the case of calf injuries this is especially important as there is a risk of Deep Vein Thrombosis (DVT).

Symptoms of DVT include pain, swelling and tenderness in the calf often accompanied by warmth and redness of the skin. Unfortunately these are often common symptoms after a calf injury even without DVT. In many cases people sent for investigation of suspected DVT are found not to have one, however if in doubt get it checked out as a DVT is a serious condition and can lead to pulmonary embolism which is potentially life threatening.

Treatment of a calf injury depends largely on severity (timescales detailed below are approximate and may vary considerably between individuals) but I follow these principles of treatment for calf injuries;

  1. Respect the healing process
  2. Allow a period of relative rest
  3. Maintain calf flexibility and strength where possible but exercise within pain limits
  4. Gradually re-introduce activity that involves stretching or loading the calf muscle
  5. Rehab any deficits that exist after the healing process (this might include calf strength, power, endurance or bulk, reduced calf flexibility, altered movement control etc etc.)

With a minor calf injury symptoms will be mild with minimal swelling, you will be able to walk unaided with slight discomfort but sudden movements that stretch or work the calf may cause an increase in pain. Initial treatment involves rest for 2-3 days after which you can often resume gentle cross training, providing it's pain free. This might include swimming, or cycling (with low resistance) but should avoid impact, heavy resistance or sudden movements. Once symptoms settle you can start some light jogging on a treadmill and see how it feels before gradually returning to training. The timeframe for this varies from around 1-4 weeks depending on the injury and the individual. When you do return to running avoid hill training and speed work initially as this places a greater stress on the calf muscle.

Moderately severe calf injuries need to be treated with a little more caution. In the early stages there will be noticeable swelling and discomfort. You will be able to walk unaided but with some difficulty and pain. Any movements that place even a small stress or load on the calf are likely to be painful. This might include going up or down stairs, moving the ankle or pressure on the calf area.

The first 2-3 days are likely to involve bleeding within the muscle and significant swelling. In these acute stages you'll need to be more attentive to rest, elevation and ice and I wouldn't recommend cross training. You may benefit from offloading the calf a little. This can be done by putting a heel wedge in your shoe, strapping the calf or even wearing shoes with a heel (although probably something stable rather than stilettos!). This should be a short term strategy and you should aim to walk in normal shoes or barefoot as soon as comfortable to do so.

By days 4-7 you may find you're comfortable enough to start very gentle exercises for the calf. Simply move the foot up and down, first with the knee bent, then with it straight. Move only as far as comfortable – don't push through pain. Little and often is usually best – around 10-15 reps 3 times per day. The aim is to encourage the muscle to contract and relax, this should help clear swelling and maintain flexibility.

After day 7 you're usually in the sub-acute phase of injury. The muscle is still healing and that new tissue will be vulnerable so you want to avoid excessive stress on it. The body is amazing when it comes to healing and it's worth respecting that. We often aim to accelerate things but perhaps, in truth, our aim is more to promote the best environment to allow things to heal at their normal rate. It's important to maintain flexibility and strength in the calf muscle as things heal, but this shouldn't come at the expense of the healing process.

From approximately day 7 to 21 post injury scar tissue is still developing but isn't usually strength enough to handle large loads. As a result I would avoid static stretches during this period, instead use the 2 traditional calf stretches (pictured below) but do them dynamically. Rather than moving until you feel a stretch and holding it, just focus on controlled, gentle movement in pain free range. Alternatively a minisquat is a simple way to maintain ankle mobility. You can also start some supported calf raises if able – do on both feet (rather than just 1) – push up onto your toes and slowly lower. You can usually resume cross training from 2-3 weeks post injury but keep it pain free and avoid impact and resistance work.


From 3-4 weeks after calf injury the scar tissue will usually have developed enough to handle a little more load, at this stage you may benefit from starting static calf stretches if comfortable. In which case stretch both the gastroc and soleus muscles, using the techniques above and holding for around 30 seconds for 3-5 reps. You can often progress strength work at this point, if comfortable try single leg calf raises on your weaker side. Do as many as comfortable and gradually increase until you can do the same on both legs. Stop if painful!

Severe calf injuries can result in a complete tear of the gastrocnemius muscle. There will be significant swelling and pain and a haematoma may develop. You may be unable to walk without help from crutches, even then it will be difficult to weight bear and many people choose to hop instead! Management of these injuries varies considerably and will be guided by your consultant or physiotherapist.

Final thoughts: calf injuries can be painful and potentially debilitating and should be assessed by a health care professional to rule out serious complications such as DVT. As ever on RunningPhysio if in doubt, get it checked out. Most calf tears respond well to treatment but the healing process must be respected and it's important not to do too much too soon.

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72 Comments
  1. joe

    Very useful info. I think I’ve got the grade 2 tear in my gastrocnemius (medial head). I will follow the treatment programme prescribed here. I am not looking forward to the next two months of rehibilitation and missing my trainning,just to think I have been making so much progress over the last 2 months!

    • david harris

      I believe I have a 2nd or 3rd tear. I feel ya. I have been making progress as well and its gonna suck. Guess my legs ar gonna shrink. How is/did your recovery go?

    • Brian

      I hear you brother. I had a pretty bad grade 2 because I couldn’t put any weight on it for a few weeks. I was also so happy with my progress with running. I have put on 10kgs since then which is 8 weeks now. I wanted to be extra careful not to re-injure. I’ll start again slowly very soon.

  2. Jose

    Very useful info. It is very difficult to find specific muscles damaged by sprint. I’ve started sprinting about a few months, I suddendly I felt serious pain that I never felt before. It was the soleus muscle damaged. I got some minor swelling in ankles, but it’s is impossible to sprint with this pain, I get to the point to losing equilibrium. I’m concerned about how much time I will lose resting, and how to avoid serious injury again.

  3. Kathryn

    This is an excellent article, sums up my injury perfectly, and one of the few I’ve found that gives me hope it will recover. Mine feels like a moderate calf injury from the description. My cross-training is usually spin, body pump, Pilates and strength & core work in the gym. Would you recommend avoiding all of these activities for at least 2 weeks? I know it doesn’t sound like long, but I don’t want to lose my CV fitness or what little strength I have!

  4. Stuart Swan

    Doesn’t relate to my problem. I tore both calf muscles in 2000 & have always had problems since. Have had physio & supports for my running shoes but calfs still seize up when I go running. Any ideas??

  5. Lina

    I injured my calf 2 wks ago. I was traveling so only saw my doctor 1 week ago… I’ve been in pain ever since. With a big bruise un the back of my leg. Taking Celebrex but pain still remains and I’m unable to walk… Not sure for how long this pain will stick with me. I am very active an too frustrated…

    • claire

      Lina, how are you doing now? I seem to be at the same point as you were on May 3rd. I injured myself 13 days ago and will be moving house on May 31st. I’m really hoping I’ll be able to walk properly by then.

  6. Jay

    Finally found all the info I needed. Busted knee, broken fibula but the worst pain was calf . Great treatment at hospital but the calf was ” dismissed” as other stuff was worse. Thank you for excellent site.

  7. Ron

    I think I have a grade two injury in my right calf muscle. I have been running for over twenty years but have suffered more injuries in the last two years than I have ever had. It’s about two weeks after the injury but it is still painful to walk on the calf and very painful to up and down stairs. The calf still appears to be swollen and is actually a different shape to my left calf though I am putting that down to the swelling, there is no bruising. It’s hard, I am an exercise ‘addict’ and running has been my stress crutch for many years so having difficulty sitting still. I thought it was getting better and made the mistake of exercising and it has only made it worse. Going to see a therapist this week as I think it could be worse than I think it is and I have a tendency (along with a very high pain threshold) to tough it out. It’s very stressful and what changed, well I was 6 weeks into my marathon schedule and had just done two 12 mile long runs, and the following week did a 15 miler. Hoping to get this sorted out soon, thanks for the details. Ron.

    • VM

      You should definitely get it checked out by a physical therapist / orthopedist if you are worried. The damage can be much worse than it feels, or much better, its really hard to tell without going to a physical therapist / getting an MRI, or it was in my case anyway.

      • VM

        *Actually, I am not 100% sure about if it can be much worse than it feels: that was really just an assumption based on all of the people who get sudden achilles tears :-/

  8. VM

    Update: I got some pains from hopping (on my crutches), but the pains went away after a week or so. My physical therapist said not to worry about pains in that foot if I am just using the crutches for small distances (2 minutes, a few times a day).

    . . . but dont quote me on this :-.

  9. Jon Goss

    I had the “hit in the back of the calf with a canoe paddle feeling” 10 days ago. I went to ER and was put in a lower leg fiberglass splint to immobilize foot. Initial diagnosis of gastrocnemius tear with possible strain of soleus and Achilles as well. Referred to an orthopedic specialist for care. Specialist unable to rule out Achilles damage. MRI recommended by ER, primary care physician, and specialist. Insurance denied all 3. Very frustrating. Dr will appeal but in meantime we wait without a plan.

      • Jon Goss

        2 weeks after a MRI was allowed. Specialist called the next day to inform me of a slight tear in the middle to upper portion of the Achilles with suspicion of the tearing getting worse higher up in the Achilles where it joins the gastrocnemius. She immediately immobilized with a cast as the tearing is in a non surgical area. Prime example not to allow insurance to dictate patient care. Swelling did persist throughout calf, shin, and foot area with bruising areas as well including heel. Now on a strict plan of rest and elevation. It was very easy to overuse foot since there was not a large amount of pain. This was very counterproductive and only enhanced the swelling. Specialist also recommended a baby aspirin a day and utilization of arms and good leg to avoid potential blood clotting.

  10. david

    tore my left calf recently doing a quick start to get to a short tennis shot…..initially calf was swollen and painful but no bruises….took advise and iced, elevated heels in shoes, wrapped leg, kept leg elevated….days later, reinjured same but this time bruising up and down leg and foot and angle….ER gave me split and ace wrapping and crutches…..my concern 5 days later is ankle is still swollen, leg is not…..i’m able to walk with moderated pain……i’ve removed the splint, wrapped the leg, but foot still swollen…..am i trying to walk around too much? should I ice? the splint was causing sciatica pain badly……david

    • PhysioTom

      Hi David,
      First I should say make sure you’re seeing a Physio or health professional to help manage this. They’ll guide you through the rehab process to stop it recurring but also they can keep an eye on things and make sure it’s healing properly.
      I would expect the swelling to continue for some time, if the pain is improving I wouldn’t be too concerned about the swelling. In some cases ankles can remain swollen even a few months after a significant calf injury. I would keep an eye out for signs of DVT though – tight, cramp like feeling in the calf, redness and pain need to be checked out ASAP. Again this is part of the reason why seeing someone is good as they can keep an eye out for these things.
      Hope that helps
      Tom

  11. Chuck

    I recently suffered a right calf injury in a 5k race on 7/4/13. I went into the race with a strained calf sue to “breaking-in” a new pair of barefoot running shoes and probably should not have ran. Anyway, I made a sudden burst to the left and felt more of a vibration in my right calf. I ran the remaining 2 miles in pain. This morning, I have swelling in my right calf, bruising (more of a red bruise..not black and blue) on the inside of the right calf area. I am also getting a tingling feeling periodically in my foot while I am sitting. I can barely walk and going up and down stairs is down right terrible pain. I went to a Med Express and the PA-C said I have a strain. She gave me a pain med and sent me on my way. After reading some of these cases, I am thinking I should see another doctor..maybe ER?

    • amy

      Hi after some advice. 3 weeks ago tore belly of my right calf muscle sprinting. Swelling became terrible by day 4 with calf muscle circumference at 50 cm compared to left of 42. Was sent home 3times from a and e. Pain was excruciating. Day 9 was urgently referred to medical diagnostics with suspected compartment syndrome. Anyway to cut a long story short an mri found an intramuscular hematoma 4cm by 3cm and muscle damage. Was hospitalised for 6 days. Whole leg went yellow with bruising except deep blue bruising around ankle. Was put on clexane injections for 6 weeks. My concern is-almost a month post injury leg and ankle still swells when leg not elevated and leg aches terribly at night. Also have frequent light headedness. Had blood tests today. Should I worry that this leg is still swelling on and off? Ive had an ultrasound and cleared of DVT. I have felt generally unwell since day 4 post injury. Not seeing consultant for another 6 weeks. Any advice would be very gratefully received. Thanks. Age 29 female.

      • PhysioTom

        Hi Amy,
        I would still expect an injury like this one to swell at this stage. In fact I wouldn’t be surprised if that swelling continued for some time. Calf and ankle injuries can result in swelling for 6 months or more. The swelling itself is quite normal and not usually a concern on its own.
        I’m relieved they’ve rule out DVT and are doing blood tests – hopefully they’ll work out why you feel unwell.
        Are you seeing a physio for rehab or waiting on more tests first?
        Tom

        • amy

          Thankyou so much for the reply tom, and such a speedy one! My consultant has advised I shouldn’t have any physio yet until my review in 6 more weeks. He said light headedness and general unwell feeling could be to do with amount of blood that leaked at injury site. What do you think? If by walking on it it causes bad swelling again would you suggest I keep it elevated still as much as possible and keep walking to a minimum? I have 2 young children so this has been so traumatic the whole thing. Calf swells to 46cm most days that ive been trying to walk. Not sure if I said earlier but im on clexane self injectors until my next appointment. Thanks. Amy

          • PhysioTom

            Hi Amy,
            Lightheadedness and feeling unwell could be a number if things to be honest. I couldn’t say what’s causing that I’m afraid!
            Obviously it’s important to follow the advice of your consultant who has assessed you properly. Generally with these injuries you try to stay active but do things in small manageable amounts rather than a long time on your feet. This isn’t always realistic though, especially if you have a young family!
            Are you using a compressive bandage or TED stocking to help?
            Tom

          • amy

            Thanks for the advice. Yes I think that’s where im going wrong as im sometimes hobbling about for up to 3 hours without resting. I will make a much more conscious effort to be on the leg less now. I guess I knew this anyway but yes its so hard with a young family to run around after. Im lucky in getting lots of help and support though. TBH I don’t fully trust any of the specialists at my hospital after 3 times being sent home after raising concerns at a and e and then being marked up for surgery for compartment syndrome almost went ahead with it. Thank goodness they didnt. And other problems I’ve had that would shock you. I won’t bore you with the details though and I don’t want to moan about the orthopaedic profession because I know there are some wonderful specialists. Unlucky for me I haven’t met one yet that has given me more than 5 minutes of their time! I really appreciate your advice thankyou tom. Fingers crossed my body does what it needs to to absorb the h!

          • amy

            Ps sorry didnt answer compression Q. Answer is no.I only had one on mygood legfor the6 days that I was hospitalised. Should I ask myGPfor one?

          • PhysioTom

            Good idea, see what the GP says, it might help the swelling.
            Hope you recover soon! Keep us posted, it’d be nice to hear how you’re getting on!
            Tom

  12. scott

    You could have a partial calf muscle tear (hence the bruising) but you could also have, in addition, some damage to tendons in the foot, as well as possibly, the achilles. I have just rehabed from a torn medial gastroc head tear, with associated achilles damage (no tear) and it is a long road (minimum 3 months).
    You have probably figured out by now that you need to stay off the leg, elevate, ice and use compression. They wont do anything in the ER, so I would recommend an ortho, or your regular doctor. Until then, stay off that leg–get some crutches. PT is very useful, they will give you appropriate stretches, which really helped me, and some strength exercises. Best of luck, this is a bummer of an injury.

  13. Troy

    PhysioTom: Thank you for the great information. My injury was similar to David’s, although it was closer to a Grade II calf tear (bruising, swelling, etc.). I followed my doctor’s guidelines and am seven weeks out from the injury. Very little swelling is present, though about 3 weeks ago I could see that a golf ball’s size of scar tissue had formed. My doctor confirmed this a few days ago. The thought is that this should reduce over the next few months. Can you comment on this please? Also, outside of stretching and using a foam roller, are there any other treatments I can do to eventually eliminate the scar tissue? Thank you!

  14. Sally Hatton

    Hi
    On June 20th I tore my calf muscle. Since then I have not been able to put my heel to the ground. The bruising on my calf was quite spectacular and has now gravitated to my feet and ankles. I’m still in pain although walking is definitely getting easier (on my toe to avoid putting my heel down). My worry now is the swelling. My foot and leg (below the knee) are twice the size of the other leg. Extremely unsightly and very uncomfortable. What can i do to reduce this swelling? I can’t elevate my leg at work but do so when i’m at home with cold compress. Please help :)

    • Amanda

      If you have not been to the Dr, GO! You need to make sure it’s not DVT/blood clot. After ruling that out, I have found that elevation is about the only think that reduces my swelling. Also if you have access to a pool, “hang” in the deep end with a pool noodle under your arms. The water pressure helps (opposite of gravity) to reduce swelling. And Dr may prescribe diuretics or other meds to help.

  15. Victoria

    Hi, I run a few times a week, nothing crazy … About three miles. No pain when I run however, I frequently pull my calf muscle doing things like jumping up (not in exercise but like when you jump up in excitiment) or turning suddenly. Is that due to weak calf muscles and what should I do to fix it? I can walk on it but it’s sore and tender to touch. No swelling or bruising. Just that awful snapping feeling… Thanks!

  16. Amanda

    I’m currently rehabbing a ruptured plantaris tendon (runs from behind knee down to Achilles). Ortho first thought it was torn calf muscle but MRI was negative for that. I heard the “pop” and had swelling, pain, light bruising, and cramping. It’s now been about 6 weeks, and I am walking fairly well on both feet but with crutches. They put me in an ortho boot for first 4 weeks and did not have me start PT until then. That was a mistake! Being in boot too long caused other problems. In hindsight, the PT-ist seems to know a LOT more than the Drs, and I wish I would have started that much sooner. Overall I think online info about these types of injuries is too optimistic for a quick recovery. These are slow and complicated types of problems! This site is helpful to get insight on similar experiances. Best of luck to all of you!

  17. Paul

    I suffered a calf injury to my left leg 6 weeks ago. I felt or heard a pop and could feel the muscle tear apart. The first week was very painful and I had a large amount of bruising/bleeding that colored my calf and foot purple. The injury happened on June 9th. These past few days are the first that I can take a normal step with my left leg. The main area of concern is the amount of swelling in my leg from the knee down. I can push in about an inch deep on my shin and my ankle disappears by the time I get home from work. I elevate it while I sleep which helps, but about 3 hours after being up on my feet, it looks pretty bad again. How long does it take for this fluid build up to subside? Should I see a doctor about this or is this still normal 6 weeks after the injury?

    • Amanda

      I’ll also be curious to hear Tom’s advice on this. About 7 weeks post injury I was still dealing with lots of swelling (and still have a little about 9 weeks later but it’s much better). One thing that helped me was to lay on my back with injured leg raised at a right-angle, and then use finger tips massage upward. Using both hands, with fingers spread about a 1/2 inch apart, I start at my ankle and then pull long lines up to my knee, applying pressure as tolerated. After doing this periodically over a few days, the swelling notably subsided. I still do it at least 2x day to keep muscle loose and swelling/tightness down. I hope that helps!

      • Amanda

        Just realized I calculated my weeks incorrectly. Injury was May 27, so I am currently on week 8, not 9, if that matters. Swelling has finally started to subside over the last week or so.

      • Paul

        Amanda,
        Thank you for sharing your experience with this injury. Glad to hear your leg is doing better. I thought since there is little to no pain at this point, that the swelling would have begun to subside. It seems as bad as ever.

  18. Geraldine

    I tore my right calf yesterday while playing tennis – heard a pop and am unable to put any weight at all on the leg- went to A+E and was told the gastoc. muscle was torn, and to expect swelling and bruising. It’s now around 36 hours later, and I have followed instructions on ice and elevation (tho maybe over iced if that’s possible?), and there is no swelling or bruising yet- is this normal (or good?!)? I’m meant to be going on a holiday involving lots of walking in about 2 weeks- what are the chances I’ll be off the crutches by then? Is there somewhere I can find a set of gentle exercises I can do while I’m recovering? (I understand gently pushing the muscle while it regrows is a good idea..

    • Cat

      Hello Geraldine, Tom, and anybody else who might read this.

      I wonder if Geraldine was able to do the heavy walking on for the holiday that she said was scheduled only 2 weeks after her calf injury!

      I’m asking because I injured my calf almost 4 days ago, and I am booked to go on a ski holiday in 3 weeks and 4 days (26 days) after my injury.

      If Tom or anybody else can weigh with some opinion on this, I’d really appreciate it.

      My injury seems to be a moderate stage 2 calf strain. There is not too much swelling; I currently have only 3 bruises: Two on the bottom part of my medial Gastroc head (the smallest bruise is about 0.5″ in diameter, and the larger one is about 1″, but the outside of it is very faint purple, and only about 0.5″ diameter of it is a more visible purple; The third bruise is small (0.5″) and very faint, and it’s located lower, towards the interior side of the leg, probably just at the bottom of the interior Soleus muscle.

      Immediately after the injury (tennis sudden lateral jump), pain was unbearable if I attempted to walk normally, but I was able to walk slowly, as long as I did not use the forepart of the foot at all, and instead I walked holding my ankle stiff and loading the weight solely on my heel. It also heart when I attempted any dorsiflexion, even w/o any weight load, and even with the knee slightly bent.

      After 3 days of RICE, and minimal walking using a tall orthopedic boot (so I guess I could call it POLICE), the condition improved considerably in the sense that -without load- I now have full range of ankle motion with almost no pain. However maximum dorsiflexion still cause moderate pain in the Gastroc muscle (but only if I do it with a straight knee); also, I still get very sharp pain if I forget to walk carefully and I make some sudden movement that involves the calf, or if I attempt any calf raises.

      Maybe I should also mention that the bruising that I described above appeared only last night.(end of the 3rd day). Initially I had only some very faint bruising above the medial Gastroc, which disappeared in the meantime.

      I still hope that I will be able to ski 3 weeks from now, seeing that my progress seems fast up to this point, and also because I have noticed that I do not feel any pain as long if I am able to stick just to ski-specific leg movements (meaning any type of movements with foot flat on the ground and BENT KNEE, even with full weight load ONLY on the injured leg). I do have to admit that if I attempt small jumps (which are expected while skiing), then I still feel the pain, even if not as severe as when the knee is straight.

      So if anybody can weigh in with any comments or advice on this, I’d really appreciate it.

      Thanks!

  19. Angela

    I don’t understand why I am getting acute attacks of pain in the left calf.
    I do not run or jog or walk. I am overweight. This problem has just started about one month ago. I just healed from my acute calf pain and it just happened again on the same leg. All I did was take a step down on stairs.
    The exact same movement with the first injury. Is there something more I should be worrying about?

  20. Kate

    I run my dogs in Agility competitions and about 2 weeks ago I tore my Gastrocnemius. Never heard a pop, just felt like someone punched me in the calf as hard as they could. Initially, I thought it was a cramp! It never went away. Due to a family emergency I wasn’t able to go to the Dr (Ortho) until yesterday. Grade 2 tear, with minor damage to the Soleus and Achilles. He gave me some stretches to do and told me it’ll just take time. Ice, elevate, compression and DO NOT RE-INJURE IT! Was considering getting some compression sleeves/socks. Any recommendations? Have to say, this page has some great info. Many of the other pages made it sound like I might be up and running in a couple weeks. Sort of glad to know that’s not the case. Would have hated to hurt myself even worse!

    • Troy

      Depending on the swelling, it is a good idea. I was not able to use mine right away, but after a few weeks it definitely helped.

  21. Ive being struggling with a calf problem for two years now and really struggling from the start of the year. I took 14weeks getting physical therapy and strengthen it back up I even got laser on it to take away the scar tissue at the end I lasted bout 6 weeks and now I’m back to normal, can’t get through training anymore and very down in myself, do I require some sort of surgury?? I don’t mind if I do at least it will fix the problem

  22. KBN

    I injured my right calf 13 days ago. Initial injury felt like something popped in the middle of my calf (I fall under the “weekend warrior” [former] athlete category.) I’ve never been on the receiving end of a gun shot, but this could be close!! At first I thought it was just a REAL bad cramp, but most of the cramp didn’t subside after an hour or so – though even as recent as day 9 was still experiencing occasional cramping around the initial “pop”. I went straight to elevation and ice (which was actually difficult to put ice on something that DID NOT want to be touched!!) and walked gingerly on it, and found elevating the heal helped (am wearing “clog” type soles – with about 3cm lift). As many others stated, by day 4 swelling and discoloration was severe. The part of ICE therapy I forgot (and am noticing many here are not mentioning as part of their post injury treatment) was COMPRESSION!! Can’t have ICE without the “C”!!? I would not have believed how much keeping the leg wrapped from below the knee down past the ankle helps with the swelling if I hadn’t experienced not wrapping it at first (again could not fathom wrapping something that didn’t want to be touched!). The majority of my distal/associated pain was due to the amount of swelling in my leg and ankle. I am now using an ankle compression wrap, and am wrapping the rest of the calf to the knee with an ace bandage – a compression stocking would also be a good thing to use. I am fortunate that I can elevate the leg on a second chair behind my desk at work. Now I notice that the more I stand for long periods, the worse the leg feels. Moral of this story – ELEVATE the leg as often as possible, and WRAP the lower leg when not sleeping. Ice 3ish times daily (unwrapped) 20mins on 20mins off for an hour as long into the injury as you feel it helps – 2 weeks minimum. My GP also suggested writing the alphabet with your toes while icing – if you can handle multi-tasking!? Don’t rush back into activity – let the pain (and your therapist) be your guide. Great therapy exercises recommended here. Am sad to see that this could be a 6-month healing process (or longer!?! D-’; )

  23. Tim

    Hey guys! I’ve had some ongoing calf issues too – some on each leg in fact – which baffled me from time to time. Short version – it’s worth keeping nerve irritation/tension issues in view when you’re having calf pain, especially if you don’t have a classic injury story (force/velocity involved, bleeding/bruising/swelling etc). I have been a lot better since focusing on neural stretches/mobilisation, as I think my problems were mostly from nerve entrapment/irritation in the calf.

  24. Dana

    I injuried my right calf 9 days ago and the ER said it was a tear in the muscle. I have not been able to walk since or flatten out my foot for that matter. I am doing PT exercises but the calf is still tight and painful. I am so frustrated with not being able to walk or drive, does anyone have a similar story? I want someone to give me an idea as to when I will be able to walk again.

    • Kate

      I understand your frustration. After I tore my calf muscle, it was probably a solid month before iI was walking close to normal. I’m am two months now, and while it still feels a bit tight, it feels so much better now. I have not been running at all, except while playing with the dogs in the yard. All I can tell you is what was told to me: RICE … rest, ice, compression & elevate. Do the exercizes, DON’T reinjure it. And be patient.

  25. Colby

    Definitely a grade 2 tear presents just as the description in the original text & I appreciate the clear precise & informed presentation – It has really helped me.
    My problem was caused by 6 stud boots ( typically 12mm ) on a heavy damp pitch. Both calves R >> L.
    Am using the rehab approach you listed – can cycle thank goodness – have slightly shortened my leg extension in the pedal to ensure no irritation – seems ok – certainly keeping the blood circulating

    Ideal advice for me would be whether multi studded / shorter moulded studs would be better in the future. I have also replaced the insole with much more shaping & a little heel elevation. Thanks Colby

  26. Lisa

    I was playing five a sides last weds evening, ran for the ball popping in sound on my left calf and I was out. Severe pain ans instant swelling. Ten mins prior I did feel my calf tighten but thought I could run it off. Managed to get home. Ice elevation, Thursday morning could not physically move without screaming in pain, straight to a and e, doctor looked and said straight away I have torn my gastrocnemius muscle. Strapped top to bottom of leg, crutches and extra strong pain killers… Physio to be arranged. Now on day 5, pain is still severe, can hobble about but walking on side of my foot helps, strapped up helps, but still at the plenty of rest stage unfortunately. I can feel the tenderness in my calf even when I am resting…

  27. Andrew

    I’ve injured my calf for the third time in six months. My first injury I got running, in the last few hundred metres of a 5k run, so not a long run and it was like i was shot… It recovered in 2/3 weeks, went back to playing aussie rules footy and crossfit with no more issues for 4 and a half months, until 5 weeks ago. This time it went just after half time of a basketball match, and worse, couldn’t really walk on it for 3-4 days. Gradually got better each day, had a slight jog after 2 weeks, few more jogs and box jumps during the week, then took it easy for a game of basketball exactly 3 weeks after the injury. The next game I was running fine, no issues, skipped and double unders during the week and i thought i was fully fit. Anothet game pf basketball, 5 weeks after the 2nd strain and with 6-7 minutes to go bang, it went again, not as bad thought i dont think. Its been 5 days now and i can walk normal, back doing crossfit (modified) but dont intend on running or jumping for a few weeks yet.. How do I stregthen my calf to prevent injuring again… And when do you suggest I start running at speed again?

  28. David S.

    Hey Tom! First thank you for this resourse have been searching the web for meaningful advice & help & found some good stuff here. I’m a 36 yr old male, former athlete (now just a weekend warrior). I’ve never experienced a major injury athletically & just may have had my first real injury. I’m without med insurance & trying to just get an idea of what I’m up against. Playing Football (American Football, not soccer) & after a sudden change of direction I feel a “pop” in my right calf. There was no immediate pain & I was able to walk under my own power to the sideline. After trying to walk it off, I decided to call it a day. Being an athlete I’ve used RICE many times before & went right to that treatment. The first day the only pain I felt was when I put weight on the right leg. I am able to walk with a limp, but not able to walk normally. By day two my range of motion with my ankle while my leg is elevated seemed to be normal (meaning I can roll my ankle in every direction without any significant pain) The hardest position is toes pointed down. I’m now on day 6 of RICE & trying to figure out if I have a mid to high grade 2 or if a Grade 3 is a possibility. There has been no significant bruising or swelling but today for the first time a small golf ball sized brusie has showed up just below the middle of my calf, but nowhere else. I’m not sure if my RICE treatment has prevented the swelling or bruising that would be present with a grade 3. Whci is why I’m questioning the injury. On day 6 I can not flex my calf muscle to make it hard (as I can normally), but can walk on it with a limp. I can walk heel to toe but with some moderate pain. I can also do a toe raise while standing pulling my heel off the ground for a few seconds before pain starts. After reading some of these posts I feel like my injury isn’t as significant as others who were told to just rest. But I don’t feel as though mine is getting better. Thoughts?

  29. David S.

    I also feel as though every description of a grade 2 is what I have. But most of the posts I read about a grade two said after 3-4 days of RICE they were able to get back to at least walking pain free normally. I’m not looking to get back on the field but would like to walk normal & get back to actually normal living not just laying around elevating the leg all day. Also do you typically wait til injury is pain free to start stretching & using some heat therapy to loosen the tightness of the muscle?

  30. David S.

    Okay last post until I get an answer, but in my earlier post I said the bruising was the size of a golf ball, well within 6hrs of that post bruising is now from the bottom of my calf down to the top of my ankle (but not into the ankle or Achilles area (yet). Is that typical that bruising takes 6 days from injury to finally show up? Is the bruising now a sign that it is a grade 3 or is that level of bruising still consistent with grade 2?

    • PhysioTom

      Hi David, have you had the injury examined by anyone? It’s hard to safely advise online without being able to assess someone properly. My first advice would be to see a health professional for assessment and treatment.

      Grading a calf tear without investigation isn’t easy. I suspect you have a grade 2 tear, bruising can take time to appear and is normal after a muscle injury. It can take a couple of weeks to settle to allow normal walking so give it time. I’d avoid heat if it’s bruised at present. I would try to keep the ankle flexible but wouldn’t aggressively stretch it at this stage.

      I hope that’s some help.
      Tom

      • David S.

        Tom!

        Thank you for your reply. the answer to your first question is no I have not had my leg looked at by a Doctor. From past experience with muscle pulls (granted these were more minor than this) I’ve been told there isn’t much that can be figured out until the swelling has gone down.

        With that, I have taken a 7 day run of pretty much RICE almost all day every day. Although I did try and move around on day 4 more than should have. I feel as though the injury is getting better. I’m now on day 7 & am able to walk around with a light limp. I have had my wife who has massaged the leg a couple time a day to loosen the muscle & am applying a compression bandage around the entire leg. This seems to support the muscle and give me the ability to walk with less pain and not as much as a limp. The pain I do feel is still Sharpe at times, but is mostly at the middle base of the calf & then moving up the left side toward the shin. Its painful along the outside of the biggest part of the calf muscle, but not typically in the “meaty” part of the calf.

        From all the pictures I have seen researching this injury, I feel as though its the least common injured of the two calf muscles. I do feel its getting better as the days pass, but am wondering will the calf muscle naturally heal normally without medical evaluation. Or is other a chance it could heal or incorrectly and create issues down the line without seeing a doctor & having some form of surgery?

        Thanks again for all your sharing your effort, experience, answers & time!

  31. Alyson Levis

    I got a gastroc tear about a month ago in my left calf. I believe after it had started healing I tore it again when i fell from a ladder and injured my right ankle. I was put in a boot to help my right ankle but now my left leg is hurting even more. I have seen an ortho about it and he advised that it would take time to heal. Is there anything you could suggest to speed up the healing process? I will be in a boot on the right leg for another month or so. Two messed up legs is a real bummer.

  32. Murrough

    Great article and very useful. I popped my calf muscle yesterday playing tennis and the physio thinks it’s a bad grade 2 – I can’t really put weight on my left leg and am on shoulder crutches. Quite depressing as I had signed up for my first tennis comp. next month and have been making great progress fitness-wise in the past 12 months.

    Anyway I know that the road to recovery will be quite long, but do you think that using compression socks during rehab and when I return to tennis will help reduce the chance of this injury happening again? I really don’t want this to happen again.

    Thanks

  33. TLM

    Thanks for the useful information. I was wondering if you can help me? Tore left calf muscle a month ago doing Zumba (elastic band ping, pain and unable to continue). Healed after about a week (did not seek any medical advice). Tried to exercise and then did it again and this time noticed a dent when flex the muscle. Is this normal? Also calf feels softer in that area. Have just torn it all over again for third time so now in extreme pain. GP says not a Achilles but not had any scans just felt it and visually no swelling.
    is it normal to get a dent?

  34. paul jacob

    Good advice. I suppose my two comments are – re-setting your own expectations if you had a competition in mind and get injured. I think my rather unspectacular running career could have been improved had i given up on the race (marathon, county championships….) that i had in mind and instead set a new goal post recovery. The problem being the tendency to run ‘through a minor injury’ which invariably just creates a major injury and longer downtime. Also I realte to the above comments around weight gain .. running is I think the most effective way to lose weight of all sports, i do triathlon now I used to do middle distance track. So adding 10kg in the 6-8 weeks that a serious injury takes to recover from say a bad soleus tear / sore achillies ought to have consideration of changing diet. If as a serious runner your suddenly replacing 50-60 miles a week with a few dips in the pool and stair lifts/drops and walking , then stop the cakes and bread :0) The upside of triathalon of course is that you can generally swim or cycle with many running injuries and your used to spening a mind numbing 45minuts swimming !!.

  35. Marlene

    I tore my left calf muscle skiing 3 weeks ago. I carried on skiing for the rest of the holiday and found wearing ski boots actually helped I guess due to the compression and angle. Calf swelled overnight and bruising appeared about 3 days in from below knee to ankle. Initially found walking difficult but can now walk really well especially in heels although I feel a tightness and slight pull in the calf when flat footed. Calf remains swollen and I have some residual bruising in the ankle. Dr says no exercise for 2 months however I take pride in my fitness which is mainly achieved by running. I was due to run a 1/2 marathon this weekend which I know is impossible however I really am itching to start running again but I am worried about causing anymore damage or setting myself back. I tried a very short run this morning and found that I could feel the pulling in the fatty part of the calf muscle and I have this evening noticed more bruising developing in the ankle. I would appreciate advice on just how much I can do and when & how to increase activity, is this new bruising a sign that I should continue to rest or is it something that I shouldn’t be concerned about. Also my dr said that physio does not work on this type of injury but to try a gentle massage instead. Any advice appreciated

  36. Allison

    From reading all the comments on here, I think I may be the odd one of the bunch. I have developed some gradual irritation in the upper part of my left calf for the last few weeks. Most of the time I can’t feel anything with just sitting around or doing anything else. It really only bothers me when I run. And even when running, it is only slightly there on shorter runs and on my long run this past Saturday, I felt it tighten up from the top of my calf into the back of my knee for the last few miles. The tightness was also accompanied by a little bit of dull aching. It did not cause me to limp or alter my gait, but it was uncomfortable and annoying. In addition, I have had occasional feelings of something pulling on the inside of the upper calf. A little more intense than the aching and tightness, but these only lasted a few seconds while running. I guess I also feel little shots of pain going through the back of my upper leg on the same side (the left one). Could the calf irritation and the mild shooting pains up the back of my thigh all be related to a nerve issue? Possibly sciatic nerve issues? Anyone have something similar to what I’ve been feeling? Sorry if this post seems a bit scattered. I just feel like my situation is a little tough to describe and as a result, this entry isn’t as comprehensive as I’d like it to be. Thanks in advance!

    • Barbara

      Allison,

      ‘Hoping this might help you…
      I currently have a Partial tear of the medial Gastrocnemius, a large Hematoma and a ruptured Baker’s Cyst/right calf. My symptoms for two weeks prior to the tear: extreme cramping in right calf, cramping that was persistent with no relief. It was followed by two visits to the ER. The pain was excruciating.

      I suggest that you see a doctor right away before you experience what I’ve just gone through. I’ll be off work for weeks and everything else I do with my active lifestyle.

      Best to you,
      Barbara

  37. patrick

    Hi Tom, thanks for the info. Here’s my question: 25 years ago, after having right-calf pain training for a marathon, I gave up running. Now, after most of a decade of cycling (2K miles/yr, centuries etc) I tried running on a trail a few days ago.

    I’m talking about 10-minute pace (I felt like I was walking). I didn’t even get a half-mile before my right calf felt tight and painful. Very discouraging! Any insights? My calves may need strengthening but they’re able to get me up 1000-foot climbs on my road bike without pain!

    Thanks so much.

  38. Jerod

    Thank you for this article, a bit of a bummer though. Tore my soleus coaching football (European, not American). Not being able to model drills and exercises for my son’s football team will be interesting. Gave myself a grade 2 tear on the lateral (distal?) side of my soleus. This has been going on since 2006, on and off, about every 2-3 months. Was a very good runner who had to get a real job in construction in 06, then decided to train for a marathon in the most foolish way possible – none. Since then my calbed have been tearing alternately. Would this be most likely due to poor footwear for so many years, weakened hip flexors, and heavy weight bearing on hips and shoulders? I am 37 now and trying desperately to lose my extra 20 pounds and get back in shape before I fall apart completely. Oh forgot to mention torn medial meniscus on opposite leg,… Compensation injury?

3 Pings & Trackbacks
  1. [...] recent posts on calf tears and calf pain when running have highlighted the importance of improving calf strength. Persistent [...]

  2. [...] or doing strength work use your static calf stretches (as detailed on our previous article on calf injury) and as mentioned previously, the foam roller can help to release tight calves (although it is [...]

  3. [...] for runners and can persist despite calf conditioning work. Our previous articles on this cover calf tears, causes of pain and basic strength work. This piece looks at some more advanced strengthening [...]

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