If you’ve ever had cramp, you’ll know it can be incredibly painful, especially when in the calf. But how do you know it’s only cramp and it’s not something more serious? In this blog we will explore the differences between cramp, calf strains and calf tears and how they are diagnosed, treated and prevented.
Muscle cramps can be quite common; they only last a short time. Muscles cramps can happen at any time, commonly during exercise / physical activity, but they can also happen when resting or at night.
A cramp is when a muscle suddenly tightens, causing sudden pain making it hard to move. They can last a few seconds to as long as 10 minutes. In most cases cramps will ease off on their own. Stretching or massaging the affected muscle can help to ease the pain. Muscles may feel sore up to 24 hours post muscle cramp.
The cause of cramps can vary from no cause to putting too much load / strain on a muscle, not drinking enough fluids or causing dehydration particularly during hot or humid weather.
Some other factors that may affect cramps can be:
- Aging
- Pregnancy in later stages
- Liver disease
So how do we know when it might be something more than just a cramp. How do we identify a Calf Strain/ Tear?
It is important to note that within Clinical literature, the phrase strain is not recommended to use based due to the grading system, where MRI scans can determine the percentage of tear within the muscle. However, the term strain typically refers to over stretched muscle.
Calf “strain” commonly happens during the pushing off phase, where the movement is sudden; for example sprinting or jumping. This can cause sudden, sharp pain or even dull latent pain which may start after a few steps.
Typically patients will report that they heard an audible “pop” – which is the affected tissue tearing or as though they have been kicked in the back of the leg. A bruising can appear some what instantly or gradually appear over 24-48 hours.
“Strain” / tear or cramp? In a Tear the calf may show some of these common markers:
- Tenderness to touch at the point of injury
- Swelling
- Bruising may appear within hours or days
- Stretching of the muscle will reproduce pain
- Pain on resisted plantarflexion
Here is a small insight into how tears are graded, with approximate recovery times as seen in the table below:
The British Athletics Muscle Injury Classification (BAMIC) has defined a two-part grading system for these injuries, Grade 0-4, with the addition of A – myofascial, B – Musculo-tendinous or C – intratendinous.
| Grade of Injury | Classification | ABC | Approximate recovery time |
| 0 | Post exercise soreness, DOMS (delayed onset muscle soreness) | A,B | 0-3 Days |
| 1 | Small Tear | A,B | 0-2 Weeks |
| 2 | Moderate Tear | A,B,C | 1-3 Months |
| 3 | Extensive Tear | A,B,C | 3-6 Months |
| 4 | Full Rupture | C | 6-12 Months (possible surgery) |
When should you go and see a Physiotherapist:
- Pain is persisting
- Loud audible pop
- Bruising
- Swelling
When something does not feel quite right, or your movement, daily living, or sport is affected, do not ignore it. Early assessment can make all the difference and get you back to being pain free in your daily living.
If you are interested in booking an appointment with us, then please get in touch. Book an appointment online.
