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Management and Recovery for Acute Muscle Strains

So you’re working out in your garden and you go to stand up and “POP!”, there goes something in you calf. Most likely you have just strained your gastrocnemius, or pulled your calf. In this blog, we will discuss what to do once you have gotten up off the ground from cursing and rolling around from pain.

First off, pulling a muscle is when the muscle undergoes a certain amount force that cause the little fibers to tear. The amount of tearing and how much of the muscle is involved is what determines how bad the strain or tear is. For most muscle strains, you can manage the injury on your own but there are red flags to look out for.

If you see any of these things, contact your doctor.

–        Deformity of the muscle belly when compared to the non-affected side

–        Deep, intense, 10/10 pain that won’t subside

–        Hot, red, and very tender to touch.

–       If you can’t move the affected area, not from pain, but because you are physically unable to move it at all.


After a muscle undergoes an injury such as a strain or tearing, healing begins immediately. There are different stages that your body will go through to begin to close the gap that has just been created. You can help the process along by doing a few simple things.


RICE or Rest Ice Compression Elevation. Keep off the affected limb and use an ACE bandage to wrap the area, snug but not cutting off circulation. Ice should be utilized for about 15-20min off and on. Elevating the area will help to drain any excess fluid and swelling. All of these steps combine will help to reduce the amount of swelling which will in turn reduce the amount of scar tissue build up that occurs with healing. For a lower extremity injury such as to the calf muscle, you may need to limit the amount of walking you do. Some doctors may recommend using crutches if you are unable to walk without pain. If you can manage to stay off your feet for 50-75% of the day for the first few days, you probably don’t need to rush to the doctor to get crutches. If you have a busy week at work and will be required to walk a lot, you may need the crutches.


Day 4-14:

Depending on the severity, within the first week you will want to start moving the body part gently. Getting some early movement can help to improve blood flow and healing within the muscle. However, be careful not to start too early and not to push to the point of pain. You want to move within a pain free range of motion at first in order not to disturb the connective tissues that are trying to regrow. Immobilizing the muscle for too long can lead to atrophy and larger scar formation. If too much scar tissue forms, that muscle is more susceptible to reinjury.

During these two weeks, you will need to slowly progress through mobilization and gentle activation of the affected muscle. Here are examples for the calf as a possible progression.

1) Isometrically activate the muscle. You want to gently activate the muscle without going through a range of motion, your foot should not move during this exercise.  Use a towel to wrap around the bottom of your foot, without letting your foot move, push down into the towel like you are pressing on the gas pedal. You can also do this with your foot against the wall. Then you will want to gently and passively pull your toes towards you for a light stretch. If there’s immediate pain, hold off on this part.


2)  Begin to do more ankle pumps and even use a light TheraBand to add some resistance. Again, remember to gently stretch the calf when you finish your exercise.


3) You can begin walking for exercise when you feel like you have a normal stride with no limping. You are also free to start doing some calf raises with both feet on the ground first. When that gets easy, you can move into single leg calf raises.


4) When you are feeling about 80-90% better, you can begin a light jog. If there is any pain with jogging either during or later that night, then it is probably too soon to start. Wait another few days and then try again. You should use a run progression as well. Nothing is worse for a sore muscle than to go out and run 2-5 miles when you haven’t done anything in a few weeks. Slow and steady!


Remember, follow a slow and gentle progression when coming back from a muscle injury. If you don’t feel any change the first week or two, you may need to see a physician. If you have questions on anything, consult your physician (your real doctor, not WebMD).

Don’t hesitate to call Hemmett Health if we can help!


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