Calf Strain

Learn how the Exakt Health App can optimize your recovery.

Calf strain treatment plan

We know a calf strain can be really frustrating. Especially if you can’t access quality treatment advice immediately. Yes, you can find exercises on Google but how many repetitions should you do and are they even the right ones for you? When can you play sport again?

The Exakt Health app provides answers to all of these questions.

The Exakt Health App:

  • Guides you safely from initial injury to full return to sport.
  • Prescribes evidence based exercise programs with clear guidance on reps, sets and frequency.
  • Adapts the program according to your feedback and specific needs.
  • Implements a walk/run program for a safe return to running.
  • Provides you with a maintenance program to prevent re-injury.
See your daily calf strain exercises in the activities dashboard.
Learn more about calf strains including how to diagnose, treat and prevent them in the injury overview screen.

The App teaches you about your injury

Understanding what caused your calf strain, how it heals and when to see a doctor helps you better plan your recovery and prevent re-injury

You have two major muscles that make up your calf. The gastrocnemius muscle is the most superficial layer. It makes out the bulky part, more to the top of the calf and originates from behind the knee. The soleus muscle lies deep to the gastrocnemius muscle and its fibres run quite low down into the lower leg, nearly all the way to the heel. Both of these muscles come together through a thick layer of facia that forms the Achilles tendon. The Achilles tendon then inserts into the heel bone.

When you tear or strain a calf muscle, you usually feel a sudden sharp pain or pull in your calf. However, some people describe it as feeling like a severe muscle cramp while tears in the deeper soleus muscle of the calf often doesn’t feel sharp, but rather like a persistent tightness or ache. The severity of the symptoms that you experience in the next few days will depend on how badly you’ve injured your muscles – they can include:
  • Moderate to severe pain in the area of the tear.
  • If you have a mild strain, you may be able to walk with a near normal gait pattern. If you have a more severe strain, you may struggle to walk.
  • Likely to be painful to stretch your calf and in severe cases you may struggle to place your heel flat on the floor.
  • Running will hurt. However, not all people report pain with running; some describe it as a crampy feeling or persistent stiffness.
  • Painful to contract your calf muscle against resistance.
  • You may see some swelling and bruising but this is not present in all cases and may even take a few days to show. When it does show, the bruise is often much lower than the tear, around the ankle or even in the foot, because gravity pulls the dead blood downwards.
Most calf strains can be treated at home using a conservative exercise-based treatment plan as outlined in the app.
You should consider seeing a medical practitioner if you have any concerns about your injury, particularly if:
  • You heard or felt a pop, or as if someone kicked you in the back of the heel when you injured your leg – especially if it was in the area of your Achilles tendon. This can indicate a serious tear that involves the Achilles tendon and you need to have it investigated immediately. Delaying treatment or following the wrong treatment advice when you have an Achilles tendon tear can mean that your tendon won’t heal properly.
  • You think it’s a severe injury and have a lot of swelling and bruising.
  • Any part of your leg (thigh, calf or foot) is very swollen, red, hot to touch, or throbs with pain. This can indicate that you have a blood clot and it should be investigated as soon as possible.
  • You have pain at night that keeps you awake or interrupts your sleep.
  • You feel pins and needles or tingling in your leg. This can indicate that you’ve also injured a nerve and our treatment plan may not be right for you.
  • Your symptoms are getting worse.
  • Your injury is not healing as expected.
“Tight” calf muscles are often blamed for causing a strain, but weak calf muscles or over-training is actually the major cause for calf strains. Some of the most common causes for calf strains include:
  • Overtraining: not allowing your body to recover fully after a high intensity session, causes your muscles to accumulate micro-damage and strain more easily.
  • Fatigue: You are much more likely to tear a muscle towards the end of a hard running or training session when your muscles are tired.
  • Sudden increases in running intensities and volume doesn’t allow your muscles enough time to adapt and grow stronger, which makes them vulnerable to injury.
  • Weak calf muscles are prone to strain under forceful contractions during sprinting, hill running, jumping or kicking.
  • A previous calf strain predisposes you to straining your calf again – especially if you haven’t fully recovered from the initial injury
  • Reduced strength and control in the muscles of the lower back and around the core are also important. A weakness in one area can lead to an overload in another.
  • Not sufficient warm-up before your training, especially before intense training sessions. “Cold” muscles are more at risk of incurring a strain.
  • Old age also increases your risk of a strain. To mitigate the muscle loss and decrease in strength associated with aging, regular strength training sessions are important.


When you strain or tear a muscle, you literally tear some of the muscle fibres or cells. In order to heal, your muscle has to go through its natural three-stage healing process:
  • First, your body gets rid of the injured cells through an inflammation process (Stage 1).
  • Next, your body will start to create new muscle cells to replace the damaged ones (Stage 2).
  • Ultimately, your body will strengthen the new muscle cells, but only if you do the right exercises to stimulate this process (Stage 3).
Our treatment plan is aligned with this natural healing process. The gradual strength exercises signal the body to build and strengthen new muscle cells. Because we all heal at different rates, it is important to progress through the exercise levels and stages at your own pace.
To give you some guidance on how quickly you might recover from your strain, consider the following recovery times:
  • a very mild calf strain usually recovers in between 15 and 21 days.
  • more severe strains can take between 20 to 60 days to fully recover.
  • if you have a very severe strain, involving a large part of the muscle or the tendons, it can take 90 days or longer to fully recover.
  • if you’ve neglected your hamstring strain for a while, tried to train on it and reinjured it a few times, it may take several months to heal.


  • Regular strength training for your calves.
  • Good core strength and control – as well as in the rest of your muscles.
  • Sufficient recovery time after hard training sessions. If your calves are constantly tight and uncomfortable, it may be sign that they are not getting enough time to recover.
  • Avoid sudden increases in running volumes or intensity. Your body needs time to adapt and grow stronger.
  • A long warm-up before you training, especially before intense training sessions.

The Calf Strain treatment plan consists of 7 stages

In order to regain full strength the workout intensities have to increase as your injury heals. The app ensures that you progress at the correct time by setting you clear targets for each stage.

The aim of this stage is to allow your injury to settle and to limit the amount of swelling and internal bleeding. Follow the PRICE regime and avoid positions that stretch your calves as that can make your injury worse. Proceed to the next stage when at least 48-72 hours have passed since you sustained your injury.

It’s now time to start gentle strength training for your calves. It’s best to carefully ease into the exercises as your strained calf is not yet strong and still needs protection. Avoid strong calf stretches as this will make your injury worse. You can proceed to the next stage when you can walk for short distances at a slow pace and perform the prescribed calf strength workouts without pain.

Your aim is now to restore full flexibility and build the strength needed for explosive movements (plyometrics). You’ll also improve the strength and control in your core and legs. Avoid all running, hopping and jumping activities. Proceed to the next stage when you can walk at a slow pace for 30 minutes, complete the prescribed calf strength workouts and perform the hop tests without pain.

You’re now preparing your calf muscles for a safe return to running. Start plyometric exercises while the calf strength program increases in difficulty. Avoid running activities. Proceed to the next stage when you can walk at a brisk pace for 30 minutes and can do the assigned calf strength and hopping workouts without pain.

You’re now ready to start a return to running program. The focus in your strength sessions will shift to maintaining your strength and their frequency will reduce as your running volume increases. You should not yet do any high intensity sessions e.g. tempo runs, interval, or hill sessions. Progress to the next stage when you can jog 20 minutes at an easy pace without aggravating your symptoms.

The focus is now on regaining your previous running endurance in your calf and leg muscles. The strength workouts will maintain the strength that you’ve built in the previous stages. Avoid high intensity running e.g. tempo, sprint or hill sessions. You can progress to the next stage when you’re able to run your normal weekly running volume at your regular easy running pace pain free.

You can now start to train with increasing speed and intensity. You should continue with your weekly strength routine to support your running activities and reduce re-injury risk.

The calf strain workouts consist of exercises that increase in intensity as your injury recovers
The Exakt Health app is a sports injury app that provides exercise based treatment plans for the most common running injuries.

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