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Differential Diagnoses of Calf pain:

Differential Diagnoses of Calf pain:

Its that time of year when we are all inclined to get out in the sunshine and start exercising.

It might be dusting off the old trainers for a run or popping out onto the tennis court with a friend!

The last thing we want is calf pain that stops us doing these activities.

Discussed below are three common diagnoses of calf pain, in our next newsletter we will discuss three other potential causes..

Deep Vein Thrombosis (DVT): It is the term used to describe the formation of a blood clot which can partially or fully obstruct blood flow. This can become dangerous if the clot escapes and travels up to your heart or lung – known as a pulmonary embolism. It affects 1 in every 1000 people in the UK.

It is most common after surgery/ long car or plane journeys when you have not been as active as you normally would be. If you are post-surgery, it is very important to keep wearing your TED stockings and take your course of anti-coagulant medication as instructed by your surgical team to prevent this condition from occurring.

The main symptoms to be aware of are:  

  • Pain and swelling in 1/both legs
  • Increased tenderness
  • Changes in temperature of the calf (more likely increased)
  • Redness of the calf

If you feel worried about this, please contact your GP or 111 for immediate advice.

Cellulitis can also present very similarly to DVT. It is defined as an acute bacterial infection of the dermis or subcutaneous tissue.

This presents as an acute onset of tender, painful, red hot and swollen skin that spreads rapidly.

You can feel unwell with this infection and have fevers, nausea and shivering. It normally presents unilaterally.

If you are suspecting this, please also liaise with your GP/111 for advice as this is normally treated successfully with antibiotics.

A calf strain is probably the most common diagnosis of calf pain.  It is defined as a stretch and/or tear of muscle fibres. It accounts for 13% of all injuries in football.

It is also known as ‘tennis leg’ as a result of the injury occurring with middle aged men whilst playing tennis. The mechanism of injury is normally when the knee is fully extended with foot planted, sometimes you can feel a ‘pop’ followed by increased swelling and pain.

Calf strains are graded accordingly to severity of symptoms.

Grade 1 normally occurs as a sharp pain at the time of injury but normally able to continue with activity. This occurs when there are a small number of muscle fibres torn.

Grade 2 presents as severe muscle pain and swelling and normally are unable to continue with activity. It can also present later with bruising and usually means that there are large numbers of fibres torn.

Grade 3 presents as a ‘pop’ sensation, with total loss of muscle function, severe pain swelling and bruising and difficulty to weight bear. This can result in full rupture of the achilles tendon.

If you have suffered from this injury – the most important thing to do immediately is to follow POLICE principles, this is a modern first aid principle to treat acute musculoskeletal injuries-

P – protect the area from further damage but doesn’t meant completely immobilise the joint. This can mean using crutches but still walking – you are just offloading the area slightly

OL – Optimal loading – try to keep the area moving gently as this can help reduce swelling and optimise healing. Your physiotherapist should be able to advise you regarding this.

Ice – utilise this to reduce your swelling. Optimal times for this are 15-20 mins every 2-3 hours for the first 24-48hours.

C – Compression – using a tubigrip/elasticated bandage around your calf can also help with the reduction of swelling.

E- Elevate – Try also to keep your leg slightly higher than your heart as this will be reduce swelling.

Calf strains can reoccur very easily if not rehabilitated correctly so please ensure you avail of our expert physiotherapists for full resolution of symptoms and return to full capacity.

Please call us on 0208 542 7788 to book an appointment.