Calf Strain Rehabilitation

A structured rehabilitation program is important for optimum recovery from a calf strain. Here we outline an example Calf strain rehabilitation program for grade 1, 2 and 3 injuries.

This rehabilitation programme is intended as a guide only. We recommend seeking professional advice before carrying out any form of exercise. All timelines are given as an indication only.

Mild Calf strain rehabilitation (grade 1)

This is a minor tear with up to 10% of the muscle fibres involved. If you are not sure what your injury is, read more on Calf strain diagnosis.

Stage 1: Days 0 from time of injury

  • Rest as much as possible.
  • Apply ice or even better a cold therapy and compression wrap – this should be applied for 15 minutes every 2-3 hours.
  • Make sure you wrap the ice in a wet towel to prevent skin burns.
  • Apply a compression bandage, calf support or elastic tubi-grip type bandage to help reduce swelling and bleeding.
  • Elevate your leg. Put your feet up and read about treatment and exercises for calf strains. Elevating the leg will help swelling and blood run away from the injured muscle.

Stage 2: Days 3 since injury

  • If it is comfortable, do gentle stretching exercises.
  • Start with active stretching. If an exercise is painful do not do it.
  • If available, begin very gentle massage.
  • Electrotherapy such as ultrasound may also be beneficial in reducing swelling and relaxing the muscle.
  • Continue to rest from any aggravating activities.
  • Keep wearing a compression bandage or calf support.

Stage 3: Days 7 since injury

  • Continue to stretch on a daily basis. A calf stretcher is a useful piece of kit which can help improve calf muscle flexibility, especially in the later stages of rehabilitation.
  • If available, continue with sports massage. As your muscle gets stronger then massage techniques will become deeper and the time between treatments longer.
  • Begin strengthening exercises. Resistance bands should be used initially, followed by calf raises and then eventually single leg calf raises. Remember not to do any exercises if they are painful.
  • Once you can achieve 3 sets of 20 single leg calf raises pain-free, gradually incorporate running into your rehab program.
  • Eventually, plyometrics or hopping exercises should be done to return to full match fitness and prevent the injury recurring.

Moderate Calf strain rehabilitation (grade 2)

This is a more severe tear involving up to 90% of the muscle fibres. If you are not sure what your injury is, read more on Calf strain diagnosis.

Stage 1: Days 0

  • Rest as much as possible – use crutches if necessary.
  • Ice – this should be applied for 15 minutes every 2-3 hours.
  • Make sure you wrap the ice in a wet towel to prevent skin burns.
  • Compression – apply a compression bandage or tubi-grip bandage to help reduce swelling and bleeding.
  • Elevation – put your feet up and read about treatment and rehabilitation of your injury. Elevating the leg will help swelling and blood run away from the injured muscle.
  • Once it is comfortable to do so, perform some active stretches. Pull your toes towards you, hold for 2-3 seconds and then relax and repeat 10-20 times.
  • If you are walking, try using heel pads to temporarily shorten the calf muscles. This takes some of the strain off them.

Stage 2: Days 7

calf support for calf strain rehabilitation
  • Continue to wear the compression bandage. Continue to rest from any aggravating activities.
  • If it is comfortable to do so try to gently stretch both calf muscles 3-5 times a day.
  • Instead of icing, try alternating hot and cold for 5 minutes each, for 20-30 minutes 3 times a day.
  • Visit a sports injury professional for a sports massage. Electrotherapy may also be beneficial.

Stage 3: Days 14

  • Start to gently strengthen the calf muscles if it is comfortable to do so.
  • Begin with resistance band plantarflexion. Then progress to calf raises, then single leg calf raises.
  • Continue to stretch regularly.
  • Keeping having regular massage if it is available.
  • Gradually incorporate some running into your program once you can achieve 3 sets of 20 single-leg calf raises, pain-free!

Severe calf strain rehabilitation

This is a very severe strain with most if not all of the muscle torn.

  • Stop playing and apply the PRICE principles immediately (protection, rest, ice, compression and elevation).
  • If you are concerned that the muscle may be ruptured, go straight to a Doctor or Hospital. You may need surgery to repair the ruptured muscle.
  • If your muscle is not completely torn, follow the grade 2 calf strain rehabilitation program when pain allows.

Expert interviews: Calf strain rehabilitation

Early-stage

Physiotherapy Consultant Neal Reynolds explains the early stages of calf muscle rehabilitation.

video
This article has been written with reference to the bibliography.