Foot & Ankle

Calf Strain Recovery Time

By Last updated on April 5th, 2020 Last updated on April 5th, 2020 No Comments

Many athletes are familiar with the issue of pulled muscles. Though muscle strain is one of the most common athletic injuries, it can happen to anyone at any time – using the muscles in an unfamiliar way can cause the muscle to tear. The tear can vary in size, meaning it may have different symptoms depending on the severity. Read on to learn about the anatomy of the calf and how injury can occur, how calf strains are diagnosed, and how they are treated. Each recovery is different depending on the patient, but a general timeline can be used for reference when faced with a calf injury.

Anatomy of the Calf
The calf is comprised of bones, muscles and tendons that work together to keep it functional and stable. The major muscle of the calf is called the Gastrocnemius. This muscle is located in the top half of the calf and is sometimes visible from the outside. The soleus muscle is under the gastrocnemius and under the achilles tendon.

Major bones in the calf are the Tibia and Fibula, located in the shin. These work together with the Calcaneus in the ankle to allow for support and stability in the calf.

The Achilles Tendon connects the calf muscles to the calcaneus. This tendon is a crucial part of all motion involving the leg, foot and ankle. Damage to the Achilles Tendon can cause severe instability and pain, and if left unchecked can lead to significant issues later in life.

A strain to the muscle is different from a sprain. Sprains are characterized by damage to ligaments, which connect bone to bone. This can be in the form of a tear or simply overstretched muscle. Sprains can influence the stability of a joint by loosening the connection between two major parts of it.

Strains are characterized by damage to muscle or tendons. These soft tissues may be torn or overstretched. A strain can occur as a result of misuse or overuse. Repetitive motions are a common reason why strains occur, though they may occur due to being bent or overexerted. Some individuals have muscle strain after using the muscles in an unfamiliar way during exercise or other activity. Strains are also sometimes referred to as a “pulled” muscle.

Diagnosing Calf Strain
Calf strains can be easy to spot for those who know that to look for. There are several symptoms to look for:

  • Swelling
  • Tenderness
  • Bruising
  • Tearing sensation
  • Pain during motion or activity

Pain caused by a strain to the gastrocnemius can be a short sharp pain or a dull ache, or anywhere in between. The pain is most often felt at the back of the lower leg, but can sometimes include pain to the lower leg or foot. Many individuals who have suffered a calf strain have trouble walking due to pain or a lack of stability.

It is best to see a doctor if you are suspicious that a strain has occurred. Without the guidance of a medical professional, injuries are more likely to heal incorrectly. Improper healing can lead to issues with the soft tissue later in life.

The process of diagnosing calf strain begins with a consultation. Doctors will ask about family medical history, previous injury, activity level, and more to get a feel for how the injury may have occurred. They will listen to the symptoms and assess the area by checking for tenderness, bruising, and swelling. They may observe the patient walking or doing other exercises to locate the exact source of injury.

There are three major classifications of calf strain:

  • Grade I: sometimes referred to as a “mild” injury, grade I calf strains are a minor tear in the muscle. This is the most common form of calf strain and many individuals who experience it can still walk or move around. It typically takes 1-3 weeks to fully heal.
  • Grade II: sometimes referred to as a “moderate” injury, grade II calf strains are also the result of a tear to the muscle. Though a grade II injury is more severe, it is not a complete tear. Individuals who have experienced this level of tear should expect to recover within 3-6 weeks.
  • Grade III: sometimes referred to as a “severe injury”, a grade III calf strain is a full tear of the muscle. Grade III calf strains should be immediately addressed by a doctor and often require surgery to correct. Due to the severity of the injury, it can take 6 months up to one year to fully heal. Severe calf strains may include a hematoma and should be examined by a medical professional immediately.

Many doctors use Ultrasound imaging to determine the extent of damage, though they may also use imaging techniques such as MRIs or CT Scans. These allow doctors to gather a picture of the soft tissue and assess the severity of the injury. Knowing exactly what is happening inside the body can inform surgical decisions and treatment. X-Rays are not often used as they only show bone and calf strains are an injury to soft tissue.

Conventional Treatment for Calf Strain
Each individual patient will experience a different recovery process. Techniques that work for one person may not work for everyone, so it is the doctor’s job to ensure that each patient is getting their needs met.

The treatment will also depend on the severity of the injury. For minor injuries, often resting the muscle is enough to let it heal completely. As the injury becomes more severe, the treatment becomes more aggressive. Some of the most common treatments for calf strain are:

  • RICE Method: minor and moderate injuries respond well to the RICE method. RICE stands for Rest, Ice, Compression, and Elevation. Rest allows the muscles to heal, while ice and elevation help with swelling. Compression can help with swelling as well as prevent blood clots.
  • Anti-Inflammatory Drugs: over-the-counter drugs such as Ibuprofen or Naproxen can help reduce swelling and ease pain associated with the injury.
  • Corticosteroid Injections: some doctors will suggest steroid injections, which deliver a powerful anti-inflammatory hormone to the injury site. These can cause long-term damage to soft tissue over time, so they should be closely monitored.
  • Physical Therapy/Exercise: some patients respond well to certain exercises. Unlike some other injuries, exercise should not be used until the injury has had time to rest and heal. The goals of physical therapy are to improve strength, function, and stability. Certain exercises are not recommended as they can injure the muscle further, so it is best to have a guide through the exercises to begin.
  • Surgery: most calf strains will not require surgery, but when the muscle ruptures completely it becomes necessary to sew the muscles back together. The recovery process for this surgery often lasts from six months to a year. Knowing what to expect before, during, and after surgery can be extremely beneficial to a patient. Being aware of what exactly is going to happen and the potential risks can greatly ease any anxiety or stress that comes with making the decision.

In any recovery process, the success depends on the patient’s individual needs. Certain treatments may be delayed until the injury is healed a certain amount, or avoided altogether if it would not be beneficial to the patient.

Calf Strain Recovery Timeline
Though each individual’s timeline is unique, there is a general pattern that can be expected if further complications do not occur. Causing the injury to become worse or more torn can lead to a slower recovery process. Certain behaviors or conditions can make the recovery process take longer, such as diabetes, age, and smoking status. This timeline is a general guide to calf strain recovery and may not reflect your experience exactly.

The recovery timeline for most patients is as follows:

  • One Hour After Injury: ice and elevate the affected leg to reduce swelling. Compression can also be beneficial at this stage. Do not apply heat as it can contribute to swelling. The leg should be as rested as possible. If mobility is hindered, make an appointment with a doctor to examine the injured calf.
  • Three Days After Injury: applying heat to the injury can be beneficial at this stage as a form of pain relief. The injury should continue to remain as rested as possible. Minor injuries should begin to feel better after three days.
  • One Week After Injury: minor and moderate injuries should begin to feel slightly better at this point with the proper amount of rest. Some more severe injuries may begin physical therapy at this time, though in the beginning it is limited to avoid further damage to the muscle tissue.
  • Three Weeks After Injury: minor calf strains should be fully healed within three weeks if the patient has followed instructions. Patients whose injuries have healed can return to activities as normal. Those with moderate to severe injuries generally continue physical therapy around this time.
  • 6 Weeks After Injury: mature collagen tissue forms in around 6 weeks, so at this time most mild and moderate injuries are healed. Patients can return to normal activities with a doctor’s approval. Patients with severe injuries may begin to consider surgery at this point, as it will be noticeable if their injury is not healing through non-invasive treatment.
  • 6 Months After Injury: mild and moderate injuries are completely healed at this point. Patients who have undergone surgery to repair the muscle should observe noticeable recovery around 6 months. By one year, all types of injury should be back to activity with minimal pain and discomfort.

The Role of Regenerative Medicine in Calf Strain Recovery
Significant progress has been made recently in the field of regenerative medicine. Soft tissue injuries in particular have taken well to this new form of therapy. Using stem cells or platelet-rich plasma, these types of therapy offer pain relief and faster healing for patients suffering from an injury to the calf muscle. In some cases, it can even allow patients to surpass the need for surgery. CELLAXYS offers two types of regenerative therapy:

  • Stem Cell Therapy: this form of therapy begins with taking a patient’s stem cells, which are harvested using blood cells, fat cells, or bone marrow. The cells are then processed to be more concentrated, then reinjected into the calf muscle. Stem cells contain healing properties that the body already sends to an injury, which can aid in collagen production – allowing scars to heal and close the wound. Placing a concentrated stem cell solution into a part of the body that is healing can help the damage heal faster.
  • Platelet-Rich Plasma Therapy: this form of therapy begins with a simple blood draw. The patient’s blood is then placed in a centrifuge to separate platelets from other components in the blood. The platelets are then injected into the injury or surgery site. Platelets contain proteins and growth factors that the body uses naturally to heal damage. When a muscle tears, it relies on platelets to help repair the damage, so increasing the amount of platelets at the site of a tear could help it heal more quickly.

Both types of regenerative therapy have a low risk, as they are able to use a patient’s own cells, so the risk of rejection is lower. Some pain at the injection site may occur, but typically is relieved in a matter of days. Recovering from a calf strain can be difficult, but regenerative therapy could ease the process. Pain relief allows patients to participate more in physical therapy, and the cells heal faster with increased amounts of healing properties.

Regenerative therapy can be used for mild, moderate, and severe injuries. It can be used to help an injury heal before or after surgery. Some patients have been able to heal to the point where they no longer need surgery. When this is the case, the recovery process is simplified drastically. It is still generally recommended that patients maintain a physical therapy regimen, as it can help patients in ways that regenerative medicine cannot.

Conclusion
One of the most common athletic injuries is calf strain. Many different activities can cause even a minor tear in the muscle. Doctors can help patients find the recovery that is right for their individual needs. Though there are three types of injury, they should all be healed after one year. It may be possible to shorten the recovery time via regenerative medicine, leading to a smoother recovery and an ability to resume daily activities.

Dr. Matthew HC Otten

Dr. Matthew HC Otten

Director of Orthopedic & Orthobiologics
Fellowship-trained & Board Certified in Sports medicine
Director Angiography at Harvard Clinical Research Institute
Michigan Stage University Alumni