{"id":63,"date":"2008-10-16T01:17:31","date_gmt":"2008-10-16T00:17:31","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=63"},"modified":"2008-10-16T06:07:04","modified_gmt":"2008-10-16T05:07:04","slug":"patient-information-sheet-calf-strain","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2008\/10\/16\/patient-information-sheet-calf-strain\/","title":{"rendered":"Patient Information Sheet &#8211; Calf Strain"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/farm4.static.flickr.com\/3006\/2945632383_bb32e7ba82_o.jpg\" width=\"500\" height=\"281\" alt=\"runnersbjsm\" \/><\/p>\n<p><strong>CALF STRAIN (also known as tennis leg)<\/strong><br \/>\nBY Dr Chris Milne, Sports Physician\t<\/p>\n<p><strong>What is it?<\/strong><br \/>\nIt is a strain of one of the muscles of the lower leg.  Usually it is the medial gastrocnemius muscle that is injured.<\/p>\n<p><strong>What causes it?<\/strong><br \/>\nIt usually occurs when you are running fast or changing direction.  Because the gastrocnemius muscles pass over two joints, they have a difficult job to do and are prone to overload when they are lengthening against resistance.<\/p>\n<p><strong>Symptoms \u2013 what you notice<\/strong><\/p>\n<ul>\n<li>Pain \u2013 in the inside of the calf, about halfway between the knee and ankle.  The pain is usually of sudden onset, and severe enough to make you stop running straightaway.<\/li>\n<li>Weakness of toe-off action (ankle flexion).<br \/>\nYou may notice tracking of blood below the skin a few days after the injury.  This is a good sign, as it helps the injured muscle heal.<\/li>\n<\/ul>\n<p><strong>Signs \u2013 what the doctor finds<\/strong><\/p>\n<ul>\n<li>Tenderness over a 2-3cm length of tissue, usually at the junction between the lower end of the calcaneal muscle and the upper end of the achilles tendon.<\/li>\n<li>Pain and weakness on resisted ankle flexion (toe-off action).<br \/>\nThere may be some evidence of referred pain from the low back.<\/li>\n<li>In rare cases, there may be a contour defect over the injured area.  This is easier to see when the muscle contracts against resistance.<\/li>\n<\/ul>\n<p><strong>Investigations<\/strong><br \/>\nUsually none are required.  If the injury is not healing as expected, an ultrasound scan may be ordered.<\/p>\n<p><strong>Treatment<\/strong><\/p>\n<ul>\n<li>First aid \u2013 an ice pack applied over the injured area is useful.  Take Panadol or anti-inflammatory tablets.<\/li>\n<li>A graduated physiotherapy rehabilitation programme is the main part of treatment.<\/li>\n<li>An orthopedic felt wedge put under the inside part of the heel can help in the early recovery phase. It acts as a chock and takes some tension off the injured calf muscle.<\/li>\n<li>Surgery is hardly ever required, unless there is a significant tear of the upper part of the achilles tendon.<\/li>\n<\/ul>\n<p><strong>Recovery time<\/strong><br \/>\nAverage recovery time is 2-4 weeks.  Don\u2019t be tempted to push things too quickly, as recurrent strain in a partially healed injury is quite common.<\/p>\n<p><strong>Recovery sequence<\/strong><\/p>\n<ul>\n<li><strong>Step 1<\/strong>\tIce packs, pain relief, orthopedic felt wedge in footwear.<\/li>\n<li><strong>Step 2<\/strong>\tPhysiotherapy treatment to restore full range of motion of the knee and ankle, then build strength and endurance.<\/li>\n<li><strong>Step 3\t<\/strong>Don\u2019t run, but you should be able to start swimming or cycling a few days after the injury.  Keep doing upper body weights and calf raises.<\/li>\n<li><strong>Step 4\t<\/strong>Restart running, beginning slowly on grass.<\/li>\n<li><strong>Step 5<\/strong>\tBuild up pace and add stop-start routines.<\/li>\n<li><strong>Step 6<\/strong>\tRun figure eights.<\/li>\n<li><strong>Step 7<\/strong>\tPerform cutting and turning exercises.<\/li>\n<li><strong>Step 8<\/strong>\tTeam training and skill sessions.<\/li>\n<li><strong>Step 9<\/strong> Resume playing, half a game at first.<\/li>\n<p>\t\t\t\t\t\t\t\t      <!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>CALF STRAIN (also known as tennis leg) BY Dr Chris Milne, Sports Physician What is it? It is a strain of one of the muscles of the lower leg. Usually it is the medial gastrocnemius muscle that is injured. What causes it? It usually occurs when you are running fast or changing direction. Because the [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2008\/10\/16\/patient-information-sheet-calf-strain\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[194],"tags":[],"class_list":["post-63","post","type-post","status-publish","format-standard","hentry","category-patient-handouts"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Patient Information Sheet - Calf Strain - BJSM blog - social media&#039;s leading SEM voice<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2008\/10\/16\/patient-information-sheet-calf-strain\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Patient Information Sheet - Calf Strain - BJSM blog - social media&#039;s leading SEM voice\" \/>\n<meta property=\"og:description\" content=\"CALF STRAIN (also known as tennis leg) BY Dr Chris Milne, Sports Physician What is it? 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