Calf Strain (Tennis Leg)
This injury is known in Dutch as a ‘zweepslag’ (literally ‘whip crack’), named after the sudden, sharp stab of pain that occurs during sport – a different condition from cervical whiplash caused by a car accident. It can range from a small strain to a complete tear of the muscle, and while it can occur in any muscle, it is most common in the calf or thigh muscles. The tear is usually located at the transition between muscle and tendon tissue. During activity, the person suddenly feels a sharp stab of pain in the calf, as if they had been struck with a hard object; after this it is usually impossible to keep exercising or even to stand on the affected leg. Alongside pain, swelling, bruising and loss of function of the affected muscle also occur. The bruising may appear in a different spot to where the tear itself occurred.
Symptoms
- Pain when tensing or stretching the calf.
- Bruising in the area around the calf.
- Loss of function of the affected muscle.
Causes
Various factors can play a role in the development of this injury, such as cold, damp weather conditions, insufficient or one-sided training, a hard surface, poor footwear, an inadequate warm-up, and uncoordinated or explosive movements. Of all these factors, the warm-up is particularly important. Research has shown that athletes who warm up for at least 10 minutes have a reduced risk of sustaining this injury. Experience also shows that athletes who complain of painful or stiff calf muscles before exercising have an increased risk of developing it.
Treatment
During the first 48 hours after the injury occurs, it's advisable to apply the RICE principle (see hamstring injury) to the affected leg. If you are then able to move again without pain, or with noticeably less pain, it is likely a mild injury. Try performing gentle, loosening movements of the ankle in all directions. Stretching exercises are also needed at this point: wrap a towel around the front of your foot and slowly pull the foot towards you. A mild stretching pain may occur. You can then gradually increase the load each following day, until everything can be done completely pain-free again. If you are unable to move with less pain the next day or over the following days, it is advisable to see your GP, who will in many cases refer you on to physiotherapy.
The patient will be treated by the physiotherapist (massage/dry needling/connective tissue massage/kinesiology taping) and given exercises to do at home. The physiotherapist may also advise the patient to walk with a temporary heel raise, the height of which can vary but will be reduced gradually. A heel raise serves to relieve the calf muscle and prevent it from being stretched to its full length. Using manual therapy, the physiotherapist will treat the calf through massage and friction techniques, working firmly on the painful area with the aim of speeding up recovery. The idea behind this is that, after treatment, the body receives an extra stimulus to restore the imbalance in the calf. The home exercises focus mainly on three areas: strength, stretching and coordination.
Stretching the short calf muscles:
- Kneel with your right knee on the floor.
- Rest your left armpit on your left knee.
- Press the left knee forward until the heel is just about to lift off the floor (without bouncing).
- You should feel a stretch low in the calf.
- Hold for 15–20 seconds.
- Then rest for 10–20 seconds.
- Repeat 3 times.
Starting more functional exercises:
- Jog on the spot for 2 minutes.
Strength and coordination exercises:
- Jump on the spot from one leg to the other.
- Gradually make wider jumps, building up to speed-skater jumps.
- These jumps can also be performed on both legs and in a forward-backward direction.
Finally:
- Stand upright on the injured leg.
- Push off with this leg and jump straight up.
- Land on the injured leg and hold your balance on this leg for 3 seconds.
- This can also be performed on both legs.