Calf injuries are common in field sports and distance running with a longer return to competitive sport and greater risk of re-injury depending on the extent of aponeurosis tissue affected. Not all calf injuries are the same therefore a clear diagnosis and a deep understanding of the anatomy of the calf muscles and connective tissue structures are important to determine the prognosis of the injury and direction of rehabilitation.

Similarly not every calf injury is a calf strain and vigilance to the differential diagnosis and potential red flags where is critical. It is also important to understand the contribution of the calf muscles to running across different speeds, acceleration and change of direction. There is a greater risk of re-injury when the athlete returns to running so it is important to have robust outcome measures to progress along the rehabilitation pathway.  

Learning Objectives:

• Anatomy of the Gastroc-soleus complex and its connective tissue structures 
• The mechanical demands of the calf muscles during sport
• Injury pattern recognition, diagnosis and classification of injury using imaging
• The use of strength and performance testing to guide rehabilitation and return to performance 
• Principles of rehabilitation  
• Case study of a recurrent Grade 2C soleus (central tendon) strain