Pulled Calf Muscle

What is a pulled calf muscle?

A pulled calf muscle, or a calf muscle strain, occurs when the muscles in your calf — the soleus and gastrocnemius — get overstretched.

The calf muscles are in your lower leg behind your shin bone and extend from the base of your thigh down to your heel. They help you flex and bend your foot, ankle and knee. A calf strain can cause pain and prevent you from running, jumping and doing other activities.

A severely pulled calf muscle can result in partial or complete tears. A torn calf muscle may require surgery.

Is a strain the same as a sprain?

A calf strain isn’t a sprain. Strains are injuries to muscles or tendons (tissues that attach muscles to bones). Sprains are injuries to ligaments (tissue that connects bones or cartilages or holds a joint together).

Who gets pulled calf muscles?

Anyone can get a pulled calf muscle. But these strains are more common in athletes who perform lots of stop-and-go movements with quick bursts of speed. Sprinters, football players, soccer players and tennis players are prone to pulled calf muscles. Sometimes the injury is called “tennis leg.”

Other risk factors for pulled calf muscles include:

• Age: People over 40 may be more likely to get strains during physical activity.
• Sex: Some studies suggest that men are more likely to get calf muscle injuries.
• Lack of conditioning: It’s important to warm up and stretch before physical activity and condition your muscles before the start of a sports season.
• Muscle quality: People with tight or short calf muscles have a higher risk of calf strains.

How common are pulled calf muscles?

One study estimated that calf strains make up about 1.3% of all lower limb injuries in runners. Another study of soccer players identified gastrocnemius strains as making up 12% of all muscle injuries. Gastrocnemius strains (near the middle of the calf) are more common than soleus strains (the lower calf, closer to the heel).

What causes pulled calf muscles?

Calf muscle strains usually occur when someone suddenly moves or overstretches their calf after standing still. Quick pivots, jumps or abrupt stops can cause strains. This injury is especially common when your toes get forced upward (toward your body) and your ankle pulls your calf muscles down too quickly.

What are the symptoms of a pulled calf muscle?

A pulled calf muscle can cause:

• Difficulty tensing your calf muscles or standing on toes.
• Muscle pain when flexing your ankle or pointing your toes.
• Problems bending your knee.
• Snapping or popping sensation in your calf.
• Sudden pain in the back of your lower leg.
• Swelling in your calf muscle.
• Bruising on your calf muscle.

Most people with a pulled calf muscle report not being able to continue with their activity immediately following the injury.

How are pulled calf muscles diagnosed?

Your healthcare provider will perform a physical exam and review your symptoms. It’s important to describe in detail how you got the injury and how your calf felt immediately after the injury. This information can help your healthcare provider make a diagnosis.

You may need imaging exams to determine if there are any partial or complete tears in your calf muscles. These tests can also rule out other conditions that cause lower leg pain, such as Achilles tendon ruptures or deep vein thrombosis (DVT). Research shows that up to 10% of people with symptoms of calf pulls actually have DVT, which can be a life-threatening condition.

Your healthcare provider may perform a/an:

• Ultrasound, to check for tears or fluid buildup around the calf muscles.
• MRI, to check for blood clots, a tear, or internal bleeding.

How are pulled calf muscles treated?

Immediate treatment for pulled calf muscles usually includes RICE, which stands for:

• Rest: Stop running or physical activity to avoid further damaging the calf.
• Ice: Apply an ice pack or cold compress for 20 minutes every two hours. Don’t apply ice directly to your skin.
• Compression: Reduce swelling and fluid buildup by applying a compression bandage or wrap to the injured area.
• Elevation: Lift your leg into an elevated position, preferably above the level of your heart. Support the entire length of your leg with pillows, blankets or cushions.

You can perform RICE at home, but it’s always good to check in with your healthcare provider about any special instructions.

Avoid:

• Applying heat to the injured area.
• Drinking alcohol.
• Massaging the calf.
• Walking or performing physical activity.

Once your healthcare provider diagnoses your injury, they may recommend additional treatments such as:

• Pain relievers.
• Soft cast or boot to keep your lower leg from moving.

Will I need surgery for a pulled calf muscle?

Complete calf muscle tears usually require surgery. A surgeon makes an incision in your calf and reattaches the two ends of your muscle with stitches. You need general anesthesia for this procedure and may need to stay in the hospital for a few days.

After surgery, you may wear a cast in plantarflexion for three weeks, and then a gentle dorsiflexion stretch cast for another three weeks. You use crutches or an assistive device to move around.

Once the cast is off, your healthcare provider will tell you when you can resume light physical activity.

How can I prevent a pulled calf muscle?

You can reduce your risk of a pulled calf muscle by:

• Keeping your calf muscles strong and conditioned.
• Stretching routinely.
• Not pushing through pain.
• Resting and recovering between workouts.
• Using proper technique when playing sports.
• Warming up and stretching your calf muscles before physical activity.
• Wearing supportive footwear that fits properly.

What’s the prognosis (outlook) for people with pulled calf muscles?

Most people recover fully from pulled calf muscles without any permanent damage. Ask your healthcare provider when you can gradually start to do light activities again. Depending on the severity of your injury, it may be several weeks before you can return to full activities.

Recovery after surgery can take up to six months. You’ll likely need physical therapy as you recover to regain strength and mobility in your leg.

Once you’ve had a pulled calf muscle, you have a higher risk for future strains in that area. Reduce your risk of reinjury by allowing your injury to fully heal before getting back to normal activities.

When should I contact my doctor?

Contact your doctor if you:

• Are unable to walk or bear weight on your leg.
• Can’t bend or flex your ankle or knee.
• Have severe pain in your calf.
• Notice swelling in your lower leg, foot or ankle.

A note from Cleveland Clinic

A pulled calf muscle happens when you overstretch the muscles in the back of your lower leg. It’s a common injury with athletes that do a lot of stop-and-go movements, but it can also affect older, active individuals. Most calf strains heal with rest, ice, compression and elevation. In rare cases, calf muscle tears require surgery.