In this video, we're going to look at what happens in your muscle when a calf muscle pops. Then,
why you may not see a bruise, or, the opposite: your calf muscle popped, and then suddenly,
a week later, you start to see a bruise. And then lastly, we'll look at how do you actually treat a
calf muscle that has popped. For those of you who don't know me, my name is Maryke. I'm one of the
physiotherapists from sports-injury-physio.com, where you can get online physiotherapy assessment
as well as treatment for your injuries – have a look at the description of this video if you
want the link to our website. Okay, so what happens in a calf muscle when you feel a pop?
It's basically, a popped calf muscle usually means that you've torn part of that muscle. And that
'pop' sensation is because it's a quick thing that happens, so it feels a bit of like a pop.
And it can often mean that it's quite a significant part of the muscle that you've torn.
Also, you may even sometimes hear a bit of a pop when it happens.
The important bit is that you make sure that that pop happened in the muscle fibres and
not actually on the Achilles tendon, because it's typical for an Achilles tendon, when that
tears, to feel like a pop, or you can hear a really loud sound when that happens.
And the treatment for these two things are quite different. A popped calf muscle can be
easily and really well treated via a progressive strength training program, and that's the main
way that you treat it. But if it's an Achilles tendon that's torn, you have to get it assessed
and treated in the correct manner within the first 48 hours for the best effect, because
you want to have it immobilized in a boot very likely, and you will need specialist input there.
If you don't get the correct management for an Achilles tendon that's torn,
then you can actually end up with a tendon that doesn't heal that well. I've linked to a video
about how you can tell if you've torn an Achilles tendon in the description of this video. Okay, so
calf muscle popped, but you're not actually seeing a bruise. Surely, if something … if a muscle
tears, you should see bruising? Now, actually not always. Remember how a muscle … the anatomy of a
muscle, basically. You've got your muscle fibres and your muscle cells, and then in between them
you have little blood vessels, and you've got a thick sheath of fascia around all of this, keeping
it all together. Now, you will only bruise if you also tear a significant blood vessel that can
bleed quite a bit before the bleeding stops. Also, you will only see that bruise if the dead blood
can actually come all the way up to the skin, where you can see it. So, what happens sometimes
is … Remember, you've got a nice, thick kind of fatty a sheath around your muscle. Now, fascia
is the white, sinewy stuff that you see in meat. If the bleeding happens all inside a thick sheath
like that and it doesn't get enough time to move through the sheath before the body absorbs it,
you'll never see a bruise. Second, if it's only a teeny-weeny little blood vessel that you tore,
again, the body's going to absorb that bad blood before it gets to move to the skin. So,
you don't have to see a bruise for your muscle to be torn. The opposite is also true: that you can
sometimes see an immediate bruise. But if you're wondering, ‘Wait a second, I popped ... This
calf muscle popped a week ago and only now I see a bit of a bruise. What's going on here?’
It's just because it took quite a while for that dead blood to come to the skin. And it could be
that the bleeding was quite deep inside, or it was in this fascia sheath and only later
on managed to move past that. So, that's why it can be that you only see the bruise after several
days. Now ... Fine! You understand now that you've torn your calf muscle; how do you actually treat a
calf muscle that's popped or torn? The first step is: You've got to protect it, and the first 48
hours is really important, or, that moment that it happens, do not try and run through it or try to
do your sport through it. People often think, ‘Oh, it just feels a bit like a cramp. I can go on.’
But actually, if you continue to train on it, you'll make it much worse, because that muscle is
now not as strong as it used to be. So, the first thing is, stop what you're doing and just protect
it for a couple of days, that that injury can settle. So, we talk about using the PRICE regime,
which is ‘protect, ice, compression, elevation’, and it's all just about taking care of it. Now,
around Day 2, it's time to start doing a strength training programme. So, from ... You don't
just rest until you don't feel any more pain, you just give it the first one or two days quite a
bit of rest. But then, after that, you start with relative rest and strength training. Now, relative
rest means that you do not immobilize it fully; you just cut out the aggravating activities. So,
you try to figure out, what can this calf muscle still do that feels comfortable for it? Now,
the answer to that will depend on how bad your injury is. Some people with a minor calf tear find
that they can walk around as much as they want; they just can't walk fast, or they just can't jog.
Others may find that, really hard to even place a heel to the floor if it's a bad tear. So,
relative rest means different things for different people, and your physio should
help you figure out what is the right amount of activity that will allow your calf muscle to heal
and not actually make it worse. Now, strength training is the second important component.
But when I say strength training, I don't mean just jump into it and go for it. Because that
muscle isn't strong; you'll just make your injury worse. You have to use a graded strength training
programme. And at the beginning, it can mean really simple movements that don’t actually really
strain things - just getting it going. And then, as it recovers, it should increase in difficulty.
Now, we've made some videos in the past about why people keep on getting calf strains; if they've
had one, it keeps on coming back. They had no pain, thought they could go back running, and
Boom! it happens again. The most important reason for this is usually that they’ve not actually
strength trained to the level they need for the sport they want to be doing. Now, that level
varies depending on your sport. So, if you're a runner, it will have to be quite a lot heavier
that you do your strength training to, eventually, compared to somebody who just walks. If you do
a sport where you do a lot of explosive movements, so, lots of jumping, or perhaps you’re a sprinter,
you have to really get quick movements going, then your rehab has to look different from a regular
runner’s, again - if somebody just wants to slow jog, for instance. So, it's important to
work with somebody who can help you really attain the strength you need before you go back to your
sport. Hope you found this useful! Let me know if you've got any questions. And remember, if you
need more help with an injury, you're welcome to consult one of our team of physios via video call;
you can find the link to the website in the description of this video. Take care!