Dr Martin's Blog

Friday, February 03, 2012

Matthew Rees and Luke Narraway to miss 6 Nations openers due to calf strain

Wales hooker Matthew Rees and England flanker Luke Narraway are set to miss the opening matches of the RBS 6 Nations this weekend, due to calf strains picked up in training.


Calf strainA calf strain injury - also known as a 'pulled calf', 'pulled muscle' or even ‘tennis leg’ - is common in many sports. It is caused when the muscle is stretched beyond its limits and the muscle tissue is torn.

There are three main muscles at the back of the calf: the medial gastrocnemius, the lateral gastrocnemius and the soleus, and a further small muscle called the plantaris. All of which come together above the back of the ankle to form the Achilles tendon.

Gastrocnemius strains are most common, thought to be due to the muscle crossing two joints (knee and ankle) and because the muscle contains a particular type of fast twitch muscle fibre. It is difficult to distinguish this from the less common plantaris strain, unless diagnostic imaging is used. The soleus muscle only crosses the ankle joint, and is mostly made up of slow twitch fibres, so is considered low risk for strain injury.

Depending on its severity, a calf injury is classified as a first, second or third degree strain. The grading can be done by medical examination and by diagnostic imaging, most commonly diagnostic ultrasound and MRI scanning.

It sounds like Matthew and Luke are suffering from a first or second degree strain. They will initially be prescribed ‘RICE’: rest, ice, compression and elevation. Followed by gentle muscle stretching, through to muscle strengthening exercises, for about 10 days. Massage and ultrasound are often added at this stage.

We wish them both a speedy recovery.


For more in-depth information: Curr Rev Musculoskelet Med. 2009 June; 2(2): 74–77. Gastrocnemius vs. soleus strain: how to differentiate and deal with calf muscle injuries


Posted by Martin Errington on 02/03 at 04:17 PM