Table of ContentsView AllTable of ContentsTypesRisk FactorsWhen to See a ProviderTreatmentOther Causes
Table of ContentsView All
View All
Table of Contents
Types
Risk Factors
When to See a Provider
Treatment
Other Causes
Acalf muscle strainis a tear in the calf muscle. It can be minor or severe. Symptoms vary depending on how bad the injury is, and treatment also depends on severity.
Other reasons forcalf paincan include serious conditions likeperipheral artery disease, nerve damage, trauma, ordeep vein thrombosis(DVT), a blood clot that may occur in the calf.
This article outlines types of calf muscle injuries and how they are treated.
Verywell / Kelly Miller
Types of Calf Strains (Tears)
Muscle strains and muscle tears are the same thing. These injuries can be mild or severe and can affect muscles and/or tendons, which attach muscle to bone. Strains are different from sprains, which are injuries to the ligaments that attach bone to bone.
A calf strain occurs when fibers of themuscles of the lower legare overstretched. This can happen when you’re increasing your speed, or if you change direction suddenly while running.Calf strains may be minor or severe, and most commonly occur in thegastrocnemiusmuscle rather than thesoleus, which lies beneath it.
Calf strains are classified into three grades:
Grade 1 Strain
The type of strain happens when a stretch causes small micro-tears in the muscle fibers.
The main symptom of a grade 1 strain is pain, but the pain doesn’t usually interfere with activity. Full recovery takes about two weeks.
Grade 2 Strain
This strain involves a partial tear of the muscle fibers. You’ll need to limit activity, but full recovery takes approximately five to eight weeks.
A grade 2 strain can cause symptoms like:
Grade 3 Strain
This is the most severe calf strain, and involves a complete tear or rupture of the affected muscle fibers. Full recovery can take three to four months and, in some instances, surgery may be needed.
A grade 3 strain may make a popping sound when the injury occurs. Symptoms include:
Plantaris Muscle Pain: Strains and Tears at the Back of the Leg
1:23Click Play to Learn About Treating a Pulled Calf Muscle
1:23
Click Play to Learn About Treating a Pulled Calf Muscle
Risk Factors for Calf Strains and Tears
Playing sports and engaging in other activities puts you at higher risk of strains and sprains. Your risk increases if you haven’t had much conditioning prior to engaging in higher risk activities.
Research suggests that you are more likely to experience a calf strain as you get older. Having a calf strain in the past also puts you at higher risk for experiencing future calf strains.
Other types of leg injuries including hamstring, quadriceps, knee, and adductor injuries are also associated with calf strain risk.
6 Common Reasons for Calf Pain While Walking—And How to Address Them
When to See a Healthcare Provider
See your healthcare provider if you have other symptoms with calf pain, such as:
Seeing a healthcare provider and aphysical therapistcan help ensure a proper diagnosis and fast rehabilitation. Taking steps to heal properly can help to make sure you regain full function of your injured muscles and prevent future strains.
When Should You Worry About Calf Pain? (and What to Do Next)
Treatment for Calf Strains
Minor calf strains can be managed at home. If your tear is more severe, your healthcare provider and/or physical therapist can create a treatment plan to help speed your recovery.
RICE Treatment
The initial treatment for a calf strain isR.I.C.E. (rest, ice, compression, elevation), used in the first three to five days after the injury:
Physical Therapy
Some calf strains need more than simply the R.I.C.E. protocol. Depending on how bad your injury is, you may need rehabilitation with a physical therapist. Your physical therapist may recommend certain exercises, including:
Be sure to follow the advice of your therapist when beginning these exercises.
The goal of rehabilitation is to return to normal activity as quickly as possible without long-term effects. If you return too soon, you risk developing a chronic injury. Keep in mind that everyone recovers at a different rate. Your rehab needs to be tailored to your needs and your progress, not the calendar.
In severe cases, your healthcare provider might recommend a walking boot. Rarely, surgery is needed to repair the muscle.
Medication
For pain relief, your healthcare provider may suggest taking an over-the-counteranti-inflammatory medicationlike Advil (ibuprofen) for up to three days to reduce pain and swelling.If your pain persists, they may recommend a prescription NSAID.
Other Causes of Calf Pain
Tennis Leg
Tennis leg is usually a sports-related injury, and it most commonly affects people who are middle-aged. You may feel sudden, severe (acute) pain in the middle of your calf and you may feel a snapping sensation and/or hear a snapping sound.
It is usually a tear of the gastrocnemius muscle, and it can also occur due to a fluid collection between the gastrocnemius and the soleus muscle.
About 10% of people who experience tennis leg symptoms actually have a blood clot, not a calf strain. This is why it’s so important to have an accurate diagnosis.
Calf Muscle Cramp
A far less severe but often painful cause of calf pain is a muscle cramp, or spasm.This involuntary contraction of a muscle is short-lived, but it may be so strong that it causes a bruise.
Dehydration and electrolyte imbalances may be a factor in calf pain, especially cramps related to running or similar exercise activity.Research suggests there may be other reasons for cramping calf pain, however.It’s healthy to stay hydrated, but it may not be the only reason why you have muscle cramps.
How to Treat and Prevent Leg Cramps
What causes calf muscle pain at night?Exercise overuse, medications and alcohol, and dehydration all may contribute to calf muscle pain at night.This pain shouldn’t last more than a few minutes, and it’s not the same as restless legs syndrome. Contact your healthcare provider to discuss your symptoms if it happens often, or if you have pain when sitting or at rest during the day.
What causes calf muscle pain at night?
Exercise overuse, medications and alcohol, and dehydration all may contribute to calf muscle pain at night.This pain shouldn’t last more than a few minutes, and it’s not the same as restless legs syndrome. Contact your healthcare provider to discuss your symptoms if it happens often, or if you have pain when sitting or at rest during the day.
Calf Muscle Bruise
A direct blow to your calf may cause a contusion (bruise) as blood pools in the area. Most muscle bruises are mild and can be treated with the R.I.C.E protocol and NSAID pain relief.
Blood Clot
A serious cause of acute calf pain may be a deep veinthrombosis(DVT), a blood clot in a vein. Along with pain, a DVT can cause:
Clots can break loose and travel to the lungs, which is serious and life-threatening.
If your healthcare provider suspects a DVT in your leg, they will order an ultrasound of your leg to confirm the diagnosis. A blood clot requires immediate therapy with a blood thinner.
It can be tricky to tell the difference between a muscle or tendon injury, which is why it is important to see a healthcare provider for acute calf pain.
How Deep Vein Thrombosis Is Diagnosed
Baker’s Cyst
ABaker’s cystis a fluid-filled sac that usually forms as a result of arthritis in the knee joint. It may cause swelling or achiness, or no symptoms at all. A large or ruptured Baker’s cyst can cause calf pain or swelling.
Usually, Baker’s cysts resolve on their own, but sometimes a steroid injection in the joint can reduce swelling and discomfort.Surgery is needed in rare cases.
Achilles Tendon Injury
The Achilles tendon is the largest tendon in the human body. It connects the heel of the foot to both the gastrocnemius and the soleus. A tear orrupture of the Achilles tendoncauses acute pain at the back of the ankle or lower leg below the calf muscle. In some cases, an audible “pop” or “snap” may be heard.
If you believe you may have injured your Achilles tendon, apply ice and elevate your leg right away. You will need to see a healthcare provider to determine whether or not the tendon is intact and whether surgery is needed.
Summary
For athletes, calf muscle strains are common—but treatable—injuries. However, calf pain can have a number of causes, and some, like a blood clot, are serious.
If you believe you may have strained your calf muscle, remember to use the R.I.C.E. protocol and to contact your healthcare provider. They will help to determine whether additional treatments are necessary to help you recover from your injury.
They can also rule out serious conditions that may be causing your calf pain.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Leow KS, Chew KM, Chawla A, Lim TC.Sonographic assessment of musculoskeletal causes of calf pain and swelling.Emerg Radiol. 2019;26(3):349-359. doi:10.1007/s10140-019-01680-5Green B, Pizzari T.Calf muscle strain injuries in sport: A systematic review of risk factors for injury.Br J Sports Med. 2017;51(16):1189-1194. doi:10.1136/bjsports-2016-097177Grassi A, Quaglia A, Canata GL, Zaffagnini S.An update on the grading of muscle injuries: A narrative review from clinical to comprehensive systems.Joints. 2016;4(1):39–46. doi:10.11138/jts/2016.4.1.039Green B, Pizzari T.Calf muscle strain injuries in sport: a systematic review of risk factors for injury.Br J Sports Med. 2017;51(16):1189-1194. doi:10.1136/bjsports-2016-097177National Health Service.Calf problems.Hotfiel T, Seil R, Bily W, et al.Nonoperative treatment of muscle injuries - recommendations from the GOTS expert meeting.J Exp Orthop. 2018;5(1):24. doi:10.1186/s40634-018-0139-3American Physical Therapy Association.Physical therapy guide to calf strain.Harwin JR, Richardson ML.“Tennis leg”: Gastrocnemius injury is a far more common cause than plantaris rupture.Radiol Case Rep. 2016;12(1):120–123. doi:10.1016/j.radcr.2016.10.012Lau WY, Kato H, Nosaka K.Water intake after dehydration makes muscles more susceptible to cramp but electrolytes reverse that effect. BMJ Open Sport Exerc Med. 2019;5(1):e000478. doi:10.1136/bmjsem-2018-000478Maughan RJ, Shirreffs SM.Muscle cramping during exercise: Causes, solutions, and questions remaining.Sports Med. 2019;49(S2):115-124. doi:10.1007/s40279-019-01162-1Sleep Foundation.What causes leg cramps at night?American Academy of Orthopaedic Surgeons.Muscle contusion (bruise).Frush TJ, Noyes FR.Baker’s cyst: Diagnostic and surgical considerations.Sports Health. 2015;7(4):359-65. doi:10.1177/1941738113520130Boyd RP, Dimock R, Solan MC, Porter E.Achilles tendon rupture: How to avoid missing the diagnosis.Br J Gen Pract. 2015;65(641):668-9. doi:10.3399/bjgp15X688069
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Leow KS, Chew KM, Chawla A, Lim TC.Sonographic assessment of musculoskeletal causes of calf pain and swelling.Emerg Radiol. 2019;26(3):349-359. doi:10.1007/s10140-019-01680-5Green B, Pizzari T.Calf muscle strain injuries in sport: A systematic review of risk factors for injury.Br J Sports Med. 2017;51(16):1189-1194. doi:10.1136/bjsports-2016-097177Grassi A, Quaglia A, Canata GL, Zaffagnini S.An update on the grading of muscle injuries: A narrative review from clinical to comprehensive systems.Joints. 2016;4(1):39–46. doi:10.11138/jts/2016.4.1.039Green B, Pizzari T.Calf muscle strain injuries in sport: a systematic review of risk factors for injury.Br J Sports Med. 2017;51(16):1189-1194. doi:10.1136/bjsports-2016-097177National Health Service.Calf problems.Hotfiel T, Seil R, Bily W, et al.Nonoperative treatment of muscle injuries - recommendations from the GOTS expert meeting.J Exp Orthop. 2018;5(1):24. doi:10.1186/s40634-018-0139-3American Physical Therapy Association.Physical therapy guide to calf strain.Harwin JR, Richardson ML.“Tennis leg”: Gastrocnemius injury is a far more common cause than plantaris rupture.Radiol Case Rep. 2016;12(1):120–123. doi:10.1016/j.radcr.2016.10.012Lau WY, Kato H, Nosaka K.Water intake after dehydration makes muscles more susceptible to cramp but electrolytes reverse that effect. BMJ Open Sport Exerc Med. 2019;5(1):e000478. doi:10.1136/bmjsem-2018-000478Maughan RJ, Shirreffs SM.Muscle cramping during exercise: Causes, solutions, and questions remaining.Sports Med. 2019;49(S2):115-124. doi:10.1007/s40279-019-01162-1Sleep Foundation.What causes leg cramps at night?American Academy of Orthopaedic Surgeons.Muscle contusion (bruise).Frush TJ, Noyes FR.Baker’s cyst: Diagnostic and surgical considerations.Sports Health. 2015;7(4):359-65. doi:10.1177/1941738113520130Boyd RP, Dimock R, Solan MC, Porter E.Achilles tendon rupture: How to avoid missing the diagnosis.Br J Gen Pract. 2015;65(641):668-9. doi:10.3399/bjgp15X688069
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Leow KS, Chew KM, Chawla A, Lim TC.Sonographic assessment of musculoskeletal causes of calf pain and swelling.Emerg Radiol. 2019;26(3):349-359. doi:10.1007/s10140-019-01680-5Green B, Pizzari T.Calf muscle strain injuries in sport: A systematic review of risk factors for injury.Br J Sports Med. 2017;51(16):1189-1194. doi:10.1136/bjsports-2016-097177Grassi A, Quaglia A, Canata GL, Zaffagnini S.An update on the grading of muscle injuries: A narrative review from clinical to comprehensive systems.Joints. 2016;4(1):39–46. doi:10.11138/jts/2016.4.1.039Green B, Pizzari T.Calf muscle strain injuries in sport: a systematic review of risk factors for injury.Br J Sports Med. 2017;51(16):1189-1194. doi:10.1136/bjsports-2016-097177National Health Service.Calf problems.Hotfiel T, Seil R, Bily W, et al.Nonoperative treatment of muscle injuries - recommendations from the GOTS expert meeting.J Exp Orthop. 2018;5(1):24. doi:10.1186/s40634-018-0139-3American Physical Therapy Association.Physical therapy guide to calf strain.Harwin JR, Richardson ML.“Tennis leg”: Gastrocnemius injury is a far more common cause than plantaris rupture.Radiol Case Rep. 2016;12(1):120–123. doi:10.1016/j.radcr.2016.10.012Lau WY, Kato H, Nosaka K.Water intake after dehydration makes muscles more susceptible to cramp but electrolytes reverse that effect. BMJ Open Sport Exerc Med. 2019;5(1):e000478. doi:10.1136/bmjsem-2018-000478Maughan RJ, Shirreffs SM.Muscle cramping during exercise: Causes, solutions, and questions remaining.Sports Med. 2019;49(S2):115-124. doi:10.1007/s40279-019-01162-1Sleep Foundation.What causes leg cramps at night?American Academy of Orthopaedic Surgeons.Muscle contusion (bruise).Frush TJ, Noyes FR.Baker’s cyst: Diagnostic and surgical considerations.Sports Health. 2015;7(4):359-65. doi:10.1177/1941738113520130Boyd RP, Dimock R, Solan MC, Porter E.Achilles tendon rupture: How to avoid missing the diagnosis.Br J Gen Pract. 2015;65(641):668-9. doi:10.3399/bjgp15X688069
Leow KS, Chew KM, Chawla A, Lim TC.Sonographic assessment of musculoskeletal causes of calf pain and swelling.Emerg Radiol. 2019;26(3):349-359. doi:10.1007/s10140-019-01680-5
Green B, Pizzari T.Calf muscle strain injuries in sport: A systematic review of risk factors for injury.Br J Sports Med. 2017;51(16):1189-1194. doi:10.1136/bjsports-2016-097177
Grassi A, Quaglia A, Canata GL, Zaffagnini S.An update on the grading of muscle injuries: A narrative review from clinical to comprehensive systems.Joints. 2016;4(1):39–46. doi:10.11138/jts/2016.4.1.039
Green B, Pizzari T.Calf muscle strain injuries in sport: a systematic review of risk factors for injury.Br J Sports Med. 2017;51(16):1189-1194. doi:10.1136/bjsports-2016-097177
National Health Service.Calf problems.
Hotfiel T, Seil R, Bily W, et al.Nonoperative treatment of muscle injuries - recommendations from the GOTS expert meeting.J Exp Orthop. 2018;5(1):24. doi:10.1186/s40634-018-0139-3
American Physical Therapy Association.Physical therapy guide to calf strain.
Harwin JR, Richardson ML.“Tennis leg”: Gastrocnemius injury is a far more common cause than plantaris rupture.Radiol Case Rep. 2016;12(1):120–123. doi:10.1016/j.radcr.2016.10.012
Lau WY, Kato H, Nosaka K.Water intake after dehydration makes muscles more susceptible to cramp but electrolytes reverse that effect. BMJ Open Sport Exerc Med. 2019;5(1):e000478. doi:10.1136/bmjsem-2018-000478
Maughan RJ, Shirreffs SM.Muscle cramping during exercise: Causes, solutions, and questions remaining.Sports Med. 2019;49(S2):115-124. doi:10.1007/s40279-019-01162-1
Sleep Foundation.What causes leg cramps at night?
American Academy of Orthopaedic Surgeons.Muscle contusion (bruise).
Frush TJ, Noyes FR.Baker’s cyst: Diagnostic and surgical considerations.Sports Health. 2015;7(4):359-65. doi:10.1177/1941738113520130
Boyd RP, Dimock R, Solan MC, Porter E.Achilles tendon rupture: How to avoid missing the diagnosis.Br J Gen Pract. 2015;65(641):668-9. doi:10.3399/bjgp15X688069
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