Ankle & Lower Leg

What It Is

Two line drawings of the calf from behind: on the right, the two heads of the gastrocnemius coming down from behind the knee into the Achilles tendon at the heel; on the left, the same leg with the gastrocnemius cut away to show the flatter soleus underneath. — A calf strain is usually in the gastrocnemius, the larger muscle on top, though the soleus underneath can be strained too.

Individuals with calf strains have tearing or stretching of a calf muscle (gastrocnemius or soleus). Calf strains are often the result of an injury. Most strains are partial tears, and tears can be classified as Grade I, II or III depending on their severity (Dixon, 2009). Severe calf injuries can cause a complete tear through the muscle, which is known as a muscle rupture. The calf muscles join to form the Achilles tendon, and this is also susceptible to a strain or tear.

Calf strains are common in sports that involve running (Pagan-Rosado et al., 2025).

Calf Strain Anatomy

Above the knee is the thighbone (femur), with the kneecap (patella) at the front of the knee. Below the knee, there are two long bones in the leg: the thick bone at the front (tibia) and the thin bone along the side (fibula). The muscles within the lower leg are responsible for movement of the ankle and the foot. The back part of the lower leg is referred to as the calf.

The calf is made up of the gastrocnemius, the soleus and a small muscle called the plantaris, which together form the Achilles tendon, attached to the heel (Dixon, 2009). The gastrocnemius is the calf's largest muscle. It is attached to the femur at the back of the knee, so it crosses the knee and helps the knee to bend. Next to and underneath the gastrocnemius is the second main calf muscle, the soleus. The gastrocnemius and soleus point the foot downwards, for example when you rise up on your toes. The plantaris is small and is rarely injured (Dixon, 2009).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat a Calf Strain

After the first couple of days, hands-on treatment and gentle stretching, then progressive strengthening and functional exercises, help you recover and return to sport (Dixon, 2009; Pagan-Rosado et al., 2025). If your strain is taking longer than usual to get better, physiotherapy may help with your recovery (NHS, 2024). I can guide you through this, from hands-on work to a graded strengthening and return-to-running programme. See the My Approach tab for how I work.

For the first 2 to 3 days, the NHS recommends PRICE: Protect the injury, Rest, Ice, Compression and Elevation (raising the leg on a pillow). To help prevent swelling, avoid heat (such as hot baths and heat packs), alcohol and massage for the first couple of days (NHS, 2024). If you tear the calf badly, you may need crutches to help you walk (Dixon, 2009).

1. Compression Bandage

Wrap a bandage around the injury to support it during the day (NHS, 2024). Make sure not to wrap the injured muscle too tight. Bandages already have elasticity built in, so they provide you with a degree of compression without having to wrap them tightly.

2. Pain Relief Medication

The NHS (2024) suggests trying painkillers such as paracetamol first to ease the pain, and ibuprofen gel, mousse or spray to bring down swelling; ibuprofen tablets can be taken if needed. Some sports medicine reviews advise avoiding anti-inflammatory medicines in the first few days after a calf tear because of a possible risk of extra bleeding in the muscle (Dixon, 2009; Pagan-Rosado et al., 2025), so ask a pharmacist which is best for you. (This medicine information comes from the NHS, Dixon (2009) and Pagan-Rosado et al. (2025), not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

3. Ice

Apply an ice pack (or a bag of frozen vegetables wrapped in a tea towel) to the injury for up to 20 minutes every 2 to 3 hours (NHS, 2024). Never apply ice directly to the skin.

Tips

Make sure you warm up before exercising. Not warming up, tired muscles and playing sport are common causes of strains (NHS, 2024). Start slowly until your body is warm before you engage in sport at a harder pace. A warm-up might involve a brisk walk before running, for example.
Once you can move the injured leg without pain stopping you, keep it moving gently so the muscle does not become stiff (NHS, 2024).
Avoid strenuous exercise such as running for up to 8 weeks after a strain, as there is a risk of further damage (NHS, 2024). I'll guide you on when to return to sport.
If you tear the calf badly, you may need crutches to assist your walking.

Treatment

My Approach

A calf strain means some of the muscle fibres have been stretched or torn. My aim is to help it heal well and rebuild its strength for walking, running and sport. Where we start depends on how bad the strain is.

If it's a mild or moderate strain (grade I or II): you can walk, perhaps with a limp, and the calf is sore and tight. I treat this directly.

If it's a severe tear (grade III or a complete tear): you may have felt a pop, can't rise onto your toes, or can feel a gap in the muscle. Please see a doctor first. Once you've been checked, I support the plan they give you.

I start by assessing how you walk, how your ankle and knee move, your calf strength and where it's tender, and whether the Achilles tendon is involved.

Early On

For the first couple of days, protection, rest and ice at home (I'll show you how), and I leave the calf itself alone
Then gentle work around the injury, with warm or cool applications in the clinic
Gentle tightening of the calf without moving the ankle, in a pain-free position

As It Heals

Hands-on work closer to the injury, then cross-fibre work on stiff, stuck-down spots
Gentle stretching, only to the start of discomfort
Calf raises on two legs, then one, then slow lowering, built up gradually
Taping for support as you get back on your feet

Back to Running and Sport

Heavier calf strengthening, including gym-based work
A graded return to jogging, running, hopping and sport-specific drills
A home programme to keep the calf strong

If the calf becomes hot, swollen and painful without a clear injury, or your symptoms get worse rather than better, get it checked by a doctor promptly.

What to Expect

Typical Course

Typical course: For a mild or moderate strain, visits are usually once or twice a week early on, then weekly, then spaced out, with a reassessment at about 4 to 6 weeks; most people avoid running for up to about 8 weeks and build back gradually. After a severe tear, recovery follows your doctor's plan and usually takes longer, often around 3 months or more.

What I Focus On

Assessment

Protect Early

Calf Release

Progressive Calf Strength

Return to Running

Please read

When to See a Doctor First

When to Get Emergency Help

Call 911 or go to the emergency room at your nearest hospital if you heard a crack when you were injured, the leg has changed shape or is pointing at an odd angle, the injured area is numb, tingling or has pins and needles, or the skin around it has turned blue or grey or feels cold to touch, as you may have broken a bone (NHS, 2024).

Sources

References

Dixon, J.B. (2009) 'Gastrocnemius vs. soleus strain: how to differentiate and deal with calf muscle injuries', Current Reviews in Musculoskeletal Medicine, 2(2), pp. 74–77. doi: 10.1007/s12178-009-9045-8
Pagan-Rosado, R. et al. (2025) 'Calf strains in athletes: a narrative review of management, injury grading, and return to sport', Sports Medicine - Open, 11, 158. doi: 10.1186/s40798-025-00960-4
NHS (2024) Sprains and strains. Available at: https://www.nhs.uk/conditions/sprains-and-strains/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooCalf Strain / Calf Tear

What It Is

Calf Strain Anatomy

Self-Care & Treatment

How to Treat a Calf Strain

1. Compression Bandage

2. Pain Relief Medication

3. Ice

Tips

My Approach

Early On

As It Heals

Back to Running and Sport

Typical Course

When to See a Doctor First

When to Get Emergency Help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooCalf Strain / Calf Tear

What It Is

Calf Strain Anatomy

Self-Care & Treatment

How to Treat a Calf Strain

1. Compression Bandage

2. Pain Relief Medication

3. Ice

Tips

My Approach

Early On

As It Heals

Back to Running and Sport

Typical Course

When to See a Doctor First

When to Get Emergency Help

References

Related Conditions

Achilles Tendinopathy

Shin Splints

Ankle Impingement (Anterior)

Book a session