Gastrocnemius Muscle Tear

synonyms:Tennis leg gastocnemius muscle tear

Gastrocnemius Tear ICD-9

• 844.9 (unspecified sprain and strain of knee and leg)

Gastrocnemius Tear Etiology / Epidemiology / Natural History

• Generaly middle aged recreational athlete

Gastrocnemius Tear Anatomy

• Generally caused bya tear of the medial head of the gastroc at the muscle-tendon junction.
• Gastroc may be prone to injury because it crosses two joints (knee & ankle).

Gastrocnemius Tear Clinical Evaluation

• Acute calf pain after a sudden move or jump. "Felt like someone kicked me in the backk of the leg".
• Increasing pain and swelling develop over initial 24 hours.
• Tenderness localized to the musculotendinous junction of the medial head of the gastroc.

Gastrocnemius Tear Xray / Diagnositc Tests

• MRI: hemorrhage within the gasctocnemius muscle.
• Duplex ultrasound: indicated if there is concern for DVT.
• Comparment pressure monitoring: indicated if pain is out of proportion or any concern for compartment syndrome.

Gastrocnemius Tear Classification / Treatment

• Isolated Gastoc tear: consider compartment pressure monitoring if there is any consideration for compartment syndrome. Elevation, Ice, Compression stocking. Early gentle active assist and passive ROM exercises, heel lift, crutches prn.
• Gastroc tear with compartment syndrome: fasciotomy

Gastrocnemius Tear Associated Injuries / Differential Diagnosis

• DVT / thrombphlebitis
• Compartment syndrome (Posterior)
• Achilles tendon rupture
• Chronic exertional compartment syndrome

Gastrocnemius Tear Complications

• Compartment Syndrome

Gastrocnemius Tear Follow-up Care

• Advance to WBAT. Generally full-weight bearing by 2-3 weeks.
• 2 weeks: Start strengthening exercises with sport specific rehab
• 4 weeks: graduated return to sport. Full painfree motion, 90% strength required for full return to sport.

Gastrocnemius Tear Review References

• Miller W, AJSM 1987;5:19