{"id":9598,"date":"2020-11-07T06:00:18","date_gmt":"2020-11-07T05:00:18","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=9598"},"modified":"2020-11-04T14:09:05","modified_gmt":"2020-11-04T13:09:05","slug":"medial-gastrocnemious-tears-in-sports-is-it-about-muscle-aponeurosis-or-tendon","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2020\/11\/07\/medial-gastrocnemious-tears-in-sports-is-it-about-muscle-aponeurosis-or-tendon\/","title":{"rendered":"Medial Gastrocnemious Tears In Sports: Is It About Muscle, Aponeurosis Or Tendon?"},"content":{"rendered":"
Even More, Does It Really Matter?<\/em><\/h5>\n

Calf muscle injuries are common in sports involving high-speed running and specially in acceleration and deceleration actions. It has been reported that calf muscle injuries contribute about 13% of muscle injuries in football, though it may be that this percentage is even higher nowadays (1, 2).<\/p>\n

It is easy and really common to speak about tennis leg (TL) injuries but, what is exactly a TL? It is a syndrome. It is defined as an acute pain in the postero\u2013medial region of the calf with functional limitation. Most frequently, it is a medial gastrocnemious (MG) rupture, but it can also be a plantaris rupture or a soleus rupture(3). Another important aspect is to understand that an intermuscular hematoma is only one of the signs that we can see (NOT always) in TL syndrome.<\/p>\n

Let\u2019s focus on the most frequent injuries in the calf, the MG injuries.<\/p>\n

Anatomy<\/strong><\/p>\n

One of the most important things is to understand the particular anatomy of the MG and the calf region. This region was well described by Blitz et al in 2007, summarised in figure 1.<\/p>\n

\"\"<\/p>\n

Fig. 1.<\/strong> Anatomical schema of the MG region. MGA (Medial Gastrocnemious Aponeurosis); SA (Soleus Aponeurosis); FGA (Free gastrocnemious Aponeurosis); AT (Achilles tend\u00f3n).<\/small><\/p>\n

What about Classifications and Imaging?<\/strong><\/p>\n

As is well known, there are in the recent years some important and interesting general muscle injuries classifications (5, 6). General classifications are really important but, in most cases, they don\u2019t show the whole picture of what is happening in a specific area.<\/p>\n

We realized, in recent years, that injuries affecting the MG had a great variety in their presentation and a highly variable prognosis despite occurring with the same injury mechanism and that all this could be seen easily with ultrasound. As such, we devised our own ultrasound classification system of medial gastrocnemious injurie<\/a>s.<\/p>\n

115 subjects (64 athletes and 51 occupational workers )with an injury to the medial head of the gastrocnemius were divided in 5 MG injury types.<\/p>\n

Ultrasound classification.<\/strong><\/p>\n

TYPE 1<\/strong>. Myoaponeurotic injury WITHOUT Aponeurotic deffect:<\/p>\n