Both stretching, strengthening and sports specific exercises are important for recovering from calf strain injuries.
When can I begin exercises?
- Rehabilitation exercises can begin once the initial acute phase has passed and pain allows.
- This may be a couple of days or longer depending on the injury.
The following is for information purposes only. Always consult a professional before attempting self-treatment.
Calf stain stretching exercises
- A good starting point is to assess the flexibility of the calf muscles.
- One method of assessing calf muscle flexibility is to apply gentle pressure to the forefoot with the patient sitting with the leg out straight in front.
- There will be a point where the resistance noticeably increases as the muscle begins to stretch.
- It is likely the therapist will feel this before the patient feels a stretch on the calf muscles.
Active calf stretch
- Active stretching is used in the early stages of a calf injury as it applies only a gentle stretch to the muscle.
- Muscles work in pairs and by contracting the muscles in the front of the lower leg, the muscles at the back must relax.
- In order to stretch the gastrocnemius, sit on the floor or a chair with the leg straight out in front of you. Pull the toes and foot back towards you, hold for a couple of seconds and relax. Repeat this 10-20 times.
- To stretch the soleus muscle, sit with the knees bent and feet on the floor. Raise the toes and foot up towards you, keeping the heel on the floor. Hold for a couple of seconds, relax and repeat 10-20 times.
- To stretch the big gastrocnemius muscle the back leg must be kept straight.
- Stand with the leg to be stretched at the back and hands on a wall at shoulder height.
- Bend the front knee and lean forward, keeping the back knee straight and pushing the heel down into the floor.
- When you can feel a stretch, hold for 20 seconds.
- If the stretch eases, lean further forwards until you can feel it again. But do not push too far in the early stages.
- Perform 3 repetitions and repeat this 3-5 times a day.
Soleus muscle stretch
- To stretch the deeper soleus muscle the knee of the leg to be stretched needs to be bent.
- This is because the soleus muscle attaches below the knee and bending the knee allows the gastrocnemius muscle to relax leaving the soleus on stretch.
- Lean against a wall with the leg to be stretched at the back.
- Bend the knee keeping the heel in contact with the ground until a stretch is felt.
- Hold for 15 to 20 seconds and repeat three times.
- If a stretch is not felt then another method is to place the ball of the foot against the wall and bend the front knee until a stretch is felt.
Stretching on a step
- As flexibility increases or if you have particularly flexible calf muscles it may be better to stretch using a step. Lower the heel off the step dropping down until a stretch is felt.
- Hold for 15 to 20 seconds for 3 repetitions and repeat 3 to 5 times a day. The soleus muscle can be stretched similarly but with the knee of the leg to be stretched kept bent.
Plantar flexion with band
- This is a gentle exercise to start with using a rehab or rubber resistance band.
- It is more suitable in the very early stages of rehab as long as pain allows after a severe contusion.
- Hold a loop of resistance band and use it to apply resistance as you point the foot away or plantarflex the foot.
- Start with just 2 sets of 10 once a day and build up to 3 sets of 20 twice a day.
- If it does not hurt the next day then increase the resistance by shortening the section of band.
- If there is any pain during, after or the next day then reduce the load or rest a bit longer.
Seated calf raise
- This is a gentle exercise that will strengthen the soleus muscle which is the smaller muscle lower down.
- This is also an early stage rehab exercise as it can be done with no weight at all, to begin with, if necessary.
- Sit on a chair with the knees bent and lift your heels off the ground as high as possible.
- Resting a weight on the knees will increase the resistance.
- Start with 2 sets of 10 once a day and increase a little every two or three days when you are sure there has been no adverse reaction (pain).
- Stand on a step with the heels off the back of the step making sure you have something to hold onto for balance.
- Lower the heels just below the step then raise up onto tiptoes.
- Start with 2 sets of 10 reps provided it is pain-free and gradually build up to 3 sets of 20 reps.
- If after a few days this feels easy, transfer more of your weight on to the injured leg and then go on to single leg calf raises.
- This exercise can also be done leaning against a wall if a suitable step is not available.
- To isolate the soleus muscle the calf raise exercise can be done as above but with the knee bent to 45 degrees which puts more load onto the soleus muscle.
- This exercise is more suitable for the later stages of rehabilitation when the athlete is attempting to return to more specific sports training.
- The athlete steps back and then in one movement steps back onto the step.
- This is a more explosive, plyometric exercise related to the specific demands of sport. It works the calf muscle eccentrically during the stepping back phase and plyometrically as they push off.
- The athlete should be capable of normal running before starting this exercise.
- Alternate so both legs are exercised and do not do any more on the good leg than you can achieve with the injured leg.