Calf Tear Diagnosis London | Private Ultrasound Diagnosis

Calf Muscle Tears Explained

Basic Calf Muscle Anatomy

A calf muscle tear is a common condition seen in both sportspeople and the general population, most often caused by rapid acceleration movements.

The calf muscle complex consists of:

• The large gastrocnemius muscle, which has two heads visible in the upper calf

• The soleus muscle, which underlies the gastrocnemius in the calf

• In many individuals, a thin muscle called the plantaris, which blends with the medial (inner) aspect of the Achilles tendon

Causes of a Calf Muscle Tear

The primary function of the calf muscles is to perform plantarflexion of the ankle — the movement involved in pushing off the ground during:

• Walking

• Running

• Acceleration

Due to its key role in rapid, forceful movements, the gastrocnemius muscle is by far the most commonly injured muscle in the calf.

Diagnosing a Calf Muscle Tear

Below is an example of a large haematoma (bleed) within the medial head of the gastrocnemius, as demonstrated on ultrasound three days following injury.

In comparison, here is an example of a more rare plantaris muscle and tendon rupture, where remnant inflammation can be seen in the region of the tendon and muscle belly, deep to the medial head of the gastrocnemius on ultrasound.

Ultrasound diagnostic imaging is the most effective method for:

• Locating the exact site and extent of a calf muscle tear

• Excluding significant injury to the Achilles tendon complex

Treatment for a Calf Muscle Tear

Early Treatment for a Calf Muscle Tear

Progressive Stretches for Calf Muscle Tears

Progressive Strengthening for Soleus Muscle

Progressive Strengthening for Gastrocnemius Muscle

Calf Muscle Tear | Evidence base

Calf muscle tears, most commonly involving the medial gastrocnemius or soleus, are acute soft-tissue injuries characterised by sudden pain, swelling, and functional limitation. Most cases follow a predictable healing course over weeks to months with appropriately graded rehabilitation. Evidence supports conservative management as the mainstay of treatment, including relative rest, progressive loading, and neuromuscular rehabilitation. The role of injection therapy is limited and should be carefully selected. Ultrasound guidance is primarily valuable for diagnostic clarification, identifying the location and extent of the tear, associated haematoma, and stage of healing. In selected cases with a persistent, symptomatic fluid collection or organised haematoma, ultrasound-guided aspiration may be considered to reduce pain or mechanical restriction. Corticosteroid injection into muscle tissue is not routinely recommended due to concerns regarding impaired healing and increased risk of re-injury. Overall, ultrasound-guided procedures in calf muscle tears are adjunctive and supportive, with recovery driven primarily by a structured, progressive rehabilitation program.

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