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Calf Strain Diagnosis

Calf muscle assessmentA thorough assessment is required to properly diagnose a calf strain injury. We outline some techniques a therapist may use to assess and diagnose a calf strain.

The following examples are for information purposes only. We highly recommend seeing a sports injury professional or Doctor to receive a full assessment of your injury.

Pain in the calf muscle is often due to a strain however there are other conditions which could cause similar symptoms, including deep vein thrombosis and contusions. A full assessment helps the therapist to determine the most likely cause of the pain.

Assessment of any injury should include questions concerning the patients general health, previous injuries and current injury. The aim of these questions is to determine which structure may be causing the pain and what treatment is appropriate. Following this, the therapist will perform a series of tests, often including:


  • Observation is usually the first point of any injury assessment.
  • The therapist usually observes the patient in both standing and laying positions, looking closely for swelling, bruising and deformity, as well as postural issues such as overpronation.


  • The therapist should palpate the entire calf area, looking for tight or painful areas.

Range of Motion

The therapist will usually assess both active (the patient moves) and passive (the therapist moves the joint) range of motion at the ankle with the knee both straight and then bent:

  • Calf strains usually present with pain and weakness on active plantarflexion.
  • Passive range of motion is usually pain-free as the muscles are not contracting, although the end of range into dorsiflexion (toes pointing upwards) may be painful as the muscles stretch.

Resisted Muscle Tests

  • These tests are used to assess muscular strength compared to the other side.
  • Again they should be tested with the knee straight and then bent:
  • The therapist applies resistance as the patient plantarflexes the ankle (points the foot away).
  • A positive result is pain on contraction and weakness compared to the other leg.

Special Tests

  • Thompson's test for complete muscle rupture.
  • The therapist squeezes the calf muscles observing for movement at the ankle into plantarflexion (pointing the toes away).
  • If no movement is seen, suspect a total rupture of one or both calf muscles.

Functional Tests

  • Assessing the ability to carry out the following tasks gives the therapist a clear picture about the patients current abilities.
  • They can also be used as objective markers to show progression once treatment and rehabilitation have been initiated:

Calf Raise

  • Single leg calf raise
  • Assess ability to hop on spot with one leg- only do so if previous tests have not proved conclusive or have not elicited any symptoms.

Additional imaging tests such as ultrasound and MRI may be needed to fully diagnose the injury.