Calf Strain and Muscle Spasm of the Leg

A calf strain is an injury to the muscles of the back of the lower leg. These injuries are most often caused by minor tears of muscle fibers. Usually, the bulk of the muscle tissue remains intact.

More severe strains may be caused by a complete tear of the muscle. There may be loss of function.

This article looks at the causes, diagnosis, and treatment of calf strain injuries.

Calf Strain Symptoms

If you strain your calf, you may notice a sudden, sharp pain in the back of your leg. 

This injury usually occurs between the knee and ankle. When a muscle strain occurs, this part of the calf becomes tender and swollen.

A calf strain can be quite painful. The amount of pain depends on the severity of the injury.

Calf strains are usually graded as follows:

• Grade I calf strain: Mild discomfort. Often minimal disability. Usually minimal or no limits to activity.
• Grade II calf strain: Moderate discomfort with walking. Limited ability to perform activities such as running and jumping. May have swelling and bruising.
• Grade III calf strain: Severe injury that can cause an inability to walk. Patients often complain of muscle spasm, swelling, and significant bruising.

Causes of Calf Strains

The calf muscles span the distance from the knee to the ankle. The Achilles tendon connects your calf muscles to the heel bone in the lower part of the leg. 

The calf muscle is made of two major muscles: 

• The two-headed gastrocnemius muscle 
• The soleus muscle

A calf strain is a tearing injury to the gastrocnemius or soleus muscle. Most often, the injury occurs in the medial gastrocnemius. This part of the muscle is on the inner side of the back of your leg.

This is often called a "muscle strain." 

Muscle fibers can tear when a muscle is overstrained. The muscle remains intact with less severe strains.

Diagnosis of Calf Strains

A calf muscle strain is usually a clear diagnosis. Still, there are other causes of calf pain that may be considered, including:

• Baker's cyst
• Leg cramps
• Blood clots

Severe calf strains should be seen by a doctor. Rarely, there may be complete muscle rupture. When this happens, surgery may be necessary to reattach the torn ends of the muscle. 

Fortunately, this is rarely needed, even in patients with Grade III calf strain injuries. Most patients can be treated successfully without surgery.

See a doctor if you aren't sure if you have a calf strain or if your symptoms don't go away quickly.

Because there are other conditions that can be confused with a calf strain, see a doctor if your symptoms do not resolve right away.

How Calf Strains Are Treated

Treatment of a calf strain usually depends on the severity of the injury. Rest is the key to successful treatment. 

As a rule of thumb, if you have a calf strain, you can do activities that don't make your injury worse.

Rest until you are pain-free. This will allow the injured muscle to heal. If you don't get enough rest, it may take longer to recover. 

Common treatments used for calf strains include:

• Rest: Get plenty of rest after the injury. This will help the muscle heal. Let pain guide your level of activity. Avoid activities that cause symptoms.
• Calf muscle stretching: Gentle stretching is helpful. It should not be painful, though. Excessive stretching can be harmful and may slow the healing process. Simple calf stretches can help you along with your rehab.
• Icing the injury: Apply ice to the injured area in the first 48 hours after injury. Apply ice after activities, too. Ice will help slow blood flow to the area and decrease swelling.
• Heat application: Gentle heat can help loosen the muscle before activities. Apply a heat pack to the calf before stretching or exercising. As a rule of thumb, heat the area before exercise and ice after.
• Anti-inflammatory medications: Oral anti-inflammatory medications like Advil (ibuprofen) or Aleve (naproxen) can help relieve pain and calm inflammation. These medications are most effective if you start taking them in the early stages just after the injury.
• Physical therapy: A physical therapist can help guide treatment and speed your recovery. Exercise-based therapy can help. Therapies like ultrasound or therapeutic massage may have additional benefits. Work with your physical therapist to find the right treatment for your condition.

Recovery time depends on the severity of the injury. A typical grade I calf strain will heal in seven to 10 days. A grade II injury will heal in about four to six weeks. A grade III calf strain may take about three months.

Calf strain injuries don't usually require surgery. Unlike an Achilles tendon rupture, calf muscles don't usually tear completely.

This means calf muscle strains should heal with noninvasive treatments rather than surgery. An Achilles tendon rupture, on the other hand, may not completely heal without surgical treatment.

Summary

A calf strain is an injury that affects the muscles on the back of the leg. The amount of pain depends on how severe the injury is.

Grade I strains only hurt a little. Grade II strains are more painful and will limit your activities. Grade III strains may impair your ability to walk.

Calf muscle strains are usually easy to diagnose. Sometimes, though, calf pain may be caused by something else. If your pain doesn't go away quickly, see a doctor.

Rest is the key to recovery. Your physical therapist may also recommend ice, heat, and gentle stretching exercises. Over-the-counter medication can help with pain. 

Recovery from a calf muscle strain depends on its severity. It may take anywhere from seven days to three months for complete recovery.

A Word From Verywell

Calf strain injuries are common. Middle-aged athletes and weekend warriors are especially at risk.

Symptoms of calf strain are often severe at first. With proper treatment, though, they tend to settle down quickly.

In some cases, complete healing of a calf muscle injury can take several months. The vast majority of people are able to return to most activities much sooner, though. You may need to wait a few months before you can go back to sports activities.