Emergency and Urgent Care - Calf Strain Advice

What is a calf strain?

A calf strain is a common injury often caused by overstretching or putting excess force through the calf muscles at the back of the lower leg; this results in bleeding into the muscles due to the muscle fibres being stretched and weakened.

What are the symptoms?

• Mild ache when resting to moderate pain when using the calf muscle
• Swelling
• Bruising or redness
• Difficulty in rising up onto your toes or pushing off from your foot

How is it treated?

R - Rest: will help prevent further injury and allows the healing process to begin. Reduce the amount of walking you do for the first few days. Gentle ankle exercises will prevent stiffness in the ankle and lower leg. Avoid forceful or strenuous activity such as running or jumping until you can walk without any pain. Always try to walk normally – heel striking the floor first, rocking forwards on your foot and then pushing off with your toes.

I - Ice: Can help reduce swelling and reduce pain. To make an ice pack, you can use a small bag of frozen peas or some crushed ice cubes in a bag, wrap them in a damp tea towel - do not put ice directly onto the skin. Put the ice pack onto your injured leg for 10-20 minutes every 2 hours for the first 2-3 days. After this you can use the ice pack 3 times a day until the swelling subsides. You can re-freeze the ice pack, but do not eat food that has thawed and been refrozen.

P - Painkillers. It is important that you take your regular pain relief to reduce the pain and help to keep you mobile.
Paracetamol and ibuprofen are effective painkillers if taken regularly and work well when taken together. These can be purchased over-the-counter, at supermarkets of pharmacies, and cost much less that the price of a prescription. Please read the instructions on the pack carefully, and only take the recommended dosage. Also, you may need to check if there are any reasons why you may not be able to take these medications, i.e. allergy, asthma, other medications that you take regularly - a pharmacist will be able to advise you about this.

E - Elevation: Keep your injured leg raised above the level of your hips for the first 2-3 days after your injury. This will help reduce the swelling and pain.

Compression – elasticated bandages are not routinely dispensed anymore for sprains and strains. Whilst they can help to reduce swelling in severe cases, there is no consistent evidence that they make any difference to how quickly or well you may recover from your injury.

Recovery

Healing of muscles takes about 6 weeks, although everybody recovers from injuries at different rates. How quickly you will recover from your injury will depend on how severe your injury is, as well as any other medical problems that you may have.

As healing begins, it is important you begin a series of exercises to gently stretch the calf muscles. This will help your knee and ankle joints to get back into their normal position and will help to reduced further injury.

It will be safe for you to return to normal activity when you have:

• Full strength
• Full range of movement (you can move the injured leg the same as your uninjured leg)
• Can walk briskly without any pain or swelling

Seek medical attention immediately if:

• The pain and swelling increase despite resting
• Your calf looks very red, is tender and hot to touch
• If you are having continuing problems with pain, swelling, problems using your calf or leg, or your injury is not recovering at the rate you expect

Exercises

Sit on the floor with your legs straight out in front of you:

• Keep your heel on the floor and gently stretch your foot up towards you as far as possible with your toes pointing up and towards you
• Hold for 5 seconds
• Then point your foot away from you as far as possible
• Hold for 5 seconds
• Repeat 10 times

Sit on a chair and straighten and bend you knee 10 times

Facing a wall and put your hands against the wall at about eye level:

• Keeping your BAD leg back and the heel on the floor, take a small step forward with your GOOD leg and then lean in towards the wall (bending your GOOD leg at the knee) until you can feel a stretch at the back of your BAD leg
• Hold for 30 seconds
• Repeat 4 times
• Do this several times a day

When you can stand on your toes without any pain, stand behind a chair and balance yourself on both feet:

• Rise up onto your toes and hold for 5 seconds
• Lower yourself back down
• Repeat 4 times
• Do this twice a day
• Increase the number of repetitions every second day
• Increase the time you hold the position by 5 seconds every week

Driving

It is important that you contact your insurance company to let them know about your injury. You may be able to drive once you are able to perform an emergency stop safely and fully operate your vehicle.

Physiotherapy

If you are unsure about what to do and feel you need support with your rehabilitation, then you can always go to see a Physiotherapist.

If you live in the Heywood, Middleton and Rochdale area, you can refer yourself by using the following link: www.physiodirect.northerncarealliance.nhs.uk

Work

If you do not feel capable of working either due to pain or reduced movement/mobility, you are able to self-certify sickness for the first 7 days.

You must complete a self-certification form found on the government website and give this to your employer. This entitles you to statutory sick pay from your employer for up to 7 days.

To access the self-certification form, follow this link:
https://www.gov.uk/government/publications/statutory-sickpay- employees-statement-of-sickness-sc2

If you feel you need longer than 7 days off work, you must contact your GP for a sick note. The Urgent Treatment Centre does not issue sick notes.

Possible complications

If follow up has been arranged you should attend this.

If your injury does not require follow up you will have been given an approximate recovery time during your visit to the Urgent Treatment Centre:

• If the pain is ongoing despite treatment and analgesia
• You experience tingling/change in sensation to the lower leg or foot
• You develop signs of a DVT such as redness and hard swelling to calf please contact Rochdale Urgent Treatment Centre on 01706 517023 or return to the department.