we refer to as the calf muscle actually consists of three separate muscles.
That’s the gastrocnemius, the soleus and the plantaris muscles. A recent
article in Sports Physio Magazine brought forward an interesting discussion on
injuries to the soleus muscle.
The soleus originates just below the knee
joint at the tibia and fibula. It then attaches (along with the tendons of the
plantaris and gastrocs) via the Achilles tendon at the calcaneus (the heel
bone). Its action is to plantarflex your foot. In other words, it allows you to
point your toes downwards.
What muscle fibres are the calf made of?
muscle is made up of slow twitch (type 1) muscle fibres. This means that it is
more resistant to fatigue than the more power generating gastrocnemius. Despite
this however, in the high level athlete who undergoes multiple training
sessions per week, this muscle can be aggravated through repetitive use.
are prone to developing a level of delayed onset muscle soreness (DOMS)
following training sessions, however, the sensation of a deep dull ache or even
a mild cramp that lasts 1-2 days post training or following a game may be an
indication of injury to the soleus muscle ( grade 1 or 2 strain).
some cases, when pain levels are elevated and accompanied by swelling and loss
of function, there may be a full thickness tear of the muscle. Other possible
causes of calf pain include injury to the gastrocnemius muscle or Achilles
tendon while cramping may also be caused due to a lack of potassium (hypokalemia).
Following a comprehensive assessment, the physiotherapist may be able to
determine the cause of the calf pain. A cramping calf is equivalent to a
low-grade muscle strain.
event that the athlete’s symptoms have risen from an injury to the soleus muscle,
rehabilitation for this injury needs to commence as soon as possible in order
to prevent further injury as well as avoid delays in returning to sport.
Treatment for the calf injury depends on the severity of the muscle strain.
How can we treat a calf injury?
for the injury depends on the severity of the injury.
The varying degrees of muscle injury
are variable dependant on the degree of muscle fibre disruption.
- Grade 1 strain: Mild injury <10 degrees
muscle fibre disruption
- Grade 2 strain: Moderate injury; 10-50%
muscle fibre disruption
- Grade 3 strain: Severe injury; 50 – 100%
disruption of muscle fibres.
involves the RICER (rest, ice ,
compression, elevation and referral) to alleviate any inflammation, a
progressive strengthening program provided that the athlete experiences
improvement in symptoms, proprioceptive training and sports-specific training.
It may take a minimum of three weeks for the injury to recover (and that’s just
for a grade I or occasionally grade II injury) and as you can imagine, this is
a long time off training for the athlete at any level!
While all you sporting enthusiasts have rather blazay attitude about the less painful stuff, we hope reading this reminds you to be aware of the subtle presentations in your muscles that can indicate more serious injury!
Australian Physiotherapy Association (2012) Sports Physio Magazine. Issue 2: 10-11.
Dixon, J.B., (2009) Gastrocnemius vs. soleus strain: how to differentiate and deal with calf muscle injuries. Curr Rev Musculoskelet Med 2:74-77.
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