Calf Tear (Calf Strain): Causes, Symptoms, and How Physiotherapy Helps You Recover

If you’ve ever felt a sudden sharp pain in the back of your lower leg, almost like someone kicked you, hit you with a rock, or something “popped”, there’s a good chance you’ve experienced a calf tear.

Calf strains are one of the most common lower limb injuries we see in physiotherapy clinics, particularly in runners, weekend athletes, and anyone who needs explosive push-off power.

What Is a Calf Tear?

The calf complex is made up of two main muscles:

• Gastrocnemius – the bigger, more powerful calf muscle that crosses both the knee and ankle

• Soleus – the deeper, endurance-based muscle that sits underneath gastrocnemius

  
  

A calf tear (or calf strain) occurs when muscle fibres are overstretched or overloaded, leading to micro-tears or larger partial tears.

The severity can range from mild (Grade 1) to significant partial ruptures (Grade 2–3).

Gastrocnemius Tear vs Soleus Tear

These injuries feel similar, but they behave differently:

• Gastrocnemius tears usually happen during sprinting, jumping or sudden acceleration

• Soleus tears are slower-building and often occur during long-distance running or uphill walking

  
  

Correctly identifying which muscle is involved drastically changes the treatment plan, which is why physiotherapy assessment is important.

How Do People Get a Calf Tear?

Calf tears usually happen during activities that require explosive power, rapid acceleration, or sudden change of direction. Common mechanisms include:

• Sprinting or taking off quickly

• Jumping or pushing off forcefully

• Sudden deceleration

• Running uphill

• Overstriding while running

• Fatigue or poor warm-up

• Returning to sport too quickly after a previous injury

  
  

Common Signs and Symptoms

A calf tear presents with a very recognisable pattern:

• Sudden sharp pain in the calf

• Feeling or hearing a “pop” or snapping sensation

• Localised tenderness in the muscle

• Difficulty pushing off when walking

• Pain when going up stairs or hills

• Tightness, swelling, or bruising in the lower leg

• Reduced calf strength and endurance

• Sometimes the injured person cannot fully weight-bear immediately after the incident

  
  

Gastrocnemius tears often feel more dramatic, while soleus injuries can feel like a persistent deep ache that worsens with prolonged activity.

How Physiotherapists Diagnose a Calf Tear

During a physio assessment, we look at:

• Palpation of the calf to identify the tear location

• Strength testing for gastrocnemius vs soleus

• Functional tests (heel raises, hopping tolerance, walking gait)

• Range of motion of the ankle and knee

• Assessment of biomechanics and calf loading

• Ruling out more serious conditions like DVT or Achilles rupture

  
  

Imaging (ultrasound or MRI) is only required when the severity is unclear or the patient is struggling to progress.

Physiotherapy Treatment for Calf Tears

Treatment depends on whether the gastrocnemius or soleus is injured and the severity of the tear, but all rehab follows a similar staged approach.

1. Acute Phase (First 3–7 Days)

• Load modification or temporary offloading as needed

• Compression and elevation to control swelling

• Gentle mobility drills to maintain ankle movement

• Pain-free isometric calf contractions

• Advice on avoiding stretching (early stretching can worsen the tear)

  
  

This is also where careful differential diagnosis is vital to rule out DVT or Achilles tendon injuries.

2. Early Rehab Phase

• Gradual progression of calf strengthening

• Activation of foot and hamstring muscles to support lower-limb loading

• Controlled walking re-introduction

• Combining bent-knee and straight-knee calf exercises to target both soleus and gastrocnemius

3. Strength and Conditioning Phase

This is where the real rebuilding happens:

• Progressive calf raises (double-leg → single-leg → weighted)

• Eccentric strengthening

• Plyometrics depending on goals (skipping, hops, bounds)

• Running drills: marching, A-skips, cadence work

• Strengthening of hips and core to reduce load on the calf

• Sport-specific conditioning for athletes

  
  

Good rehab ensures the muscle fibres heal in the right alignment and can tolerate high loads without re-injury.

4. Return to Running or Sport

A structured, criteria-based plan is essential to reduce recurrence. This includes:

• Running tolerance testing

• Hop tests

• Acceleration and deceleration drills

• Change-of-direction progressions

• Fatigue testing to ensure load sustainability

  
  

Rushing this phase is one of the biggest causes of recurrent calf tears.

Differential Diagnosis: What Else Could It Be?

Calf pain isn’t always a calf tear. Physios will always rule out:

1. Achilles Tendon Rupture or Tendinopathy

• Pain at the lower part of the calf or heel

• Weak push-off

• Possible “gap” in the tendon with rupture

• Often mistaken for a calf tear

  
  

2. Deep Vein Thrombosis (DVT)

• Redness, heat, swelling

• Pain not linked to a specific injury

• Requires urgent medical assessment

  
  

3. Soleus vs Gastrocnemius Injury

• Soleus pain is deeper and worse with endurance

• Gastrocnemius pain is sharper and worse with sprinting

  
  

4. Posterior Compartment Syndrome

• Tightness and pain during exercise that eases with rest

• Pressure issues inside the muscle compartment

  
  

5. Sciatic Nerve Referral

• Pain that tracks down the leg

• May not change with calf contraction

  
  

Correct diagnosis determines the right exercise plan, the right load, and the right timeline.

A calf tear may feel like a simple muscle strain, but without proper management, it can quickly become a recurring issue that affects running, sport, and even day-to-day walking.

Physiotherapy plays a crucial role in diagnosing whether the gastrocnemius or soleus is injured, guiding early load management, and building a strong, safe return-to-running plan.

If you’re experiencing sudden calf pain, tightness that won’t settle, or repeated “twinges,” an early physiotherapy assessment will help you recover faster and prevent re-injury.

If you're dealing with any of these symptoms. Book with Urban Physiotherapy today! - https://urban-physiotherapy.au2.cliniko.com/bookings?business_id=423637795941128200#service