Emergency Department Calf Strain Advice Information for patients page 2 What is a calf strain? A calf strain is a common injury and is often caused by overstretching or putting excess force through the calf muscle at the back of the lower leg. In this injury the muscle fibres are stretched and weakened, resulting in bleeding into the muscle. What are the symptoms? • Mild ache at rest to moderate pain on using the affected muscle • Swelling • Discolouration, redness or bruising • Difficulty in rising up on your toes or pushing off from your foot. page 3 How is it treated? The first treatment is to calm the inflammation and control the swelling and pain. This can be managed with the “RICE” treatment. R Rest: This will help prevent further injury and allow the healing process to begin. For the first few days, reduce the amount of walking you do until you can walk without pain. Avoid forceful and strenuous activity such as running and jumping until walking is pain free. I Ice: Ice can help reduce swelling and minimize pain. Make an ice pack by wrapping a small bag of frozen peas (which you can re-use several times by re-freezing) or by wrapping some crushed ice cubes in a damp towel. Put the ice pack on your injured calf for 10 minutes every 2 hours for the first couple of days after the injury. Then use ice 3 times a day until the swelling goes down. C Compression: You may have been given an elasticated bandage to support your calf and help reduce the swelling. If so, you should wear it during the day but leave it off at night. As the pain and symptoms settle, gradually reduce the length of time that you are wearing the bandage. The bandage can be washed and dried overnight. You should find that you no longer need the bandage within 2-3 weeks of the injury. E Elevation: Keeping your injured calf raised above the level of your hips for the first few days after injury helps to decrease the swelling and pain. page 4 Painkillers You can take painkillers such as paracetamol or a paracetamol / codeine mixture (e.g. co-codamol) as well as anti-inflammatory medicine such as ibuprofen. Paracetamol and ibuprofen tablets can be taken together. Please read the dosage instructions on the packets carefully. Rehabilitation and recovery Healing of the muscles normally takes about six weeks, though everyone recovers from injuries at different rates. This is related to the severity of the injury and any other medical problems that might be present. As healing gets underway, it is important you begin a series of exercises to gently stretch the calf muscle and regain normal positioning of the knee and ankle joints. This will help to reduce the risk of further injury. page 5 Exercises 1.Draw your foot up as far as possible, with toes pointing towards you. Hold for 5 seconds. Then point your foot away from you as far as possible. Hold for 5 seconds. Repeat 10 times. 2.Sit on a chair and straighten and bend your knee 10 times 3.Facing a wall, put your hands against the wall at about eye level. Keeping your injured leg back and the heel on the floor, lean in towards the wall (bending your uninjured leg at the knee) until you can feel a stretch in the back of your injured calf. Hold for 30 seconds. Repeat four times. Do this several times a day. 4.When you can stand on your toes without any pain, while standing, balance yourself on both feet behind a chair. Rise up onto your toes and hold for 5 seconds, then lower yourself back down. Repeat four 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. page 6 Remember • If the pain and swelling increase despite rest and / or • the calf looks very red and is tender and hot to touch please see your GP immediately. If you have persistent problems with pain, swelling or loss of function, or your injury is not recovering at the rate you expect, please see your GP. It will be safe for you to return to normal activity when you have: • Full strength • Full range of movement • Can walk briskly without pain or swelling Useful telephone numbers If you have any questions or concerns, please contact: Minor side, Emergency Department John Radcliffe Hospital Tel: (01865) 220224 Or contact your GP. page 7 If you need an interpreter or need a document in another language, large print, Braille or audio version, please call 01865 221473 or email [email protected] Emergency Nurse Practitioner Team John Radcliffe Hospital Version 2, April 2011 Review date: April 2014 Oxford Radcliffe Hospitals NHS Trust Oxford OX3 9DU www.oxfordradcliffe.nhs.uk/patientinformation OMI 2987