Pull in Calf muscle: Cause, Symptoms, Treatment, Exercise

Pull in Calf muscle

What is a pull in calf muscle?

A pull in calf muscle is also called calf muscle strain, it occurs when the muscles in the calf (the soleus and gastrocnemius) get overstretched during performing any activity of leg.

The calf muscles are located in the lower leg behind the shin bone and extend from the base of the thigh down to the heel. They work as flex and bend the foot, ankle, and knee. A calf strain can cause pain and make  difficulty to perform running, jumping, and doing other activities.

A pull in calf muscle can result in partial tear or complete tears depends upon level of injury. A torn calf muscle may require surgery to repair it.

What is the difference between muscle strain or muscle pull or a sprain?

Pull in Calf muscle also you can say A calf strain but it isn’t a sprain. Strains mean injuries to muscles or tendons (tissues that attach muscles to bones) while Sprains occurs injuries to ligaments (tissue that connects bones or cartilages or holds a joint along).

Where is the calf muscle located?

The calf muscle is a group of two main muscles — the gastrocnemius muscle, the soleus muscle and additionally plantaris muscle.

These two muscles the gastrocnemius and soleus muscles are collectively big muscles with two sections.

a small muscle called the plantaris travels between the gastrocnemius and soleus muscle throughout the length of the lower leg. these 3 muscles are also called the triceps surae. however, not everyone have a plantaris muscle. Mostly 100 % of individuals have 2 larger muscles.

Gastrocnemius Muscle is the larger Calf Muscle Forming The bulge of Muscle mass and visible beneath the skin. Gastrocnemius has 2 heads which looks like Diamond shape.

The Soleus Muscle is a Small Muscle, Flatt and located underneath The Gastrocnemius Muscle.

A majority of soleus muscle fibers originate from each side of the anterior aponeurosis, attached to the tibia and fibula.

Insertion:

Both Muscle Insertion merge via Tendo Achiilis and the Achilles tendon inserts into the heel bon(calcaneus).

Action:

Calf Muscle is one of strong lower limb Muscle which Planter Flex from Ankle Joint. 

This muscle is anti-gravity Muscle and normally all anti gravity Muscle require high Power that's Why All anti gravity Muscles are Bulky and Strong. 

Running, Jumping, Dancing, Cycling all this Activity uses Calf Muscle. 

Jumping is the activity where Highest uses Calf Muscle.

Who gets Pull in Calf muscle?

Anyone can have a pull in calf muscle. But these pull are most commonly seen in sports person who perform lots of stop-and-go movements with jerky bursts at ankle such as Sprinters, football players, Hockey players, soccer players, and tennis players are at risk of calf muscles strain. eventually, the injury is also called “tennis leg.”

What is the causes of pull in calf muscles?

Call muscle pull mostly occur when someone suddenly moves or overstretches in the calf muscle during moving or playing activity such as Fast pivots, jumps, or abrupt stops can cause muscle strains. This injury is mainly common when ankle get forced upward (toward the body) and the ankle stretches the calf muscles down too rapidly.

Following are the most common cause of calf muscle pull, these are:

• Not warming up correctly before sports or physical activity
• Calf Muscle tightness (deficient flexibility)
• Calf muscle weakness (deficient conditioning)
• Overexercise or Over physical activity (Overexertion and fatigue)

Acute calf muscle pull occurs during Slip body, jump, run, throw something, raise something heavy, lift something while clumsy position.

Chronic calf muscle pull occurs during Sports like row, playing Hockey, tennis, golf, or baseball, poor posture, holding back or neck in an ungainly position for long periods of time, like after work at a desk.

Overuse:

Repeated ankle movement can lead to microtrauma of calf muscle will cause overuse calf muscle pull.

Don’t stretch or warm up prior to exercise: Stretching prior to calf exercise step by step will increase how much stress you place on muscles.

Calf muscle tightness: If your calf muscles are tight and not flexible to high intensity activity in full range then your calf muscles (and the fibers in them) are tighter, which build them additional risk to strains.

Other risk factors for calf muscles pull are:

Age: People over 40 may be more likely to have muscle strains during physical activity.

Sex: Men are more likely to get calf muscle pull as compared to females.

Calf muscle weakness: It’s important to do warm up and stretch your calf prior to any physical activity and condition muscles before the start of a sports activity.

The Calf muscle pull is classified into three grades:

Grade 1: It is the type of muscle strain that occurs once a overstretch causes very few micro-tears among the muscle fibers. It could also be ready to resume an activity without pain or with gentle discomfort. Mostly post activity tightness and aching, Full recovery take within 1 weeks. average time to return to sport 10-12 days. sign-pain on unilateral calf raise or hop.

Grade 2: This strain include a partial tear of the muscle fibers. you may acquire to limit activity, but full recovery takes around five to eight weeks. average time to return sport after 20 to 30 days. sign-pain with active plantar flexion, pain and weakness with resisted plantar flexion, loss of flexion.

Grade 3: severe injury and instantly pain in the calf, and involves a complete tear or rupture of the affected muscle fibers. Full recovery can take 3 to 4 months and, in some instances, surgery may even be required. average time to come sport 6 months after surgery. sign-inability to contract calf muscle may have the palpable defect, Thomson’s test positive.

What are the symptoms of a pulled calf muscle?

• Difficulty stretching the calf muscles or standing on toes or limping during walking.
• Calf Muscle pain when flexing ankle or pointing toes.
• Difficulty in knee movement or painful knee movement.
• Snapping or popping sensation in calf muscles.
• Sudden pain, spasm in the back of lower leg.
• Swelling in calf muscle and also Ankle swelling.
• Bruising on calf area.

Most people with a pulled calf muscle shows that not able to do their regular activity instantly following the injury.

Differential diagnosis:

• Medial leg bone stress syndrome
• Plantar fasciopathy
• Ankle Joint sprain
• Medial leg bone stress syndrome
• Leg injuries related to sports with same symptoms and treatment as a calf strain are mentioned below.
• Chronic exertional compartment syndrome (CECS)
• TendoAchilles tendinopathy
• Popliteal Artery entrapment Syndrome (PAES)

Diagnosis and tests:

You may require imaging study to checkout if there are any partial or complete tears in calf. These tests can also rule out other conditions that related lower leg pain, such as Achilles tendon ruptures or deep vein thrombosis (DVT).

Ultrasound, to examine for calf tears or fluid buildup within the calf muscles.

MRI, to examine for blood clots, a tear, or internal bleeding.

Assessment of lower leg:

Subjective assessment

Ask the patient pain history with associated symptoms

mechanism of injury:

Inciting trauma- side and magnitude of injury force

recurrent trauma-faulty postural related injuries

Objective assessment

Examine the foot and ankle in supine and standing position

Ankle Active range of motion

Ankle Passive range of motion

Resisted strength check the ankle and foot

Knee Active ROM and manual muscle testing

On objective assessment, there will be:

muscle 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 plantar flexion.

Treatment of Pull in Calf muscle:

Medical Treatment

Calf muscle pull treatment mostly depends upon grade of injury. Grade 1 or Grade 2 muscle strain recover with few days rest with Pain relieving medicine mostly Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and use of RICE Principle.

RICE Principle are:

R- rest

I- ice for cooling

C- compression: tapping and splinting

E- elevation

Few days rest helps to recover calf muscle strain to heal properly while ice pack helps to relieve pain and swelling.

Elevation of limb is required if Ankle swelling is present otherwise not required.

Crep bandage or taping also helps to stabilize calf muscles.

After few days rest pain will disappear and other related symptoms such as muscle spasm, swelling is relived exercise is the best option to return to normal activity.

Physiotherapy Treatment:

Physiotherapist will assess your condition and accordingly start the treatment depends upon severity of injury and symptoms.

Mostly Physiotherapist uses pain relieving Electrotherapy modalities such as Transcutaneous electrical nerve stimulation (TENS), Interferential therapy(IFT), Ultrasound therapy machine. This electro. modalities helps to relieve pain, swelling and muscle spasm.

Physiotherapist teaches you initially light exercise and as pain and other symptoms relive they give you stretching and strengthening exercise of calf muscles.

Pull in calf muscle rehabilitation exercises:

Phase one- the 1st week after injury

Use of ice pack 3 times par day

Rest

Avoid exercise or do only isometric pain free exercise.

Phase two- the 2nd and 3rd weeks after injury

Start active Ankle range of motion (ROM) exercises

Avoid painful activities.

range of motion exercise: knee flexion exercise

knee extension

plantar flexion-dorsiflexion

genital pain free calf resisted exercise

Gradual pain free calf stretching exercises

Use of ice appliance 15-20 min, after exercise

Phase three-3 to 4 weeks after injury

Gentle strengthening exercises:

knee flexion-extension

plantar flexion- dorsiflexion

gental pain-free calf stretching

you can also start with thera-band resisted calf exercise(pain free)

Following are the few best exercise you can start at home in pain free manner.

1. Towel calf stretch:

Towel calf stretch

Sit on a firm mat with one leg straight ahead of you. Loop towel circling your ankle as per picture and pull the towel toward body keeping knee straight. now hold this position for 15 to 30 seconds and then relax. Repeat 3 times.

2.Seated heel Raises:

Take a sitting position on a chair with both legs on the ground. Pressing down through the toes, raise heels off the floor.

Hold this position for 5 to 10 seconds.Repeat 10-15 times.

3.Standing calf stretch:

Standing calf stretch

Keep your both leg in same line position with around minimum foot distance with forward leg flexed from Knee and back leg straight , You will feel stretching in back of lower leg in Calf muscle and Hold for few seconds then relax. exercise must be pain free and gentle stretch initially for few days.