Calf Strains – The “Old Person’s Injury” Misnomer

The calves

are an important muscle group when it comes to locomotion such as walking and running, especially in explosive movements such as sprinting. We are going to talk about calf strains, how they can occur, what happens to the calf when it is strained, what symptoms will present, how it can be treated or managed and expected outcomes after treatment.

All about the calves and how does a strain occur?

The calf is made up of multiple muscles. The most well-known is the gastrocnemius which is the bulk of muscle at the top of the lower leg, however the lesser-known muscles are the soleus and plantaris. A good way to feel the difference between these muscles is to do a calf raise when standing with straight knees, which will use the gastrocnemius, whilst doing a calf raise in a seated position with knees bent at 90 degrees will use the soleus.
Importantly, the gastrocnemius is a muscle that crosses over two joints, the ankle, and the knee, which is a factor that makes this muscle the more common one to strain, particularly more towards the inside of the leg. The strain to the muscle typically occurs as the muscle fibres are lengthening with a load that they cannot handle before it tears. This would happen with a lot of accelerating or change of direction when running during a game of soccer, AFL or basketball for example, though any sport requiring fast acceleration or change of direction could see this occur.

What does a calf strain look and feel like?

After a calf strain occurs, the affected person may feel the following symptoms:

  • Tenderness to touch at the point of injury
  • Swelling
  • Bruising may appear within hours or days
  • Stretching of the muscle will reproduce pain
  • Pain on resisted plantarflexion

    Muscle strains are often categorised through a grading system which can help determine the magnitude of the injury, which then guides treatment, outcomes and estimated timeframe for recovery. The below table shows the different grading for a calf strain:




  • Sharp pain during or after activity
  • Feeling “tight”
  • May be able to activity with mild or no discomfort
  • Post activity tightness and aching


  • Pain during a single leg calf raise or hop

Average Recovery Time

10-12 days




  • Sharp pain during activity in the calf
  • Unable to continue activity
  • Significant pain whilst walking after completion of activity
  • Swelling in the muscle
  • Some bruising may present


  • Pain whilst actively pointing toes
  • Pain and weakness with resistance applied to foot whilst pointing toes
  • Unable to pull toes up towards shin
  • Pain during double leg calf raise

Average Recovery Time

16-21 days




  • Sever and immediate pain in the calf
  • Unable to continue activity
  • Considerable bruising and swelling soon after activity


  • Unable to squeeze or use calf muscle at all
  • May be able to feel the defect on touch
  • Thomas Test positive

Average Recovery Time

6 months after surgery

Grade I: A first degree or mild injury is the most common and the most minor

Grade II: A second degree or moderate injury is a partial muscle tear halting activity.

Grade III: A third degree or severe injury results in a complete rupture of the muscle and is often present with a hematoma.

Ok so I have a calf strain, what’s next..?

After getting your calf strain diagnosed by a physiotherapist there are multiple potential avenues of treatment depending on the severity. Typically, surgery is not necessary unless there is a complete rupture. In most cases, the following are conservative treatment methods that have been shown to be effective in treating a calf strain.

  • Physiotherapy (acute phase of injury)
  • Exercise physiology (sub-acute phase of injury)
  • Soft tissue injury management (PEACE and LOVE)
    • P: protect E: elevate A: avoid anti-inflammatories/ice C: compression E: educate
    • L: load O: optimism V: vascularisation E: exercise
  • Steroid injection if necessary

With the aid of a physiotherapist, the initial phase of the injury might involve trying to reduce swelling, increasing pain-free range of motion and a return to function. After that initial phase, gradual loading and exercise will be the best treatment which can be carried out in supervised sessions with an exercise physiologist, who may also prescribe a home exercise program to be carried out at home. As with any injury, it will be important to not only focus on treating the injury but also maintaining or improving the performance of the body from a wholistic point of view which is not only a focus from our exercise physiologists but also out physiotherapists at Purpose.

Having gone through a thorough, systemised, and progressive rehabilitation program, the goal and often the outcome will be that people will return to their pre-injury status, whether that be return to work, return to sport or return to life even stronger than they were which will prevent further injury and other complications down the track.

Let’s summarise

So we spoke about what a calf strain is, how it can typically occur and some common sports or activities in which it is prevalent, what signs and symptoms may present with a calf strain, and finally how it would be treated with expected outcomes. Unfortunately, muscle strains are all too common in a variety of aspects of life and as frustrating as it can be to have time off work or sport, it is not all bad and sometimes it can lend time to ensure that not only does the injured area get rehabilitated but other aspects of the body and mind can also take a check, focusing on moving with purpose and living with purpose. The key to a great injury rehabilitation is a focus on the individual and not on the injury alone. This is something we pride ourselves on here at Purpose Healthcare. If you would like to find a time to see one of out physiotherapists of exercise physiologists don’t hesitate to give us a call.