Medial Gastrocnemius Strain

Tennis Leg

medial gastrocnemius strain
The calf muscle is commonly injured in sports activities. Photo © Maridav

A medial gastrocnemius strain (MGS) is a specific type of injury to the calf muscle in the back of the leg.  A muscle strain occurs when the muscle is stretched too far, which causes tears to occur within the muscle. A calf strain occurs when the muscle in the back of the leg sustains this type of injury.

The Calf Muscles

The calf is made of three major muscles, the medial and lateral gastrocnemius and the soleus muscle.

They unite to form the Achilles tendon to attach to the heel. The most commonly injured muscle when a calf strain occurs is an injury to the medial gastrocnemius muscle. It is important to determine whether the gastrocnemius is injured or the soleus in order to give the appropriate treatment and prevent recurrence.

Causes

Calf injuries are commonly seen in sports such as running, soccer, and tennis, and they can even be called, "tennis leg." The gastrocnemius muscle crosses the knee joint and the ankle joint, flexing the foot and the leg. Sudden changes in direction when running can overstretch the muscle and lead to a tear, especially in the position where you are flexing the ankle and extending the knee at the same time. Injuries can also happen in everyday life in physically demanding activities.

Signs and Symptoms

The symptoms of a medial gastrocnemius strain include:

  • Pain in the back of the leg (more on the inner side)
  • Swelling of the calf
  • Bruising of the calf down to the ankle
  • May hear an audible pop at the moment of the injury

Diagnosis

Your doctor will listen to your report of the injury and do a physical examination. Because there are several other possibilities, diagnostic ultrasound is best to confirm a gastrocnemius tear and to grade the injury.

If a deep venous thrombosis is suspected, a Doppler ultrasound may be done. MRI might also be used.

Treatment

Treatment of a medial gastrocnemius strain can usually be accomplished simple steps. Initially, patients begin with typical "RICE" treatments of:

  • Rest: Avoiding activities that cause pain. Sometimes people will use crutches for a few days or a week to allow the most significant symptoms of pain to settle down.
  • Ice: Icing the calf muscle can help with pain, reduce swelling, and ease the inflammation.  Ice is one of the most helpful treatments in the early phase of treatment.
  • Compression:  Compression can help to control swelling and can also help support the muscle and reduce spasm.  A simple compression sock or sleeve can help.
  • Elevation: Elevation is also beneficial to help swelling move out of the leg.

It's best not to use heat or massage in the first phase of therapy as that might increase the risk of hemorrhage.

Once the earliest phases of treatment have completed, patients can begin therapeutic activities and gentle stretching. Friction massage may help decrease adhesions. Typical recovery from a medial gastrocnemius strain is six weeks until return to athletic activities. You must be able to walk without pain before you are ready to return to exercise and sports.

Also Known As: MGS, calf strain, gastroc strain

Sources:

Dixon JB. Gastrocnemius vs. soleus strain: how to differentiate and deal with calf muscle injuries. Current Reviews in Musculoskeletal Medicine. 2009;2(2):74-77. doi:10.1007/s12178-009-9045-8.

Nsitem V. Diagnosis and Rehabilitation of Gastrocnemius Muscle Tear: a Case ReportJ Can Chiropr Assoc. 2013 Dec; 57(4): 327–333.

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