The calf comprises of the muscles which lay between the back of the knee and the heel bone and are made up of the gastrocnemius and soleus muscles. Pain in this region can be for a number of different reasons.
How does it happen?
The most common cause of calf pain that we see here at Back In Action Physio is a calf muscle tear. There are hundreds of muscles in your body each made up of interlocking fibres called filaments that slide past each other. A sudden stretch or hit on the muscle can cause these filaments to break resulting in a tear in the muscle. Other causes of pain are a Bakers cyst which can sit behind the knee and has a palpable lump. Deep vein thrombosis (DVT) can also cause calf pain and is due to a blood clot in the veins and requires immediate medical attention. This can occur after surgery or long flights. Referred pain or nerve paincan be felt in the calf and can come from the lumbar spine or other tight muscles.
What do they feel like?
The different conditions cause different symptoms. If the pain is from a muscle tear the pain will be sharp. You will usually feel this when you are trying to over-stretch e.g. stretching out to kick a ball or hit a shot, or a sudden lengthening in the muscle e.g. slipping down a ramp. This tearing of the fibres can cause swelling, bruising and stiffness with immediate pain. Most people are unable to use the muscle initially shown by limping. Patients with Bakers cysts feel like there is a space occupying lump behind their knee and they have trouble with full squatting or bending the knee. DVT are very painful and hot to touch and are red in colour. It also causes increased pain to pull your toes upwards which puts pressure on the back of the leg. Referred pain or neural pain can feel like a real calf tear and if often misdiagnosed as a tear. Sometimes these pain cross up into the back of the thigh or run over both the gastrocnemius and the soleus muscles.
How are they diagnosed?
Your physiotherapist will need to do some tests to differentiate between all the conditions that could cause calf pain. These will then need to be matched to how your injury occurred. They will get you to do some functional tests, some stretches and then look at colour, location, tenderness of the area. They may need to do some additional testing to see which ones produce your pain. Generally further investigations are not needed but sometimes ultrasound scans may be needed to determine the severity if there is a tear.
What should I do if I have torn my muscle?
When you first injure yourself it is important to use ‘RICE’.
- Rest: Stop playing sport, walking, or using the body part and sit down
- Ice: Ice the painful are with a bag of ice wrapped in a towel, or an ice pack for 48 hours
- Compression: See your physiotherapist or local pharmacist for a compression bandage or tubigrip.
- Elevation: Elevate the area to help decrease inflammation
See your physiotherapist as soon as possible.
What can Back in Action do to help?
The key for a calf injury is determining the right diagnosis as the management for each condition is very different. Once this has been established then here at Back In Action we can determine the extent of your injury, set goals for your rehabilitation and give you approximate time frames for your recovery.
If it is a calf tear which is the most common cause of calf pain that we see then we can help with pain management and helping you modify your lifestyle without causing further or new injuries. After the acute stage of a muscle tear (the first 48 hours) the first priority is making sure you have full movement in your joints and help with swelling reduction. We may use mobilisations, massage, acupuncture or other techniques to help with this. We will then gradually help to rebuild your strength and agility and look at the whole kinetic chain to correct any compensations that have occurred to get you back to where you want to be better, faster.