World Cup Calf Strain
A calf strain involves damage to the calf muscle in a vigorous activity and is a common injury in sports and other activities where the body weight is moved about rapidly. The calf is made up of two major muscles, the gastrocnemius and the soleus, both of which come together in the lower part of the calf to become the Achilles tendon and it is the junction area between the muscle and the tendon which often suffers injury. A person will be pushing off hard with the calf while the foot is planted behind with the weight on it, making the calf muscle contract against an immovable object. If the knee is straight this may increase the force and make injury more likely.
The initial reaction of the sufferer will be an immediate pain. Calf pain with this injury is often very sharp and severe with the person unable to weight bear on the leg or only able to limp heavily with the toe of the foot touching. This prevents stretch on the calf which is intolerable at this stage, which is followed by swelling and bruising. Initial physio management is to control the swelling and inflammation by regular ice or cold therapy and compression with a bandage. Compression is extremely useful to limit tissue swelling and should be applied firmly and as soon after the injury has occurred. Patients need to monitor the circulation in the foot to ensure the bandage is not too tight.
Crutches are often needed for this injury as weight bearing is limited and balance poor, but once the pain reduces somewhat a more normal gait pattern should be encouraged and you can start gentle exercises by pointing your foot down and relaxing repeatedly. This contracts the damaged muscle but avoids any stretching of the damaged tissues, putting some forces through the muscle in a safe position. Walk by putting your heel down and having a normal gait as soon as you can and use the crutch to avoid an abnormally pronounced limp. By two weeks you should be able to start gently upward pulling of the foot to begin the process of lengthening the muscle by very gently stretching.
Progression is to gently calf raises whilst leaning forward on something to eventually going up and down over a step, and stretching with the knee straight and with the knee bent should be performed to restore tissue length before recommencing any vigorous activities.
Author: Jonathan Blood-Smyth