Sports Injury Focus – Calf Muscle Injuries

calf muscles

The calf muscle. Muscle and achilles tendon issues. Pain on the side or front of the lower leg. We truly have a great knowledge of how to diagnose and manage this.  We see people with minor strains to complete muscle rupture, and the recovery plans and treatment process varies. The injuries (and the recovery plans) are in no particular order of importance and they all have one thing in common – they all work. There’s a great saying that goes: Small hinges swing big doors. And it’s often the simplest advice that wins in the end.

Truth is, without knowing you or your medical history intimately, I cannot tell you which of these will work best for you. And even if I did know the root cause of your sports injury, there are no guarantees that any one single strategy will work. As a disclaimer please do seek professional help and get a proper assessment of your injury.

Calf Injury – Signs and symptoms:

Immediate sharp pain in the muscle at the bottom of the leg, just below the knee. OR in the middle of the muscle belly. Often people describe the pain as having felt like they’d been “shot” in the back of the leg. These are injuries of a more acute nature. Some people describe a niggle that tends to get worse with activity and calms down when they not using the muscle. The persistent niggle is a little more difficult to deal with as there are many factors to consider. Training regime and biomechanics for example.

* Week 1

This is always about P.O.L.I.C.E Protection, Optimal Loading, Ice, Compression and Elevation
Ice is best applied little and often. 10 minutes every hour, should be enough.

Typically, a pro athlete would be advised to go swimming, take one or two gentle walks and when possible, work on core stability exercises with a balance ball.

The right selection of footwear is important – avoid plimsoles or sandals. Find and wear a pair of trainers with a nice thick heel to prevent any tension on the muscle.

From a Physio point of view – after about day 5, I’d begin some deep massage and very gentle stretching and work on the ankle joint to prevent any stiffness or get rid of any swelling.

* Week 2

Ice continues – often until day 10 depending upon how much bleeding has taken place and how badly damaged the muscle tear is.

Typically, one of my athletes would now be exercising on a bike and swimming would continue.

The athlete can expect to begin on a bike or start on the rowing machine to keep up with CV fitness but running should be avoided for now.

From a Physio point of view – deep massage is now vital. We’ll also review and correct biomechanics and start to work on improving ankle range of movement.

It’s now that the scar tissue build up is “dangerous” and if the deep massage isn’t done, it’s the number 1 reason for calf muscles tearing again in the first two weeks back to running or playing.

* Week 3

Ice has stopped. Now, heat is being used rather than ice in this stage.

Stretching is now vital. I’d be recommending the athlete to attend Yoga classes, increase the amount of Pilates exercises and that he or she be working on their balance (using a ball).

Fitness levels are increased significantly. Swimming, cycling, gentle jogging is stepped up. And by the end, the athlete may or may not be asked to be doing pace running by now.

From a Physio point of view – hands-on treatment is vital, massage continues and work on the Achilles, hamstrings, gluteal muscles and lower back is essential to prevent future reoccurrence.

PNF stretching is also introduced.

* Week 4

Athlete 90% fit. CV work increases and a return to practice and full drills is possible and the goal, by the end of week 4.

Athlete is put through drills that will include sprints, shuttles and plyometric work.

From a Physio point of view – hands-on massage continues, PNF stretching is vital and passive and active stretching is stepped up. We’ll also start to add in jumping and plyometrics.

* Week 5

Athlete returns to sport. Fitness and performance work increases.

From a Physio point of view– massage continues to prevent scar tissue build up and stretching is continued before, during and after training sessions.

Note: Hands-on massage will be need for approximately another 2-3 weeks to prevent scar tissue (collagen) tightening up the muscles.

Review of Recovery:

Take it very easy early on, stretch and mobilise the injury at just the right time and no calf injury can ever recover fully without deep massage, stretching and proper plyometric strength work.

Secret Tip:

Too much rest in the first few weeks will increase the likelihood of re-injury.

Don’t be fooled by the lack of pain after two weeks either. It does not mean you are fit to play or run and if you haven’t followed all of the protocol listed above, you will damage the muscle again sometime soon.

If you’d like more info on this, and some further easy, actionable tips on other sports injuries too. We have a free guide that we can send you. Connect with us on 020 87474 029(Chiswick) , 020 87887 804(Putney) or email us on and tell us what’s going on.



About the Author: Leslie Abrahams and the Bodies Under Construction team

Every week, for over 20 years, 100’s of people aged have consulted Leslie Abrahams and the Team at Bodies Under Construction looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.
He has previously worked and travelled with high-level athletes in the field of cycling and volleyball. Leslie also has a special interest in Spinal Treatments and Rehabilitation, lower limb injuries, and has experience dealing with patients post injury or surgery.

Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the founder of Bodies Under Construction Clinics situated in Chiswick and Putney, London. South West London’s Specialist Private Physiotherapy Practice for People of all ages, but especially those in their 30’s. 40’s, 50’s and 60’s and above, who want to keep healthy and active.

Leslie Abrahams