Monday, 21 November 2016

Calf Muscle Tears

Calf muscle tears, or a pulled calf as it is more commonly known, can be a regular occurrence in sport, especially in running. The muscle will become torn or pulled when it is forcibly stretched beyond its normal length or possibly when fatigued due to over training. Sign of a torn calf muscle is similar to that of an Achilles tendon rupture. You may think you've just been hit in the leg and potentially hear a "pop." There is sudden pain at the back of the calf. Then you’ll experience pain, swelling or bruising in the calf muscle, and you’ll have difficulty walking properly or standing on your toes.

A calf muscle tear is graded from 1 to 3, with grade 3 being the most severe. A grade 1 will not normally need professional treatment whereas grade 2 or 3 injuries, depending on their severity, may require more specialist treatment and rehabilitation advice from a sports injury professional.

Grade 1 symptoms

A Grade 1 calf strain is a minor tear with up to 25% of the muscle fibres affected. The athlete may feel either a twinge of pain in the back of the lower leg or a feeling of "tightness". They may be able to carry on playing or competing without pain or with only mild discomfort in the calf. However, after exercises finishes there is likely to be "tightness" and/or aching in the calf muscles which can take up to 24 hours to develop.

Grade 2 symptoms

Symptoms of a Grade 2 strain will be more severe than a grade one, with up to 90% of the muscle fibres torn. There will be a sharp pain at the back of the lower leg and usually significant pain on walking afterwards. There is likely to be swelling in the calf muscle with mild to moderate bruising, however this may take hours or days to be visible. On strength testing the muscle, pain will be felt on resisted plantar flexion (pushing the toes and foot downwards towards the floor) against resistance. Tightness and aching may be present in the calf muscle for a week or more before subsiding. 

Grade 3 symptoms

Grade 3 injuries involve 90-100% of the muscle fibres and are often referred to as "ruptures". The athlete will definitely be able to recall exactly when the injury occurred and this will be associated with severe immediate pain at the back of the lower leg. In these situations, the athlete will be unable to continue/finish exercising and will often be unable to walk due to weakness and pain. This level of injury also presents with considerable bruising and swelling although this may take hours to be visible. On strength testing, the athlete will be unable to even contract the calf muscle at all and in the case of a full rupture, a gap in the muscle can usually be felt. This is due to a deformity where the muscle is torn and the top part of the muscle may bunch up towards the top of the calf which is clearly visible. 

Where the muscle has torn there may be a visible lump above a depression where the torn tissue is. It is likely a grade two and three tear will be accompanied by bruising. Due to the repetitive nature of running it is important to modify your training when you suspect you have a calf tear, to reduce the likelihood of the tear progressing to the next level. For all grades of muscle tear, you will need to reduce your training volume and remove speed work. 

Healing times for a grade one tear should be approximately one to two weeks, grade two tears four to six weeks and a grade three tear would need to be assessed by an orthopedic surgeon for consideration of surgery. A physiotherapist will be able to guide you as to what exercises and modified training you are able to perform during your recovery from injury. As a general guide, it is recommended you reduce your volume, cut out intensive work and focus on calf strengthening exercises, particularly endurance strength training.

Triathlon Plus, Winter 2016

Run On!

No comments: