- Common knee injuries
Written by:Chloé Wilson, BSc (Hons) Physiotherapy
Reviewed by:KPE Medical Review Board
Calf muscle tear treatment can usually be done at home, with most people making a full recovery.
A pulled calf muscle, also known as a "calf tear" or "calf strain," is a very common injury where one of the calf muscles becomes overstretched and some of the muscle fibers tear.
There are three different grades of calf strains, classified according to what portion of the muscle is torn. Treatment for calf muscle tears depends on the degree of damage.
Here we look at the rehab and recovery process with treating calf muscle tears and what you can do to ensure a full, timely recovery without risking re-injury.
What is a calf muscle tear?
The calf region is made up of two muscles that together make up the Achilles tendon, which attaches to the back of the heel:
- Gastrocnemius:the larger, superficial calf muscle
- Soleus:the smaller, deeper calf muscle
The calf muscles work together to pull the foot down (think “good toes” in ballet!) and give us the propulsion to tiptoe, run, and jump.
Calf muscle tears can occur:
- Suddenly:when the calf muscles are suddenly overstretched or overloaded - the most common. Common in sports with sudden acceleration or changes in direction, e.g. Sprinting & jumping, especially when sudden bursts of speed from a stationary position are severe, e.g. Soccer, football, basketball.
- Gradual:if the calf muscles are repeatedly overused, especially if they are already slightly weak or strained. Typically affects runners.
You can find out more about the various causes and risk factors for calf muscle tears in thecalf muscle pulledArticle.
Classification of calf tears
There are 3 grades of calf tear depending on the amount of damage received:
- 1st Class:< 10% of muscle fibers are torn
- Note 2:10-90% of the muscle fibers are torn
- 3rd grade:Complete tear/rupture of the muscle
You can learn more about the differences between these classes in thecalf muscle pulledArticle.
calf tear symptoms
Typical symptoms of calf muscle tears are:
- Pains:Sudden, sharp pain in the back of the calf
- Swlong and bruises
- Difficulty walking:oder auf Zehenspitzen hochdrücken
- Tenderness:Touching or pressure on the torn region
- Noticeable gap:or calf lump with tear grade 2-3
Symptoms of a calf tear vary in intensity depending on the extent of the damage.
Learn more aboutcalf tear symptomsfor each degree of calf tear.
Calf muscle tear treatment
Treatment for a calf muscle strain should be started as soon as possible to ensure it is most effective.
Treatment of calf muscle tears aims to:
- Protect from further injuries:It's really important to protect the injured area in the calf - the last thing you want is for more muscle fibers to tear
- Support Healing:Accelerate healing by bringing in the necessary healing nutrients and getting rid of swelling and inflammatory chemicals
- Realign muscle fibers:As part of the healing process, the torn muscle fibers begin to reassemble, and cross fibers form between the torn areas. It is important to ensure that the transverse fibers that form are properly positioned and aligned, otherwise clumps of scar tissue can form in the muscle, affecting calf flexibility and strength
- Ensure Full Recovery:It is important to speed up the recovery process and continue treating calf muscle tears until the muscle has fully healed. Otherwise there is a high risk of re-injury, around 30%.
- Avoid Long-Term Problems:B. Persistent tension and/or weakness of the calf muscles, which means there is a high risk of re-injury
Let's take a look at the best calf muscle tear treatment options, how they work, and which treatments are best for different degrees of calf tears.
Treatment of a calf muscle tear should ALWAYS begin withrest, whatever calf strain it is.
It sounds simple, but rest is vital to allow the calf muscles to heal and to prevent the injury from getting worse.
Returning to activity too soon can turn a grade 1 calf muscle tear into a grade 2 or a grade 2 into a grade 3.
During the resting phase of calf muscle tear treatment, it is especially important to avoid activities that cause painNotto stretch the muscle.
You will likely need to rest 2-3 days for a grade 1 calf strain and up to 2-3 weeks for a grade 3 calf muscle tear.
Stretching should be avoided after a calf tear until you can plantar flex your foot against resistance without pain, e.g. Push up on your toes.
Do notExercise until you are pain free and have been given the all clear by your doctor or physical therapist or you risk further injury.
2. Ice treatment
Apply regularlyice packon the injured calf is an essential part of treating calf muscle tears and should be started as soon as possible.
Ice is an invaluable part of treating calf tears because, when used correctly, it helps:
- Reduce Swelling:Applying ice regularly will help reduce the amount of bleeding and fluid that collects around torn calf muscle fibers
- Reduce pain:Ice has an analgesic effect that helps reduce the pain felt
Both help speed healing by reducing the amount of fluid and flammable chemicals irritating the damaged area. This allows you to get moving again faster to build strength and flexibility in the calf muscles.
But it's not as easy as simply slapping a bag of frozen peas on your calf and leaving them there until you've had enough. In fact, using ice incorrectly can actually make things worse.
If using ice to treat calf muscle tears:
- If possible, use a specially designed oneice pack. If not, opt for frozen veggies or ice cubes
- Always wrap ice packs, cubes, or frozen vegetables in a towel—never place them directly on your skin
- Place the ice pack on the affected area for 10-15 minutes
- Always leave at least 2 hours between ice applications
- Try to apply ice at least 3-4 times a day for the first few days after the injury
Q. But after a calf muscle tear, can't I just leave the ice pack on for as long as I want?This is a clear no-go!
If you apply ice for too long it can:
- Causes an ice burn
- Prevent the "good" healing nutrients from reaching the torn muscle fibers, slowing healing
- Prevent the "bad" inflammatory chemicals and fluids from draining, which also slows healing
- When the blood vessels get too cold for too long, instead of constricting and reducing bleeding in that area, they actually dilate (widen), causing more blood and fluid to pool, just the opposite of what you want ice to do .
To learn more about how to use ice safely and effectively, visit theice treatmentSection.
Another useful tip in the initial stages of treating calf muscle tears is to wear a compression bandage such as a bandagetubigripor a specially developed calf bandage.
Tubigrip compression bandages help with:
- Reduce Swelling:by reducing blood flow to the calf and
- Offer help:on the pulled calf muscle, reducing the risk of further injury from overstressing the damaged muscle.
NB Tubigrip should not be worn at night.
To learn more about how tubigrip works and which size is right for you, check out ourtubigrip Compression bandageArticle.
Raising the calf area should be part of the treatment plan for any calf tear.
Elevating and supporting the injured calf above heart level will help reduce swelling as gravity pulls excess fluid away from the calf.
For the first few days after a calf muscle tear, always sit or lie down and support your leg instead of letting it hang down.
Top Tip:In this position, make sure that the back of your knee is supported, otherwise your knee will quickly become stiff and painful!
5. Heel pad
Heel pads are a MUST for anyone with a calf muscle strain. Wearing a heel pad in your shoe helps lift the heel and therefore reduces tension from the calf muscle. This reduces the risk of further injury and allows the calf tear to heal.
If you use heel pads to treat calf muscle tears, you really want adjustable heel pads.
You used to have to see a physical therapist or podiatrist for custom heel pads - I've done quite a few in my time!
But these days there are some really good, medically approved, adjustable heel pads that do a great job and just cost$10/£12 at Amazon.
The great benefit of adjustable heel pads is that you can adjust how much buoyancy there is under your heel, allowing you to control a lot of the tension you take off the injured calf muscle.
For the first few days after a calf muscle tear, you want to avoid any tension from the torn calf muscle to ensure the tear doesn't spread further. Therefore you will need a reasonable height of your heel pad, probably around 2.5 cm. .
Once the muscle begins to knit itself back together and the pain subsides, you can begin to gradually decrease the height of the heel pad. This helps to stretch the muscle very gently and ensure the muscle fibers heal in the correct position.
With adjustable heel pads, simply remove one of the layers and reduce the height depending on how your calf feels.
By slowly lowering the height of the heel pad, you give the muscle a chance to stretch properly without overloading it or risking further injury.
Top Tip:You should always wear a heel pad in both shoes, otherwise you will have one leg slightly longer than the other, which can lead to back and knee problems.
A simple but important and often underutilized aid in the treatment of calf muscle tears, heel pads are easy to obtainavailable at Amazon >
Your doctor may prescribe medications to reduce pain and inflammation as part of the treatment for your calf muscle tear.
Over-the-counter medications such as acetaminophen/acetaminophen are usually sufficient for a calf muscle strain.
Anti-inflammatory drugs such as Ibuprofen/Advil are NOT recommended for at least the first 2-3 days after a calf muscle tear as they are believed to slow healing.
Always consult your doctor before taking any medication.
You may need to use crutches for a few days to keep the weight off your leg and prevent further damage to tight calf muscles. If it is a grade 3 calf tear, it may take a few weeks before you are confident that you can do without crutches.
Crutches should be provided by a healthcare professional to ensure they are the right height for you and so they can teach you how to safely crutch your tight calf muscles.
Be sure to check out oursbest tipsto climb stairs with crutches.
8. Walker Boots
In some cases, your doctor may recommend that you wear a walking boot for calf tears for the first 3-4 weeks after a grade 2 or 3 calf tear.
A hiking boot keeps your ankle in a neutral position at 90 degrees and is said to speed healing and reduce the risk of further injury.
A torn calf hiking boot may also include a heel lift pad for added comfort. They cost around $40/£35 and are readily availableavailable at Amazon >
You can carry as much weight as you want through your injured leg and let pain guide you. People often use crutches with a walking boot initially, partly to take the weight off their strained calf muscles, but also to help balance as walking with your foot in a fixed position can feel a bit odd at first.
9. Calf exercises
Calf muscle tear rehabilitation is central to the treatment process and is really important to ensure you make a full recovery from your calf muscle tear.
In the early stages after a calf muscle strain, you need to rest and avoid engaging in activities that cause pain. The muscle fibers need time to heal and grow back together. Stressing them too soon will, at best, slow down healing, but can actually cause further damage and tears.
It is also very important to continue calf strain rehabilitation, even after your symptoms have resolved, until you have regained full strength and flexibility in your calf and feel confident doing all your usual activities. If you quit too soon, you are at high risk for future calf strains.
So what are the best exercises for calf muscle tear rehabilitation? Let's have a look.
The first phase of calf muscle tear rehabilitation is gentlemobility exercisesGet your knees, ankles and feet moving. This prevents the onset of stiffness and begins to get some movement through the injured calf muscle without overloading it.
These can be done anytime you are resting and you don't have to put any weight through the injured calf so there's no risk of making things worse.
strengthening exercisesare a really important part of treating calf muscle tears. Graduated strengthening exercises help to properly load and stress the muscles so they can heal properly without overloading them and causing more damage
if appropriate,resistance exercisese.g. The use of Theraband is important as it helps muscle fibers to align properly during healing and prevents scar tissue from forming.
Balance is often compromised by a strained calf muscle, leaving us more vulnerable to further injury in the future if not restored
A good test to see if you should include balance exercises in your calf muscle tear rehabilitation is to stand on one leg and see if you can maintain your balance. Compare how long you can stand on your injured leg with your uninjured leg.
If there is no difference, try again, but close your eyes this time - you will be amazed at how much harder it is!
The goal is to be able to stand on one leg with your eyes closed for about a minute.
calf stretching exercises
calf stretchesare one of the later parts of the treatment of calf muscle tears. You usually have to wait at least 2-3 weeks before starting calf stretches after a calf muscle strain.
A good test to see if you're ready to start calf stretches is to try pushing yourself onto your toes while standing. If there is no pain, repeat 20 times.
If there is still no pain, repeat, but this time stand only on the injured leg. If you can do this 20 times without pain, you can start calf stretching.
It's important to start calf stretches slowly, stretch each calf muscle separately, and perform stretches in a variety of positions, both loaded and unloaded, to regain full flexibility and function.
Once you regain strength and flexibility in your calf, you can begin activity-based exercises such as: You can do things like a static bike, leg press, and treadmill, and once you're comfortable, you can start jogging and then exercise.
Your doctor or physical therapist can advise you when you can start exercising again.
10. Friction massage
Deep transverse friction massage, also known as cross-friction massage, involves massaging across the affected area in a transverse direction. It helps maintain mobility, stretch the muscle, increase blood flow, prevent scar tissue and adhesion formation, and break down unwanted transverse fibers.
Cross friction massage should be performed by a physical therapist and is a truly effective treatment for calf muscle tears, regardless of the degree of the tear. The method used depends on what stage of calf tear regeneration you are at.
The deep transverse friction massage is different from a sports massage and should not be painful if done correctly.
Your physical therapist may also recommend ultrasound treatment for calf muscle tears to promote healing after a calf muscle strain.
Ultrasound is believed to help improve blood flow to the damaged calf area and break down any transverse fibers that have formed in the muscle, allowing the collagen fibers to heal in the correct alignment to ensure good strength and flexibility in the muscle.
The application is very similar to the ultrasound examination in pregnancy with gel, but a different frequency is used in the ultrasound treatment of the calf muscle tear.
12. Wadenriss Surgery
Surgery is rarely indicated to treat calf muscle tears because the muscles tend not to separate completely. In most cases, regardless of strength, the muscle will rebuild itself within a few weeks.
If this doesn't happen, or if the hernia severely impairs function, an orthopedic surgeon can sew the two pieces back together.
Which treatment is right for me?
As mentioned earlier, treatment for a calf muscle tear depends on how badly the muscle is torn and how quickly it heals.
First degree calf tear treatment
For a grade 1 calf muscle tear, treatment can usually be performed at home using a combination of the following:
- Rest:usually 2-3 days
- Heel Pad:not always needed
- Übungen:can usually start after 2-3 days
It usually takes 2-3 weeks to recover from a grade 1 calf tear. If things don't settle down, it's worth seeing a physical therapist as you could benefit from a friction massage and ultrasound.
Remember that you need to continue your exercises for about 3 months.
Treatment of grade 2 calf tears
During the recovery phase of a grade 2 calf muscle tear, treatment goes a bit further and typically includes:
- REIS:Rest (about 1 week), ice, compression & elevation
- Crutches:for the first few days
- Heel Pad:for about 2-4 weeks
- Walker Boots:in some cases
- calf exercises:can usually start after 5-7 days
- friction massage
- ultrasonic treatment
People usually need full rest for about a week, and it usually takes 6-12 weeks to recover from a grade 2 calf tear.
Again, you need to continue your calf muscle tear rehabilitation program for 3-4 months to ensure full calf tear recovery.
3rd degree calf tear treatment
Treatment for grade 3 calf muscle tears begins in the same way as for grades 1 and 2 tears, but healing takes longer and, in some cases, surgery may be required. Treatment for a grade 3 calf muscle tear usually consists of:
- REIS(rest, ice compression, elevation): typically for 1-2 weeks
- Crutches:2-4 weeks
- Walker Boots:2-4 weeks
- Heel Pad:usually 3-6 weeks
- Physical therapy:including Friction massage
- Rehabilitation Exercises:Follow the instructions of your physiotherapist
- Surgery:minority of cases
The recovery time for grade 3 calf tears is usually around 3 months, but it can take up to 6 months before they can fully return to competitive sports.
While a calf muscle tear in itself isn't usually a serious problem, there are a few things to look out for:
- Achillessehnenriss:Sometimes an Achilles tendon rupture is misdiagnosed as a calf tear. An Achilles tendon rupture is a much more serious condition that requires immediate medical intervention. If you are physically unable to stand on tiptoe, always consult your doctor for an evaluation.
- Deep vein thrombosis aka DVT:A calf muscle tear puts you at an increased risk of developing a blood clot due to bleeding in the calf area. Signs of DVT include severe calf pain, skin redness and warmth, swelling, throbbing/cramping sensation and tenderness to touch. A DVT is a medical emergency. So if you suspect you have one, you need to see a doctor right away.
What else can help?
A calf muscle strain is the most common cause of calf pain, especially in runners and athletes. Treating calf muscle tears early will help speed healing and reduce the risk of further injury.
Other causes of calf muscle pain include:
- calf muscle cramps
- Baker's cyst
- Achilles tendonitis
- Pinched nerve
- Calf muscle weakness and/or tightness
- peripheral vascular disease
You can learn much more about the causes, symptoms, diagnosis and treatment of each of these conditions in the Calf Muscle Pain section or via the links above.
The central theses
- A calf muscle strain is a common problem, especially among runners and athletes
- The sooner you start treating the calf muscle tear, the better your recovery will be
- Rest is the crucial first step when recovering from a calf tear. If you do too much too soon, you risk further damage
- The recovery time for calf tears is 2 weeks for a grade 1 calf tear and up to 3-6 months for a grade 3 calf tear
- Exercise is key during the recovery period from the calf muscle tear, and it's really important not to start stretching too soon
- There are a number of calf muscle tear treatment options that, when combined correctly, will in most cases result in a full recovery, allowing you to get back to doing the things you love.
Page last updated: 13.10.21
Next review due: 10/13/23
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Calf strains commonly affect the middle portion of the gastrocnemius. Strains of the soleus muscle are less common because it only crosses one joint (ankle) while the gastrocnemius crosses two joints (ankle and knee). The most common symptom is pain in the back of the lower leg or behind the knee.Can a torn calf muscle affect your knee? ›
Can calf pain cause problems anywhere else? You may feel some pain in the muscles around your knee, ankle or foot. This should improve as your calf problem gets better.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.Can tight calf muscle 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.Is the calf muscle connected to the 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).How long is recovery from gastrocnemius tear? ›
Grade I: Recovery from a grade I gastrocnemius tear can take up to two weeks. Grade II: Recovery from a grade II gastrocnemius tear can take several weeks. Grade III: Recovery from a grade III gastrocnemius tear can take a few months.How long should you stay off a torn calf muscle? ›
People typically need to rest completely for around a week and it usually takes 6-12 weeks to recover from a grade 2 calf tear. Again, you will need to continue with your calf muscle tear rehabilitation program for 3-4 months to ensure full calf tear recovery.Is it OK to walk with a torn calf muscle? ›
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.How long does a Grade 2 calf tear take to heal? ›
Grade 2: A moderate strain where more muscle fibers are torn but there is not a complete rupture. This usually takes 4-8 weeks for recovery and the individual can feel significant pain and loss of normal function of the calf muscle due to 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.
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 a torn meniscus affect your calf? ›
Many people with meniscus injury report cramping, or tight calves.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.Does strengthening calves help knee pain? ›
Just like the muscles of the thigh, muscles of your calves provide lots of support to your knee and strengthening them can alleviate knee pain.
- Rest. Take a break from your normal activities to reduce repetitive strain on your knee, give the injury time to heal and help prevent further damage. ...
- Ice. Ice reduces both pain and inflammation. ...
- Heat. ...
- Compression. ...
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.Is a pulled and torn calf muscle the same thing? ›
A pulled calf muscle occurs when you overstretch the muscles in the back of your lower leg. Also called calf muscle strains, this injury can involve mild overstretching or complete tearing of the muscle. Mild injuries usually improve with rest, ice, compression and elevation. A torn calf muscle may require surgery.Does the calf stabilize the knee? ›
These findings suggest that the calf muscles may function as dynamic knee stabilizers.How do you rehab a torn gastrocnemius? ›
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.How painful is a gastrocnemius tear? ›
A gastrocnemius rupture can result in significant pain, limping, and swelling of the posterior calf as well as substantial functional impairment. Proper diagnosis of this injury from other injuries in this anatomical area of the lower leg is essential to efficient management and recovery in athletes.
Severe calf injuries can result in a complete tear of the gastrocnemius muscle. There will be significant swelling and pain and a haematoma may develop. You may be unable to walk without help from crutches, even then it will be difficult to weight bear and many people choose to hop instead!How long before I can walk after a torn calf muscle? ›
Grade 1: sometimes referred to as a “mild” injury, a grade 1 calf strain is a minor tear in the muscle. This is the most common form of a calf strain and many individuals who experience it can still walk or move around. It typically takes 1-3 weeks to fully heal.What is a Grade 1 calf tear? ›
Grade I: A first degree or mild injury is the most common and the most minor. A sharp pain is felt at the time of injury or pain with activity. There is little to no loss of strength and range-of-motion with muscle fibre disruption of less than 10%. A return to sport would be expected within 1 to 3 weeks.How long does a Grade 3 calf tear take to heal? ›
They will be unable to continue the activity, and may not be able to move their calf muscle at all. If this is the case, visiting a doctor is the only option, and surgery is quite likely. The typical recovery time for a grade three strain is 3-4 months.Can you get a blood clot from a torn calf muscle? ›
Researchers found as many as 1 in 13 blood clots may be caused by small problems, such as muscle tears or ankle sprains.Why is the back of my leg hurting behind my knee? ›
The back of the knee may hurt when a person straightens their leg because of a variety of issues, including blood clots, muscle or tendon injuries, arthritis, or cysts. Physical therapy, rest, and pain medications are common treatments for many of these causes, but sometimes a person will need surgery treat the issue.What are the symptoms of a torn calf muscle? ›
- No calf strength, including being unable to balance or bear weight on the injured leg.
- Snapping or popping sensation in your calf.
- Sudden pain in the back of your lower leg, like someone kicked your calf.
- Swelling and bruising in your calf muscle.
A hamstring strain happens when the muscle is stretched too far. The muscle can completely tear, which can take months to heal. When you injure your hamstring muscle, you'll feel a sudden pain. Injuries to the biceps femoris — called biceps femoris tendinopathy — cause pain in the back of the knee.When the back of your leg hurts behind the knee? ›
The most common cause of pain behind the knee is a Bakers Cyst. A Bakers Cyst develops when excess fluid in the knee joint seeps out into the popliteal bursa causing it to swell. The main symptoms of a Bakers Cyst are tightness and pain behind the knee that gets worse when walking, kneeling, or bending the knee.