Gastrocnemius strain

Background

Gastrocnemius anatomy

• Also known as "Tennis leg"
• Typical mechanism of injury is pushing off with foot on affected side

Clinical Features

• Audible pop
• Calf pain
• Bruising
• Swollen muscle body (generally in medial calf area)

Calf Raise Test

• Plantar flex the affected ankle. Patients with achilles tendon rupture will not be able to complete the motion, gastrocnemius tears will be tender but can partially complete the motion.

Differential Diagnosis

Calf pain

• Achilles tendon rupture
• Calcaneal bursitis
• Cellulitis
• Compartment syndrome
• Deep venous thrombosis (DVT)
• Distal leg fractures
• Gastrocnemius strain
• Ruptured popliteal cyst (Bakers cyst)
• Superficial thrombophlebitis

Evaluation

• Typically a clinical diagnosis
• May consider tib/fib X-ray or DVT ultrasound to rule out other diagnoses, if unclear

Management

• RICE
• NSAIDS
• Ankle/foot bracing in a position of maximal tolerable dorsiflexion
• Early weight bearing as tolerated

Disposition

• Discharge

External Links

• https://emergencymedicinecases.com/episode-58-tendons-ligaments-missed-orthopedic-injuries/