Nov 2013 16

Runners injuries - calf strain

By: Dave Wheeler

Probably the single biggest problem that runners come to me for is treatment for a calf strain.

A muscle strain is a tear in the muscle itself.  Strains can happen when the force applied to the muscle is greater than the muscle’s strength and occurs when you forcefully stretch a muscle beyond its range of movement. Not all strains are the same, even calf strains – they’re graded according to the severity of the tear:

Grade 1 – with this strain you’ll just feel a twinge in the calf muscle.  You’ll probably carry on running and hope for the best (even though really, that’s not a great idea).  You’ll probably find that your calf muscle aches and feels tight for 2-5 days until it sorts itself out.  If you’re lucky, that’ll be an end to it and you’ll be able to take up running again.

The problem is that the where the muscle’s torn, it’s now weakened, and if you carry on doing what you did before, then it’ll tear again.  And again.  And again.  And each time the tear will get a little bit worse.

Grade 2 – here you’ll feel a sharp pain in your calf muscle whilst you’re running.  You might be able to continue with your run, but it’ll hurt… even if you walk you’ll find it’s still painful.  You may well notice swelling, even bruising appear, and the ache in your calf is likely to last about a week.

Going back to running once it feels better is likely to mean that it just tears again, so it’s really not a good idea without getting yourself treated first.

Grade 3 – this is severe and immediate.  You won’t be able to keep running, and it will probably hurt like hell even when you walk on it.  You’ll see swelling, then bruising, and you may even be able to see a lump where the muscle’s been damaged.


Treatment - The first 48 hours

The first 48 hours are called the acute stage.  The correct treatment is RICE:


Rest means stop.  Stop running; preferably stop walking. 


Ice means a bag of frozen peas, wrapped in a tea-towel applied to your injured calf for 4 mins at a time; do this at least 4 times throughout the day for a couple of days (7 times a day would really be ideal).  Remember to bin the peas afterwards.. don’t give yourself food poisoning by trying to eat them!


Compression means get yourself a support bandage from Boots or another chemist, to keep the swelling in check.


Elevation means keep your leg raised (supported) to reduce the blood flowing to the area, again, to reduce the swelling.

During this acute phase, don’t be tempted to massage your calf muscle – let the immediate damage heal.


Treatment – post-acute phase

Once any immediate swelling has gone down, you’ve got 2 choices: start running again and hope for the best, or get professional treatment to reduce the risk of repeat injury.

Obviously, I’m hoping that you opt for treatment. If you do, then make sure that you go to a soft tissue therapist who’s qualified and experienced at treating calf injuries – specifically, a Remedial & Sports Massage Therapist. 

The first thing a good therapist will do is identify which of the calf muscles has been damaged. Sound obvious? There are actually 2 calf muscles: the gastrocnemius which gives the calf its defined shape, and the bulkier soleus which lies underneath the gastrocnemius closer to the bone.  Your massage therapist should know how to access each of these muscles separately so that the right part of your calf is treated.  A combination of remedial treatment techniques, together with deep tissue massage will be needed on whichever of these 2 muscles has been damaged – the treatment will vary depending on how severe the muscle tear is.  A good massage therapist will help you with a regime (including stretching!) to avoid re-injury.

A question people often ask is, “how many treatments will I need?”  

The answer is going to depend on how bad the strain is, the general condition of your calf muscles, and how old you are… but typically a couple of treatments for a mild strain, or 3 for a moderate one, should see you back out running again without too many problems.

If you think I can help, give me a call.