Lionel Pannunzio PT / SCS
Calf Strains In Soccer Players - Part I
Introduction
Although studies documenting the injury rates of calf muscle tears are no so great, a 5-year study of European soccer players revealed that 12% of the muscle injuries sustained, were injuries to the gastrocnemius muscle, was categorized as one of the top five muscles injured. (Armfield D, et al. Sports-related muscle injury in the lower extremity. Clin Sports Med. 2006;25:803–842.)

Anatomy of the Injury
A calf strain is an injury to the muscles in the calf area (the back of the lower leg below the knee). The calf muscle is actually composed of up to 9 separate muscles, any of which can be injured individually or together.

The gastrocnemius, soleus, and plantaris muscles attach onto the heel bone, and work together to produce the downward motion of the foot. The other 6 muscles cause knee, toe, and foot movements in different directions; these muscles are the popliteus, flexor digitorum longus, flexor hallucis longus, tibialis posterior, and the fibularis (or peroneal) longus and brevis. They extend from the lower leg bones around the sides of the ankle and attach to various parts of the foot and toes.

Calf strains are a well-known problem for Tennis Players: this injury is so frequent in Tennis players as well than sometimes is called "Tennis Leg". Other sports populations with high rate of calf injuries are runners, soccer and basketball players, gymnasts, and dancers
A calf strain is caused by overstretching or tearing any of the 9 muscles of the calf.
The muscles usually affected are Gastrocnemius or Plantaris

Why soccer players suffer calf injuries?
Calf strains can occur during hi-speed motions like running and jumping, or from any type of forceful or uncoordinated movement.
What happens is that the Calf is overstretched causing the tear or strain of the muscle fiber.
This injury can be attributed or be related to
Poor running mechanics.
Improper warm-up.
Inappropriate training loads.
Lower back pathology or increased tightness in your posterior chain of muscles ( lower back, hamstrings and calf muscles )
Fatigue
Age: Middle-aged or older patient, usually over the age of 40, often present with lower leg muscle injuries following strenuous exercises. (Now I can see why I pull my calf and all my friends from the over-40 league are coming to see me more often)
How does it feel to suffer a Calf strain ?

Sharp pain or weakness in the back of the lower leg.
A throbbing pain at rest with sharp stabs of pain occurring when you try to stand or walk.
A feeling of tightness or weakness in the calf area.
Spasms (a gripping or severe tightening feeling in the calf muscle).
Sharp pain in the back of the lower leg, when trying to stretch or move the ankle or knee.
A “pop” or hear a “pop” sound at the time of injury (with a Grade 3 calf strain).
Weakness in the calf when trying to walk, climb stairs, or stand.
Limping when walking.
Difficulty performing daily activities that require standing and walking.
An inability to run or jump on the affected leg.
Bruising: When muscles are strained or torn, muscle fibers and other cells are disrupted and bleeding occurs, which causes bruising. Within a few hours of the injury, swelling can occur, causing the injured area to expand and feel tight and stiff.
Type of Calf Injuries and Severity of the Injury
Like we said before, A calf strain is caused by overstretching or tearing any of the 9 muscles of the calf.
The muscles usually affected in Soccer players are Gastrocnemius or Plantaris
Gastrocnemious

A medial Gastrocnemius strain is the most common cause of acute onset calf pain with the typical symptom described on previous post: pain in the inner part of the lower leg, swelling, bruising, inability to run or jump.

Plantaris Muscle Rupture
The plantaris muscle is a thin muscle that runs along the gastrocnemius muscle but is only a fraction of the size. When the plantaris muscle ruptures, often as a result of lunging forward, a sudden, snapping pain in the back of the leg is felt. Swelling and bruising in the back of the leg may occur, along with cramping of the calf muscle.
Soleus Muscle Strain
The soleus muscle is located below the gastrocnemius muscle in the calf. Straining of the soleus muscle is commonly a chronic injury that occurs less common in soccer and more frequently in long-distance runners . The pain is often reported as a deep soreness or tightness in the calf that can be reproduced when bending the knee and dorsi-flexing the ankle (pulling your toes back toward your shin) at the same time.
Calf strains - Classification

Calf Strains are graded according to the amount of muscle damage that has occurred:
Grade 1. A mild or partial stretch or tearing of a few muscle fibers. The muscle is tender and painful, but maintains its normal strength. Use of the leg is not impaired, and walking is normal.
Grade 2. A moderate stretch or tearing of a greater percentage of the muscle fibers. A snapping or pulling sensation may occur at the time of the injury and after the injury. There is more tenderness and pain, noticeable loss of strength, and sometimes bruising. Use of the leg is visibly impaired, and limping when walking is common.
Grade 3. A severe tear of the muscle fibers, sometimes a complete muscle tear. A “popping” sound may be heard or felt when the injury occurs. Bruising is apparent, and sometimes a “dent” in the muscle where it is torn is visible
Conclusion
Calf muscles are very common in Soccer players.
The reason for calf injuries is an overstretching of the muscle
Poor conditioning, tightness in the muscle and age are the usual reasons for calf injuries
Grade 2 and 3 injuries will take longer to heal due to the injury to the muscle fiber
Stay tuned for part II of this condition coming next week
Can't wait? ...Do you want to find out more about what you can do to get better from your Calf Strain?
Click the link below to get access to our PDF E-Book where you'll find valuable information about Muscle Injuries in general and Calf Injuries in Particular
Muscle Injuries in Soccer Players
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