Medial Head Gastrocnemius Tear

What is Medial Head Gastrocnemius Tear

Medial head gastrocnemius tear also called tennis leg, is an injury to the inner part of the calf muscle.

This injury may include overstretching of the muscle or a partial or complete tear.

This is a common sports injury.

Calf muscle tears usually occur near the back of the knee.

Medial Head Gastrocnemius Tear often causes sudden pain and muscle weakness.

What are the causes?

Medial Head Gastrocnemius Tear is caused by forceful stretching or strain on the calf muscle.

This usually happens when you forcefully push off of your foot. It may also happen if you forcefully straighten your knee while your foot is flat on the ground.

What increases the risk?

The following factors may make you more likely to develop Medial Head Gastrocnemius Tear:

  • Being male and older than age 40.
  • Playing sports that involve:
    • Quick increases in speed and changes of direction, such as tennis and soccer.
    • Jumping, such as basketball.
    • Running, especially uphill or on uneven ground.

What are the symptoms of Medial Head Gastrocnemius Tear?

Symptoms of Medial Head Gastrocnemius Tear include:

  • Sudden pain in the back of the leg when the injury occurs. You may hear a popping sound or feel like you got hit in your calf.
  • Pain that is made worse by bringing your toes up toward your shin or by straightening your knee.
  • Pain on the inside of your calf, from your knee to your ankle.
  • Not being able to rise up on your toes.
  • Pain when pressing on your calf muscle.
  • Swelling of your calf.
  • Bruising along your calf and lower leg, down to your ankle.
  • Difficulty pushing off your foot when walking or using stairs.

How is Medial Head Gastrocnemius Tear diagnosed?

Medial Head Gastrocnemius Tear may be diagnosed based on:

  • Your symptoms and medical history.
  • A physical exam. Your health care provider may be able to feel a lump or a defect in your muscle.
  • MRI or ultrasound to determine the severity and exact location of your injury.

How is Medial Head Gastrocnemius Tear treated?

Treatment for Medial Head Gastrocnemius Tear may include:

  • Resting the muscle and keeping weight off your leg for several days. During this time, you may use crutches or another walking device.
  • Using a splint to keep your ankle or knee in a stable position.
  • Wearing a walking boot to decrease the use of your gastrocnemius muscle.
  • Using a wedge under your heel to reduce stretching of your healing muscle.
  • Wearing a compression sleeve around your calf muscle.
  • Icing the muscle.
  • Raising (elevating) your leg when resting.
  • Taking medicine for pain and swelling (NSAIDs or steroids).
  • Doing leg exercises as told by your health care provider or physical therapist.

Follow these instructions at home:

If you have a splint or compression sleeve:

  • Wear it as told by your health care provider. Remove it only as told by your health care provider.
  • Loosen the splint if your toes tingle, become numb, or turn cold and blue.
  • If your splint or sleeve is not waterproof:
    • Do not let it get wet.
    • Protect it with a watertight covering when you take a bath or a shower.
  • Keep the splint or sleeve clean.

Managing pain, stiffness, and swelling

  • If directed, put ice on the injured area:
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.
  • Move your toes often to avoid stiffness and to lessen swelling.
  • Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

Driving

  • Do not drive or operate heavy machinery while taking prescription pain medicine.
  • Ask your health care provider when it is safe to drive.

Activity

  • Do not use the injured limb to support your body weight until your health care provider says that you can. Use crutches as told by your health care provider.
  • Return gradually to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Do exercises as told by your health care provider.
  • Return to sporting activity only as told by your health care provider or physical therapist. Full recovery may take several months.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

How is Medial Head Gastrocnemius Tear prevented?

  • Warm up and stretch before being active.
  • Cool down and stretch after being active.
  • Give your body time to rest between periods of activity.
  • Make sure to use equipment that fits you.
  • Be safe and responsible while being active to avoid falls.
  • Maintain physical fitness, including:
    • Strength.
    • Flexibility.

Contact a health care provider if:

  • Your symptoms do not improve with rest and treatment.

Get help right away if:

  • You have swelling or redness in your calf that is getting worse.

Medial Head Gastrocnemius Tear Rehabilitation

Stretching and range of motion exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your lower leg. These exercises also help to relieve pain and stiffness.

Exercise A: Gastrocnemius stretch

  1. Sit with your left / right leg extended.
  2. Loop a belt or towel around the ball of your left / right foot. The ball of your foot is on the walking surface, right under your toes.
  3. Hold both ends of the belt or towel.
  4. Keep your left / right ankle and foot relaxed and keep your knee straight while you use the belt or towel to pull your foot and ankle toward you. Stop at the first point of resistance.
  5. Hold this position for few seconds.

Exercise B: Ankle alphabet

  1. Sit with your left / right leg supported at the lower leg.
    1. Do not rest your foot on anything.
    1. Make sure your foot has room to move freely.
  2. Think of your left / right foot as a paintbrush, and move your foot to trace each letter of the alphabet in the air. Keep your hip and knee still while you trace.
  3. Trace every letter from A to Z.

Strengthening exercises

These exercises build strength and endurance in your lower leg. Endurance is the ability to use your muscles for a long time, even after they get tired.

Exercise C: Plantar flexors with band

  1. Sit with your left / right leg extended.
  2. Loop a rubber exercise band or tube around the ball of your left / right foot. The ball of your foot is on the walking surface, right under your toes.
  3. While holding both ends of the band or tube, slowly point your toes downward, pushing them away from you.
  4. Hold this position for few seconds.
  5. Slowly return your foot to the starting position.

Exercise D: Plantar flexors, standing

  1. Stand with your feet shoulder-width apart.
  2. Place your hands on a wall or table to steady yourself as needed, but try not to use it very much for support.
  3. Rise up on your toes.
  4. If this exercise is too easy, try these options:
    1. Shift your weight toward your left / right leg until you feel challenged.
    1. If told by your health care provider, stand on your left / right foot only.
  5. Hold this position for few seconds.

Exercise E: Plantar flexors, eccentric

  1. Stand on the balls of your feet on the edge of a step. The ball of your foot is on the walking surface, right under your toes.
  2. Place your hands on a wall or railing for balance as needed, but try not to lean on it for support.
  3. Rise up on your toes, using both legs to help.
  4. Slowly shift all of your weight to your left / right foot and lift your other foot off the step.
  5. Slowly lower your left / right heel so it drops below the level of the step. You will feel a slight stretch in your left / right calf.
  6. Put your other foot back onto the step.
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