Abstract
Calf muscle complex, consisting of the plantaris, soleus, and gastrocnemius muscle, is commonly injured, especially in athletes. Patients typically complain of acute pain in the proximal calf, ecchymosis, and significant swelling.
Based on clinical presentation, injuries of the calf muscle complex are graded 1–3. These grades are used to estimate convalescence period and to elect a suitable rehabilitation program. MRI or ultrasound can be of value in both the initial assessment and follow-up of the injury. Treatment, principally conservatively, is initiated according to the RICE schedule. Rehabilitation focuses on gentle stretching, massage, strengthening exercises, and balance exercises along with core strengthening and general conditioning.
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Appendix: Rehabilitation Program
Appendix: Rehabilitation Program
Stage 1 | Stage 2 | Stage 3 | |
|---|---|---|---|
Grade 1 (mild) | Days: 0 RICE Rest as much as possible Ice (15 min every 2–3 h) Compression wrapping Elevation | Days: 3+ Avoid aggravating activities Start with careful stretching of the calf muscles three to five times a day (once it is comfortable to do so) Start with sports massage Continue to wear a compression bandage | Days: 7+ Continue daily stretching Continue with sports massage Start with strengthening exercises (resistance bands can be used initially followed by calf raises and subsequently single leg calf raises) Gradually incorporate some running into your program (once you can achieve 3 sets of 20 single leg calf raises, pain-free) Exercises should be pain-free |
Grade 2 (moderate) | Days: 0+ RICE Rest as much as possible Ice (15 min every 2–3 h) Compression wrapping Elevation | Days: 7+ Avoid aggravating activities Start with careful stretching of the calf muscles three to five times a day (once it is comfortable to do so) Start with sports massage Continue to wear a compression bandage Instead of icing, try alternating hot and cold for 5 min each, for 20–30 min three times a day Electrotherapy may be beneficial | Days: 14+ Continue to stretch regularly Continue with sports massage if necessary Start with strengthening exercises (resistance bands can be used initially followed by calf raises and subsequently single leg calf raises) Gradually incorporate some running into your program (once you can achieve 3 sets of 20 single leg calf raises, pain-free) Exercises should be pain-free |
Grade 3 (severe) | Stop the activity and rest immediately | ||
In case of complete loss of function or considerable swelling and bruising, see a physician immediately | |||
In case of a grade 3 injury, the usual treatment involves an operation | |||
If the muscle is not completely torn, follow a grade 2 program | |||
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Wiegerinck, J.I., Rukavina, A., van der Made, A.D., Kerkhoffs, G.M.M.J. (2014). The Calf Muscle Complex. In: Kerkhoffs, G., Servien, E. (eds) Acute Muscle Injuries. Springer, Cham. https://doi.org/10.1007/978-3-319-03722-6_6
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