Is Your Calf Muscle Pain Just a Strain or Something Else?

Calf muscle pain is a common symptom, especially in athletes. This sudden pain in your lower leg is most commonly due to muscle cramps, or a muscle strain injury during activity.

However, there are other reasons for calf pain, including serious conditions like peripheral artery disease, nerve damage, trauma, or deep vein thrombosis (DVT), a blood clot that may occur in the calf. If you have calf pain, it's important to see a healthcare provider for a diagnosis and treatment.

This article outlines different types of calf muscle injuries and how to treat them when a muscle strain or cramp is the cause. It also presents information about causes that may be more of a concern.

When to See a Doctor for Calf Strain
Verywell / Kelly Miller

Types of Calf Strains

Muscle strains are defined as injuries to muscles and/or tendons, which attach muscle to bone. They are different from sprains, which are injuries to the ligaments that attach bone to bone.

A calf strain occurs when fibers of the muscles of the lower leg are 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 the gastrocnemius muscle rather than the soleus, which lies beneath it.

Calf strains are classified into three grades:

  • ​​​Grade 1: The type of strain happens when a stretch causes small micro-tears in the muscle fibers. This type of injury causes pain, but usually doesn't interfere with activity. Full recovery takes about two weeks.
  • Grade 2: 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.
  • Grade 3: 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.

Symptoms to Watch for With Calf Pain

If you have other symptoms with calf pain, such as redness, swelling, and warmth at the site, contact your healthcare provider. That's also true if you're unable to lift your leg or walk on it. Be sure to check for pulses and be sure you can feel things below your calf pain site.

1:23

Click Play to Learn About Treating a Pulled Calf Muscle

This video has been medically reviewed by Oluseun Olufade, MD.

Calf Strain Treatment

The initial treatment for a calf strain is R.I.C.E. (rest, ice, compression, elevation), used in the first three to five days after the injury:

  • Rest: It's important to rest your injured muscle, which means avoiding any activities that cause pain, as well as any impact activity or excessive stretching—like running, jumping, or weightlifting. It's also important to not return to sports until you are pain-free. Your healthcare provider may recommend crutches so you can avoid placing unnecessary weight on the injured muscle.
  • Ice: Applying ice to your calf for 20-minute intervals, several times a day, is recommended to reduce swelling. Avoid directly placing ice on your skin by placing a thin towel between the ice and your calf or by using a cold pack.
  • Compression: It's a good idea to wrap your injured calf with an elastic compression bandage (like an ACE wrap or kinesiology tape). This prevents blood from pooling in your foot. Some athletes find that taping the calf can reduce pain and help to protect from further injury.
  • Elevation: Keeping the foot elevated (at or above the level of your heart) can help to reduce swelling.

Your healthcare provider may also recommend taking an anti-inflammatory medication like Advil (ibuprofen) for up to three days to reduce pain and swelling.

The R.I.C.E protocol—rest, ice, compression and elevation—is the first line of treatment for muscle injuries like strains and sprains.

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:

  • Range of motion exercises: When the acute pain is gone, begin stretching the muscle moderately with passive range of motion stretching. Gently pull your foot and toes up, with your legs straight, if possible, to stretch your calf muscle. Hold for 10 seconds and repeat five to 10 times.
  • Progressive calf stretching exercises: As your calf heals, you can begin using a regular stretching and flexibility program to gain range of motion and prevent future calf injury.
  • ​​​Use of a foam roller: Performing gentle self-massage with a foam roller as your calf injury heals may help reduce scar tissue formation and improve blood flow to the area.
  • Muscle strengthening: Your physical therapist may recommend exercises to help build muscle strength and coordination, which may help you avoid future strain injuries.

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.

If you have a calf muscle strain, a visit to a healthcare provider and a physical therapist is recommended to 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.

Other Causes of Calf Pain

Not all acute calf pain is caused by muscle injuries. Sometimes, the pain can indicate something more serious—like a blood clot. Below are other potential causes for calf pain that occurs suddenly.

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.

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

Acute calf pain may also be the result of a deep vein thrombosis (DVT), a blood clot in a vein. Along with pain, a DVT can cause:

  • Swelling
  • Warmth
  • Redness at the site

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.

Baker's Cyst

A Baker's cyst is 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 or rupture of the Achilles tendon causes 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 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.

A Word From Verywell

Calf strains can be painful and frustrating, especially for active people. If you have been diagnosed with a calf strain, remember to be kind to yourself and give your muscle the appropriate time and therapy it needs to heal. Then you can get back to your active life.

Frequently Asked Questions

  • How is a pulled calf muscle treated?

    A pulled calf muscle should be immediately treated using the R.I.C.E protocol, which consists of four steps: rest, ice, compression, and elevation. Over-the-counter or prescription medications can relive pain, and your doctor might recommend a walking boot. In rare cases, surgery is needed to repair the muscle.

  • 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.

  • Does Dehydration Cause Calf Pain?

    Dehydration and electrolyte imbalances may be a factor in calf pain, especially cramps related to running or similar exercise activity. Yet research suggests there may be different reasons for different kinds of cramping calf pain. It's healthy to stay hydrated, but it may not be what contributes to calf pain that has other causes.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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