Is the pain in the calf muscles just tension or something else?


Sprains and calf sprains are common injuries , especially in athletes. If you experience sudden pain in your lower leg during physical activity, it may be due to a tear or stretch of the calf muscle.

However, there are other causes of calf muscle pain, including serious conditions like blood clots. If you are experiencing calf pain, it is important that your doctor lets you know appropriately so that you can receive prompt treatment.

This article describes the different types of calf muscle injuries and how they can be treated.

Get Medical Information / Kelly Miller

Types of calf strains

Muscle sprains are defined as injuries to the muscles and / or tendons (which attach the muscle to the bone). They are different from sprains, which are injuries to the ligaments (which join one bone to another).

The calf stretch occurs when the fibers of the lower leg muscles are overloaded. This can happen when you increase speed or suddenly change direction while running. Calf deformities can be mild or severe and occur most often in the calf muscle.

Calf strains are classified into three classes:

  • Grade 1 : A type of stress occurs when stretching causes small microcracks in muscle fibers. This type of injury causes pain but does not usually interfere with physical activity. Full recovery takes about two weeks.
  • Grade 2 : this tension is associated with partial breakdown of muscle fibers. You will need to limit your activity, but full recovery takes five to eight weeks.
  • Grade 3 : This is the most serious deformity of the calf that involves the complete tear or rupture of the affected muscle fibers. Full recovery can take three to four months, and in some cases, surgery may be required.


Overexertion of the calf muscles can cause injury. Calf deformities are muscle tears and are very serious. In some cases, the stresses won't affect your daily activities, but some require surgery and can take months to heal.

Treatment of calf deformity

The initial treatment for calf deformity is RICE (Rest, Ice, Compression, Lift) , which is used in the first three to five days after injury:

  • Rest :   It is important to rest the injured muscle, which means avoiding any activity that causes pain, as well as any excessive impact or stretching, such as running, jumping, or lifting weights. It is also important not to play sports again until the pain is relieved. Your healthcare provider may recommend crutches to help you avoid overloading the injured muscle with excess weight.
  • Ice :   To reduce swelling, it is recommended to apply ice to the calf at 20 minute intervals, several times a day. Do not put ice directly on the skin by placing a thin towel between the ice and the calf or using a cold pack.
  • Compression :   It is a good idea to wear an elastic compression bandage (such as an ACE bandage or kinesiology tape ) over the injured calf. This prevents blood from pooling in the leg. Some athletes believe that a shin bandage can reduce pain and protect against further injury.
  • Height :   Keeping the foot elevated (at or above the heart) can help reduce swelling.

Your healthcare provider may also recommend taking anti- inflammatory medications , such as ibuprofen, for up to three days to reduce pain and swelling.

The RICE (Rest, Ice, Compression, and Elevation) protocol is the first line of treatment for muscle injuries such as sprains and strains.


Some types of calves require more than the RICE protocol. Depending on the severity of your injury, you may need to be rehabilitated by a physical therapist. Your physical therapist may recommend certain exercises, including:

  • Exercise range of motion :   When the acute pain has subsided, begin to moderately stretch the muscles using a passive range-of-motion stretch. Raise your foot and toes slightly, stretching your legs if possible to stretch your calf muscle. Hold for 10 seconds and repeat 5-10 times.
  • Progressive Calf Stretch Exercises – As your calves heal, you can begin using a regular stretching and flexibility program to increase your range of motion and prevent future calf injuries.
  • Using a foam roller – Gently self-massage with a foam roller while the calf injury is healing can help reduce scar tissue formation and improve blood flow to the area.
  • Muscle Strengthening – Your physical therapist may recommend exercises to help build muscle strength and coordination, which can help you avoid future stress-related injuries.

Be sure to follow your therapist's advice when beginning these exercises.

The goal of rehabilitation is to return to normal life as soon as possible without long-term consequences. If you return too soon, you risk chronic injuries. Keep in mind that everyone recovers at different rates, and rehab should match your needs and your progress, not the schedule.


If you have a calf sprain, it is recommended that you visit your doctor and physical therapist for a correct diagnosis and quick rehabilitation. Taking steps to heal properly can help restore full function to damaged muscles and prevent future stress.

Other causes of acute calf pain

Not all acute pain in the calf muscles is caused by a muscle injury. Sometimes the pain can indicate something more serious, such as a blood clot. Other possible causes of calf pain are listed below.

Tennis leg

The tennis leg is usually a sports injury and usually affects middle-aged people. You may feel a sudden strong (sharp) pain in the middle of your calf, you may feel a click, and / or hear a clicking sound. This is usually a rupture of the gastrocnemius muscle and can also occur due to fluid accumulation between the gastrocnemius and soleus muscles.

About 10% of people who experience tennis leg symptoms actually have a blood clot, not a calf sprain. This is why it is so important to have an accurate diagnosis.

Calf muscle spasms

A much less serious, but often painful, cause of calf muscle pain is muscle spasm. This involuntary muscle contraction is brief but can be so severe that it causes bruising.

Calf muscle contusion

A direct blow to the calf can cause bruising (bruising) as blood collects in this area. Most muscle bruising is mild and treatable with the RICE protocol.


Acute pain in the calf muscle can also be the result of a deep vein thrombosis (DVT), which is a blood clot in a vein. Along with pain, DVT can cause swelling, warmth, and / or redness. Clots can break loose and enter the lungs, which is serious and life-threatening.

If your healthcare provider suspects DVT in your leg, he or she will order an ultrasound of your leg to confirm the diagnosis. A blood clot requires immediate treatment with a blood thinner.

It can be difficult to distinguish between a muscle or tendon injury, so it is important to see a doctor for severe pain in the calf muscle.

Baker's cyst

Baker's cyst is a fluid-filled sac that usually forms as a result of arthritis in the knee joint. This may cause swelling or pain, or may not cause any symptoms. A large or ruptured Baker's cyst can cause pain or swelling in the calf.

Usually Baker's cysts will resolve on their own, but sometimes injecting steroids into the joint can reduce swelling and discomfort. In rare cases, surgery is required.

Achilles tendon injury

The Achilles tendon is the largest tendon in the human body. Connect the heel of the foot with the two calf muscles (calf and soleus). A torn or ruptured Achilles tendon causes severe pain in the back of the ankle or lower leg (under the calf muscle). In some cases, a click or click may be heard.

If you think your Achilles tendon may have been injured, immediately apply ice and raise your leg. You will need to see your doctor immediately to determine if the tendons are intact and if surgery is necessary.


For athletes, calf sprains are common but treatable injuries. However, pain in the calf muscle can have several causes and some, such as a blood clot, are serious. If you think the calf muscle may have been strained, remember to use the RICE protocol and contact your healthcare professional. They can help you determine if additional treatment is necessary to help you recover from your injury. They can also rule out serious illnesses that can lead to calf pain.

Get the word of drug information

Calf deformities can be painful and unpleasant, especially for active people. If you've been diagnosed with a calf sprain, remember to be kind to yourself and give your muscles the time and therapy they need to heal. Then you can go back to active life.

Frequently asked questions

  • The stretched gastrocnemius muscle should be treated immediately using the RICE protocol, which consists of four steps: rest, ice, contraction, and elevation. Over-the-counter or prescription medications can ease pain, and your doctor may recommend walking shoes. In rare cases, surgery is required to repair the muscle.

  • Calf muscle pain can be caused by any injury that affects three calf muscles: the gastrocnemius , soleus , and plantar muscles. Or it could be due to an underlying non-muscular condition, including but not limited to nerve damage, arterial disease, or severe trauma.

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