We provide this free health resource to visitors of the Community Room of SeniorSSuperStoreS in an effort to keep baby boomers, seniors and the elderly informed of matters that can affect their health and lifestyle.

Gastrocnemius strain is more commonly known as tennis leg. It is a muscle strain of the leg that occurs when players forcefully push off on one leg to move toward a wide ball or when the player lunges toward a serve. The strain usually affects middle-aged tennis players. Women are more prone to the injury than men. Tennis leg is not often seen in elite athletes, young people, or those beyond middle-age.

Tennis leg is a problem of the occasional athlete or "weekend warrior." Unconditioned people are more apt to suffer from tennis leg than fit people because their muscles aren’t used to moving. The muscles are not used, they are not in shape and thus, are more susceptible to tearing. Global fatigue precedes the injury so unfit athletes should rest when weary to avoid tearing of the gastrocnemius muscle. If you’ve attended a week long tennis camp or are a weekend player who has played three sets instead of your normal two, watch out for symptoms of tennis leg because you could be setting yourself up for an injury.

Whether an avid tennis player or not, stretching and strengthening the calves with exercises is the key to preventing tennis leg.

Symptoms Include Localized, Severe Pain and Bleeding

Tennis leg is similar to an Achilles tendon injury. At the time of injury, players experience searing pain or a tearing sensation in the calf as a plantar flexed foot (up on the toes) moves to dorsiflexion (raised toes while resting on the heel); the player may actually feel a "pop" as the gastroc nemius muscle tears.

Pain is instantaneous; as soon as the bleeding starts, the gastrocnemius goes into spasm, causing intense pain. Players may move after the injury, but once they stop, the gastrocnemius tightens up; the foot plantar flexes and the player can no longer put their heel down or bear weight without pain. In extreme cases a player must be assisted off the court.

The injury may be characterized by a bulge, and is painful to the touch. The pain is always located on the medial (inside) side. Ecchymosis, or bruising, extends to the ankle and foot in about half of the cases; more severe cases have bruising apparent after the first few days along with swelling and distention.

Treatment and Rehabilitation Should Be Immediate and Aggressive

Treatment must focus on minimizing the secondary effects of the injury through early treatment and an aggressive rehabilitation program. Immediate treatment should include icing and compression. Compressing is most important so that blood will not pool in the leg; an elastic bandage should be wrapped from the toes to the knee.

A physical therapist or certified athletic trainer may use ultrasound to help eliminate pain and swelling. Ultrasound also helps by pumping fluid out of the muscle and new nutrients into it for tissue rebuilding. In addition, an e-stim (electrical stimulation device) may be used to help reactivate the muscle after it is torn. In this process, electricity is used to stimulate or contract the muscle.

One exercise patients should perform is to sit with legs extended in front of them. Then hook a sturdy elastic band over the ball of the foot and gently pull the band against the resistance of the foot pushing down. Patients should perform three sets of 10 slow repetitions at least three times a day.

In the second exercise, patients start doing seated toe raises soon after the injury occurs. They should try several sets of 10 repetitions. At first, patients should use both legs; as the injured leg becomes stronger, they can gradually begin to do the toe raises standing and then one leg at a time. For best results, patients must do toe raises frequently, performing them throughout the day whenever they find themselves standing still.

The risk of a gastrocnemius injury increases significantly after an athlete has sustained one. A recurrence often happens to an injured player who returns to tennis and quits performing the stretching and strengthening exercises. After the first injury, the athlete must continue to perform at least one-legged toe raises 2 to 3 days a week to build and maintain strength of the gastrocnemius muscle, further preventing injury.

Tennis leg can take a long time to heal if an injured player doesn’t begin a rehabilitation program immediately and stick with it. Noncompliance can prevent players from returning to tennis for 3 or 4 months. Patients will recover when treated conservatively, but nonaggressive treatment extends the recovery period. However, early and aggressive rehabilitation allows most patients to recover within a few weeks.

(Courtesy of David Vaughn at Vaughn, Buchanan Shelley and Associates, Physical Therapists, in Greenville, South Carolina, phone 864-234-5842.)

And, if you only slightly overdo it and those muscles ache, we have just what you need. We carry an extensive lineup of muscle relaxation products and hot / cold packs in our Health Products department.