You have been treated for Acute Calf Strain. You have been thoroughly examined and are now considered fit to be discharged. The following will aid your recovery.
Care Instructions for Acute Calf Pain
A strain occurs when a portion of the calf muscle tears, resulting in pain on walking or pulling the foot upwards. It usually takes about 6 weeks to heal, depending on the severity of the injury.
Treatment of acute calf strain can be described in three stages:
Early Stage – Up to 2 days after injury
The healing process begins with inflammation and swelling, but it is important to control the amount of inflammation present. This is achieved by:
- Resting the leg in an elevated position, with the foot higher than the groin. This allows gravity to drain the swelling. Every hour, the foot should be pulled up and pushed down rhythmically for 2 minutes, to ‘pump’ away the excess fluid. Only move within the painful limit.
- Wearing a support bandage to compress the calf slightly.
- Ice Packs – Every 3 to 4 hours
Put crushed ice (or a packet of frozen peas) inside a wet towel, and place lengthways on the painful part of your calf. Leave the ice pack on for 10 to 15 minutes, until the skin turns pink.
Do not use ice therapy if:
-You have a skin abnormality – poor circulation, or thin, flaky, shiny, dry skin.
-Your skin sensation is numb or diminished.
-You have sickle cell anaemia.
-It makes your symptoms worse.
Walking
Walking should be kept to a minimum. You may be given elbow crutches or a walking stick to protect the muscle from further damage. You will find it easier to walk in shoes with a heel, and you may be given some felt ‘heel pads’ to put in your shoe. Take short steps and try to get your heel to the ground if you can do so without aggravating your pain.
Middle Stage – From 2 days to 3 weeks after injury
The scar is beginning to form within the damaged muscle. Regular, gentle stretching exercises will help to encourage a strong and mobile repair.
Exercises
These exercises should be done every 2 hours. Do each stretch 8 times, holding the stretched position for 15 seconds. Do not push into pain.
- With the knee straight, pull your foot up towards your face to stretch the calf.
- Stand with your affected foot forwards, and with the whole foot in contact with the ground. With your knee bent, slowly move your knee forwards over the foot to stretch the back of your calf:
- Stand with your affected foot forwards, and with the whole foot in contact with the ground. With your knee straight, pull your foot backwards as far as you are able. Initially you may only be able to get into the normal standing position.
As you improve, you should be able to get your foot behind you.
Walking
If you cannot walk without limping, then keep walking to a minimum. If you can walk normally without discomfort (ie, with the heel down, taking even sized steps), with or without walking aids, then mobilise within your tolerance.
Swelling – If swelling persists, you must continue to:
- Elevate the foot, with hourly ‘pumping’ exercises.
- Wear the compression bandage.
- Use ice-packs.
Late Stage – 3 to 6 weeks after injury
The muscle is knitting together well now, but the scar is still ‘young’. It takes time to become strong. Gradually resume your normal activities, but let pain be your guiding factor.
Stretching
Continue with the stretching exercises until you get as much mobility as the other calf muscle. You may already have achieved this, or it may take many more weeks.
Strengthening Exercises
Progress through these as pain allows:
- With both feet, rise up and down onto tiptoes 10 times.
- Progress by standing on the affected leg only 10 times.
- Step up and down onto a step 20 times.
- Cycle if you have access to a bicycle.
- Jog on the spot for 1 minute.
- Jump on the spot for 1 minute.
- Hop on the spot for 1 minute.
- Run steadily – progress by adding bursts of sprinting.
Sports
Don’t return to competitive sports until you have full mobility of the calf muscle, and you are back to full training, including circuit type training.
It is vital that you warm up properly (5 to 10 minutes), and you spend 10 minutes stretching all major muscle groups, but particularly your calf muscles. You should also warm down and stretch again afterwards.
Refer to the “Advanced Rehabilitation for Sports Injuries” information handout for more details of warming up, stretching, circuit training, and cooling down.
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