Calf Muscle Strain: Causes, Symptoms and Treatment - Knee Pain Explained (2023)

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Written by:Chloé Wilson, BSc (Hons) Physiotherapy
Reviewed by:KPE Medical Review Board

Calf Muscle Strain: Causes, Symptoms and Treatment - Knee Pain Explained (1)

A calf muscle strain is a really common sports injury that can cause long-term problems if not treated effectively.

Other common terms for this injury are calf muscle strain, calf tear, and calf muscle tear.

Essentially, all of these terms refer to one of the calf muscles being pulled beyond its normal elastic limit, overstretching it and damaging some or all of the muscle fibers.

A calf strain usually causes sudden, severe pain, the area can be tender, with swelling and bruising, and walking is often difficult.

Here we look at what muscles make up the calf complex, how they get injured, common symptoms, what are the best treatment options, and how to prevent yourself from suffering from a calf muscle strain.

(Video) Injury Spotlight: Calf Strain

Anatomy of the calf muscles

Calf Muscle Strain: Causes, Symptoms and Treatment - Knee Pain Explained (2)

The calf consists of two muscles, gastrocnemius and soleus. They work together to pull the foot down into plantar flexion, e.g. Point your toes or lift your heel off the floor.

The deep soleus muscle originates just below the knee joint. The gastrocnemius muscle sits above the soleus muscle and originates just above the knee.

Both muscles join around the mid-calf to form the Achilles tendon, which connects the calf to the foot at the back of the heel.

The calf muscles play an important role in lifting the foot when walking, running and jumping and help stabilize the ankle.

Causes of calf muscle strain

A calf muscle strain usually comes on suddenly from an injury, but it can develop gradually from overuse. A calf muscle strain most commonly affects the larger, more superficial gastrocnemius muscle, but it can also affect the soleus muscle.

Common causes of a calf muscle strain include:

  1. overstretching:Acute calf muscle strains occur when the muscle is suddenly overstretched, usually during changes of direction or acceleration, e.g. sprint or jump.
  2. Sudden acceleration:Athletes who compete in sports such as tennis, basketball, soccer, football, or track and field events often suffer from calf muscle tears due to the sudden bursts of speed required when moving from a stationary position.
  3. Repeated Overuse:Calf muscle strains can also develop from repetitive overuse of the gastrocnemius and soleus, usually during running and jumping, especially when the muscles are weak or strained. A calf strain is the most common cause of calf pain in runners.

Calf strain symptoms

There are three degrees of calf muscle strain, depending on how badly the muscle is damaged, and the location of the pain depends on where the calf tear is located.

  • Upper calf tear:Damage near the junction between the muscle tendon and muscle belly
  • Mean calf tear:indicates a tear in the muscle belly and
  • lower leg tear:typically by damage to the Achilles tendon

Typical symptoms for any degree of calf muscle strain are:

Symptoms grade 1

Calf Muscle Strain: Causes, Symptoms and Treatment - Knee Pain Explained (3)

With a grade 1 calf strain, only a few muscle fibers are damaged, up to about 10%.

(Video) Calf Pain! MUST KNOW This- Is it Manual Muscle Strain or Clot?

Mild pain may be felt at the time of injury or may develop after the activity has stopped. The calf may feel tight and painful when moving and may be accompanied bycramp.

The symptoms of a grade 1 calf muscle strain usually last from a few days to a few weeks

Grade 2 symptoms

In grade 2 muscle tears, more muscle fibers are damaged, between 10-90%, but the calf muscle is still intact

Grade 2 calf muscle strains tend to cause a moderate, stabbing pain that is usually felt at the time of injury, and there may be swelling and bruising in the area.

The area hurts when the calf muscles contract or stretch, and the region is often tender to the touch. The affected person will usually walk with Alimp due to pain and weakness. Symptoms of a grade 2 calf tear usually last 4-6 weeks

Grade 3 symptoms

Calf Muscle Strain: Causes, Symptoms and Treatment - Knee Pain Explained (4)

At a grade 3, there is a large tear where there is a complete tear of the calf muscle, ie. H. All fibers are torn, or a complete rupture of one of the gastrocnemius heads

When you suffer from a fully torn calf muscle, the pain is intense and immediate. The person will not be able to walk on the affected leg.

A grade 3 calf tear causes significant bruising and swelling. There may also be a bulge in the back of the calf just above where the tear occurred as the muscle tissue becomes a lump.

Calf strain treatment

Treating a pulled calf muscle aims to prevent further injury, aid healing, and ensure a full recovery to prevent long-term problems.

calf muscle treatmentusually includes:

  • Rest:It's really important to rest for a few days after a calf muscle strain to avoid further injury. You should avoid anything that overloads or stretches the injured calf muscle and may benefit from using crutches for a few days
  • ice treatment:Applying ice to a pulled calf muscle regularly helps reduce pain and swelling and may speed healing
  • Compression:Wearing a compression bandage or Tubigrip also helps reduce swelling in the calf muscle and provides some support to protect against further injury
  • Elevation:Elevating the leg while resting prevents excess fluid and blood from pooling in the calf muscle, which helps reduce swelling
  • Medication:Over-the-counter pain relievers can help reduce the pain. Anti-inflammatories should be avoided for the first few days as they can slow healing
  • Heel Pad:Using heel raisers in your shoes will help relieve tension from the injured calf muscle, aiding healing and reducing the risk of tearing again

Calf Muscle Strain: Causes, Symptoms and Treatment - Knee Pain Explained (5)

  • calf exercises:Strengthening and stretching exercises are an essential part of treating calf muscle strains, but it's really important to follow a rehab program so you know what's safe and when
  • Physical therapy:A physical therapist can perform a range of treatments, including cross-friction massage and ultrasound, both of which help reduce pain and inflammation, and help the torn calf muscle heal properly without allowing scar tissue to build up and regain full strength and flexibility
  • Surgery:Occasionally, a fully torn calf muscle may require surgery, but this is rare
(Video) What causes sharp pain behind knee? How can it be managed? - Dr. Navinchand D J

With the right combination of these treatments, most people fully recover from their strained calf muscle in just a few weeks. But it's important to know which of these treatments are right for you and how to do them properly.

Find out everything you need to know inCalf muscle tear treatmentArticle.

Calf strain recovery time

Calf Muscle Strain: Causes, Symptoms and Treatment - Knee Pain Explained (6)

Recovery from a calf strain depends on the level of calf strain you've experienced and how well you're sticking to your rehab program.

  • 1st ClassCalf strain recovery time:usually 7-10 days
  • Note 2Calf strain recovery time:usually 4-6 weeks
  • 3rd gradeCalf strain recovery time: Up to 3 months

Calf Muscle Tear Prevention

Whether or not you've suffered from a calf muscle strain in the past, prevention is better than cure. By making sure your muscles are warmed up before you start exercising, you reduce your risk of suffering from a calf muscle strain.

You should also make sure your calf muscles are strong and flexible to withstand the stress you put them through:

  1. strengthening exercises: Exercises to improve calf muscle strength and endurance reduce the risk of injury
  2. stretching: Regular stretching of the calf muscles, especially before and after exercise, relieves the muscle and improves flexibility.

To find out how to effectively strengthen and stretch your calf muscles, visit theWadentrainingsection on our sister site

What else can help

Treatment of a calf muscle tear should begin as soon as possible and continue until you have regained full muscle strength, flexibility and endurance.

Be sure to check them outGuide to treating calf muscle tearsto find out everything you need to know, e.g. B. how heel lift inserts can make a big difference, when ice helps and when it doesn't, and how to know when it's safe to start stretching.

A calf muscle strain is the most common cause of calf pain, but there are other potentially life-threatening causes of calf pain - check them outcalf muscle painsection to learn more.

Page last updated: 13.10.21
Next review due: 10/13/23

(Video) Calf Pain : Cause, Prevention and Treatment

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1. Das Journal der Canadian Chiropractic Association:Diagnosis and rehabilitation of gastrocnemius muscle tear: a case report.December 2015

(Video) When Should You Worry About Calf Pain

2. British Journal of Sports Medicine:Precise moment of gastrocnemius muscle strain captured on video.June 2002

3. Harvard Health Publishing:Muscle training from A to Z.December 2018

4. Current reviews in musculoskeletal medicine:Gastrocnemius vs. Soleus Trunk: How to Distinguish and Treat Calf Muscle Injuries.June 2009


Can strained calf muscle cause knee pain? ›

Calf or Hamstring Strain or Cramp

Sudden activity and overuse are two leading causes of pain behind the knee. This is due to a calf or hamstring strain or cramp, according to Dr. Tanaka. Movements that require pushing off or severe knee bending cause this calf and hamstring pain, respectively.

Are knee pain and calf pain related? ›

Are Knee Pain and Calf Pain Related? Yes, calf pain and knee pain are usually linked to some degree. If you have arthritis, you may experience pain the radiates from the knee to the calf. Arthritic joint discomfort is primarily caused by inflammation.

How do you get rid of knee and calf pain? ›

Rest the area. Ice the area for 20 minutes, using a covered icepack or bag of frozen peas. Compress the area with a bandage (but if the pain gets worse, loosen the bandage). Elevate the lower leg by sitting or lying down (for example with pillows), so it is above the level of the heart.

What is the treatment for a calf strain? ›

You should use the RICE method, which includes rest, ice, compression, and elevation, while you're at home. Your doctor may prescribe an anti-inflammatory medication – or recommend an over-the-counter anti-inflammatory such as ibuprofen – to help reduce swelling and pain.

Is your calf muscle connected to your knee? ›

The top part of the gastrocnemius has two heads that start on the inside and the outside of the femur (thighbone). The gastrocnemius goes down the back of the leg and attaches to the Achilles tendon. Gastrocnemius strains are common because the muscle connects to two joints (the knee joint and the ankle joint).

What leg muscle can cause knee pain? ›

Muscle strain — The quadriceps muscles (front of the thigh) and the hamstring muscles (back of the thigh), which straighten and bend the knee respectively, are susceptible to strain ("pulled muscles").

Can knee pain be caused by tight calves? ›

Tight calves could cause knee pain, ankle pain, a decrease in ankle mobility, restricted movement and worst case scenario, a torn achilles tendon. Stretching is one of if not the most efficient way of treating and preventing tight calves, though a lot of people find it hard to perform effective calf stretches.

Why do tight calves cause knee pain? ›

A tight Calf muscle can cause a tendon strain that can present pain behind the knee and limit your knee flexion. Stretching out the tissue where the muscle joins the tendon can reduce the pain.

Why does my knee and calf hurt so much? ›

Deep vein thrombosis, tendonitis, muscle spasm, and a Baker's cyst are some of the reasons of discomfort below or behind the knee and calf. Although these are frequent illnesses that might cause discomfort, other medical disorders can also cause discomfort in certain areas of the legs.

What is the fastest way to relieve knee pain? ›

Do use "RICE." Rest, ice, compression, and elevation (RICE) is good for knee pain caused by a minor injury or an arthritis flare. Give your knee some rest, apply ice to reduce swelling, wear a compressive bandage, and keep your knee elevated.

What is the best medicine for knee pain in old age? ›

Acetaminophen. Acetaminophen is an analgesic or pain reliever that also reduces fever. Some people take acetaminophen to reduce pain caused by osteoarthritis, a type of arthritis that affects the joints, including the knee. People also take acetaminophen to relieve other mild to moderate pain.

Does stretching calves help knee pain? ›

Calf stretches can really help reduce knee pain and improve flexibility. The calf is made up of two muscles at the back of your lower leg. The larger muscle, gastrocnemius, starts just above the knee, and soleus, which sits underneath, starts just below the knee.

How many days does a calf strain last? ›

In the less severe cases it usually takes up to three days for a pulled calf muscle to start feeling better. In the most severe cases that don't require surgery a full recovery may take up to six weeks. In the case that the injury requires surgery the recovery period may extend up to six months to a full year.

Is walking good for calf strain? ›

Short walks are good for the healing muscle, but avoid long distances and standing for long periods. You may find it more comfortable in shoes with a thicker or higher heel to start with, as this will lessen the stretch on the calf.

Is heat good for a strained calf muscle? ›

A pulled muscle should first be treated using the R.I.C.E. method. During the first 72 hours, heat should be avoided to prevent increased swelling and inflammation. After about 72 hours, heat can be incorporated into treatment to increase blood flow and aid the overall healing process.

Which calf muscle acts on the knee joint? ›

The gastrocnemius is one of the calf muscles, but attaches to the femur at the back of the knee, and runs down to attach to the calcaneus (heel bone) through the achilles tendon. It acts as a secondary knee flexor.

What connects your calf to your knee? ›

The lateral collateral ligament (LCL) is on the outer side of your knee. It connects your femur to your calf bone (fibula). The collateral ligaments prevent the knee from moving side to side too much. Cruciate ligaments: The two cruciate ligaments are inside your knee joint and connect your femur to your tibia.

What is the most common reason for knee pain? ›

The most common causes of knee pain are related to aging, injury or repeated stress on the knee. Common knee problems include sprained or strained ligaments, cartilage tears, tendonitis and arthritis.

What muscles should you strengthen for knee pain? ›

Strengthening exercises. According to the American Academy of Orthopaedic Surgeons, you can help reduce the stress on your knee joint by regularly working the muscles around your knee. To help strengthen your knees, focus on moves that work your hamstrings, quadriceps, glutes, and hip muscles.

Why are my knees aching all of a sudden? ›

Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Medical conditions — including arthritis, gout and infections — also can cause knee pain. Many types of minor knee pain respond well to self-care measures. Physical therapy and knee braces also can help relieve pain.

When should I see a doctor for knee and calf pain? ›

See your doctor as soon as possible if you have:

A leg that is swollen, pale or unusually cool. Calf pain, particularly after prolonged sitting, such as on a long car trip or plane ride. Swelling in both legs along with breathing problems. Any serious leg symptoms that develop for no apparent reason.

Does meniscus tear cause calf pain? ›

Depending on the location of the tear will determine where a person might experience symptoms. Anterior knee pain, pain along the inner or outer aspect of the knee, even at times pain in the calf region can all be signs that a meniscus could be compromised.

How should I sleep to relieve knee pain? ›

Back or Side Sleeping for Less Knee Pain

If on your back, put a pillow under your knees for support. On your side, keep your knee in a flexed position to minimize pain. Try to never sleep with your legs crossed. If you have knee pain due to injury, you should see an orthopaedic specialist.

What is the best sleeping position for knee pain? ›

Best Sleep Position for Knee Pain

Sleeping with knee pain may require you to elevate the knee and leg. If so, sleeping on your back is the best option. Place pillow under both legs to elevate the knee above the level of the heart. If there is swelling in the knee, the elevation can help to reduce it.

What is a simple home remedy for knee pain? ›

Heat and ice can both be used to manage different parts of knee pain. Ice helps reduce swelling and inflammation and is best with injuries. Heat can help with pain management, especially on stiff joints. It can also help mobility.

What vitamin helps with knee pain? ›

Such is the case with vitamin D. When you aren't getting enough, you may get pain in your joints. Vitamin D's anti-inflammatory properties help relieve joint pain. Vitamin D also can help manage autoimmune conditions that affect the joints, including multiple sclerosis, rheumatoid arthritis, and Type 1 diabetes.

What is the best painkiller for knee pain over-the-counter? ›

Over-The-Counter Medication for Knee Pain

The main over-the-counter drugs are acetaminophen (Tylenol and other brands) and non-steroidal anti-inflammatory drugs (or NSAIDs), including aspirin (such as Bayer), ibuprofen (Advil, Motrin), and naproxen (Aleve). These can help with simple sprains or even arthritis.

What is better for knee pain Tylenol or ibuprofen? ›

Evidence shows that oral NSAIDs—specifically diclofenac , ibuprofen , and naproxen —are more effective in reducing pain than Tylenol in people with knee osteoarthritis. Oral NSAIDs can also be more effective than Tylenol in improving both physical functioning and reducing stiffness (14).

What are 3 exercises to strengthen your knee? ›

Knee exercises for runners
  • Knee bends – 3 sets of 10 repetitions (reps) ...
  • Thigh contraction – 3 sets of 15 seconds with each leg. ...
  • Straight leg raises – 3 sets of 10 reps with each leg. ...
  • Hamstring stretch with thigh contraction – 3 sets of 15 seconds with each leg. ...
  • ITB (iliotibial band) – 3 sets of 15 seconds with each leg.

What exercises can seniors do for knee pain? ›

The Best Exercises for Bad Knees. The most effective way to alleviate pain in your knee joints is simply to get moving, Woods says. “Walking, water aerobics, cycling, swimming, yoga, and strength training all help improve the symptoms associated with arthritic knee pain and knee pain in general.”

Is walking good for knee pain? ›

People with knee osteoarthritis may reduce their risk of knee pain by walking more, according to a study published online June 8, 2022, by Arthritis & Rheumatology.

What are the 4 symptoms of a pulled calf muscle? ›

Pulled calf muscle symptoms
  • mild swelling.
  • redness.
  • bruising.
  • inability to stand up on the ball of your foot.

What does a severe calf strain feel like? ›

A calf strain usually starts with sudden pain in the back of the lower leg. A pop, snap or tearing sensation may be felt. Occasionally, with a severe tear, it may feel like you have been shot in the back of the leg. Afterwards, the calf may swell and it will be difficult to rise up onto the toes.

Do calf strains heal on their own? ›

Athletes and people over 40 are especially prone to this type of muscle injury. Calf muscle tears usually heal after a few weeks of conservative treatments, such as rest, ice, compression and elevation. In rare cases, you may need surgery.

What is the fastest way to heal a calf muscle? ›

Most calf strains heal with rest, ice, compression and elevation. In rare cases, calf muscle tears require surgery.

How do you relax a calf strain? ›

Put your affected leg about a step behind your other leg. Keeping your back leg straight and your back heel on the floor, bend your front knee and gently bring your hip and chest toward the wall until you feel a stretch in the calf of your back leg. Hold the stretch for at least 15 to 30 seconds. Repeat 2 to 4 times.

Should I massage a calf strain? ›

The No HARM Protocol should also be applied – no heat, no alcohol, no running or activity, and no massage. This will ensure decreased bleeding and swelling in the injured area.

What is better for knee pain heat or cold? ›

Heat helps loosen tight muscles and joints and relieves pain and muscle spasms. If you have swelling, it's best to use ice for 24 hours, then switch to heat. If swelling isn't a problem, it's fine to use heat when you first notice knee pain.

How should you sleep with a calf strain? ›

Wearing an elastic compression bandage is also suggested to limit bleeding and swelling in the tissues. If your sporting injury comes in the form of shin splints, physical trainer Jim Frith recommends sleeping on your back, with legs stretched out and toes pointing towards you to keep calves lengthened.

Should I ice or heat a calf strain? ›

Ice wins to shut down swelling, inflammation and pain early on where heat may actually make an injury worse.” If you're dealing with lingering injuries (older than 6 weeks) then it's okay to use heat. The increased blood flow relaxes tight muscles and relieves aching joints.

What are the symptoms of a calf strain? ›

A feeling of tightness, tenderness, or weakness in the calf area. Spasms (a gripping or severe tightening in the calf muscle). Sharp pain in the back lower leg when trying to stretch or move the ankle or knee. A pulling sensation at the time of injury.

How does the calf affect the knee? ›

The calf muscles can cause pain behind your knee!

The tendons of the two heads of the gastrocnemius muscle attach separately above the knee on the back sides. When a muscle crosses a joint, it acts on it mechanically to increase joint pressure (which can cause pain).

Should you walk on a strained calf? ›

Rest: Once you feel calf pain, stop doing physical activity and rest your leg. Don't push through pain, which can make the problem worse. You might be required to use crutches or wear a boot for several days. Ice: Put an ice pack or cold compress on your calf muscles for 20 minutes every two hours.

What is the best medication for calf strain? ›

Only return to exercise and your normal activities after your calf is completely free from pain and swelling. Take over-the-counter pain medications. Unless otherwise instructed by your doctor, you can take acetaminophen or ibuprofen for pain relief.

How serious is a calf strain? ›

For athletes, calf muscle strains are common—but treatable—injuries. However, calf pain can have a number of causes and some, like a blood clot, are serious. If you believe you may have strained your your calf muscle, remember to use the R.I.C.E.

What doctor treats calf strain? ›

Most cases of leg pain go away either on their own or with self-care measures. However, there are cases that warrant a visit to an orthopedist for prompt intervention. An orthopedist is a medical doctor who specializes in the diagnosis and treatment of injuries and conditions that affect the bones and soft tissues.

Can tight calf muscles cause knee problems? ›

Tight calves could cause knee pain, ankle pain, a decrease in ankle mobility, restricted movement and worst case scenario, a torn achilles tendon. Stretching is one of if not the most efficient way of treating and preventing tight calves, though a lot of people find it hard to perform effective calf stretches.

Are compression socks good for calf strains? ›

Although compression socks cannot cure your calf strain, they can significantly help reduce and alleviate pain and help further prevent calf injuries. Copper-infused compression socks can reduce calf pain and swelling, prevent damage, and treat the issues that are causing calf pain.

When should I worry about a calf strain? ›

You may feel some pain in the muscles around your knee, ankle or foot. This should improve as your calf problem gets better. If you experience these for longer than 6 weeks, you may need to speak to a healthcare professional.


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