Calf strain (tennis leg)
I felt a sudden sharp pain in my calf. Did I tear it?
A strain of the calf muscles, common in running, court sports and older athletes. Progressive loading guides return to sport.
What it feels like
A sudden pain in the calf, sometimes described as being hit from behind, during running, pushing off or a sudden change of direction, followed by pain walking, rising onto the toes and sometimes bruising.
What is actually happening
One of the calf muscles, often the inner part of the gastrocnemius, is strained. A systematic review of risk factors found that older age and a previous calf strain are among the strongest predictors of calf injury, which is why thorough rehabilitation matters.
When to see a doctor urgently
See a doctor urgently if the calf becomes swollen, warm or red, especially if the pain came on without a clear injury, or after a long trip, surgery or time with the leg immobilised, as this can be a blood clot, or if you cannot rise onto your toes and feel a gap at the back of the heel, which can mean an Achilles tendon rupture.
How it is assessed
Assessment includes how it happened, where it is tender, calf strength and endurance, single-leg heel raise capacity, and tests to rule out an Achilles tendon rupture.
How it is treated
Rehabilitation progresses calf loading from early pain-free activation to heavier strength work, then hopping, running and sport-specific drills. Return to sport is guided by calf capacity and pain-free running rather than time alone, and previous injuries and training load are addressed to lower the risk of another strain.
What to do first
Protect the calf for the first few days, walk within comfort, avoid stretching it hard, and have it assessed so that loading starts at the right level.
Where this is assessed
- The Runner's Academy St. Clair West · Mon/Wed/Fri · 3:00 PM – 6:30 PM Book at Runner's Academy
- Athlete's Care Sports Medicine Centres Yonge & Eglinton · Mon/Wed/Fri · 8:00 AM – 2:00 PM Book at Athlete's Care
- Push Pounds Sports Medicine Downtown Toronto · Tue/Thu · 8:30 AM – 6:30 PM Call Push Pounds to book
References
This page is based on the following clinical practice guidelines and research.