Conservative Treatment for Calf Muscle Injuries

Abstract

Calf muscle strain injuries (CMSI) are common across sports involving high-speed running or high volumes of running load, acceleration and deceleration, and upon fatiguing conditions of play or performance (Orchard 2001). Football codes are significantly impacted by CMSI, with football showing match-play incidences of 0.84 per 1000 h (Carling et al. 2011), rugby union risk ratios ranging from 0.98 to 5.85 (Brooks and Kemp 2011) and CSMI representing one of the highest soft tissue injury incidences (3.0 per club per season) and recurrences (16%) in Australian Rules football (Orchard and Seward 2014). Calf injuries have a high mean time to return to sport in the event of any recurrence (Carling et al. 2011) and are more likely to occur during critical competitive periods, such as the end of the competition season in football (Mallo et al. 2011). Injuries to the lower leg/calf are one of the most prevalent muscle injuries in athletes involved in pole vault (Rebella 2015), in pre-professional dancers, in triathletes (Korkia et al. 1994), and in tennis (Colberg et al. 2015). Older players (above mean age) had an almost twofold increased rate of calf injury (HR, 1.93; 95% CI, 1.38–2.71), but no association was found in other muscle groups (Hagglund et al. 2013). Best evidence synthesis highlights chronological age and previous history of calf strain are the strongest risk factors for future calf muscle injury. Previous lower limb injuries (hamstring, quadriceps, adductors) show some limited evidence for an association. Numerous factors lack evidence of an association, including height, weight, gender, and side dominance.