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I have decided to write this month’s article about an injury that one of my patients sustained. My patient told me to write the blog “on an injury that is very close to my heart, or should I say close to my cal. I have had to spend the last three weeks sitting on the bench at netball watching my team play, due to the fact that I spent three days straight in high heels at the Easter Autumn Carnival, rocked up to play netball the next night and tore my right calf. This is the third time in the last 6 months I have been sidelined with this injury….punish!!”
The calf muscle, technically has two muscles known as the Gastrocnemius and the Soleus, are the big muscles at the back of your lower leg. The Gastrocnemius originates from the femur bone and the Soleus from the Tibia. Both muscles join to form the one Achilles Tendon, that inserts on to the Calcaneum bone of the foot. It is a powerful muscle that plantarflexes, or points the foot downwards, and it gives you strength when you go to push-off to run or jump. Damage to this muscle is common in dynamic sports with rapid movements such as tennis, squash, basketball, football and or course netball.
When the calf is torn there is a sudden pain in the leg and the athlete often feels as though they have been hit by something. When I tore my left calf three years ago I literally turned around on the netball court to see where the tennis ball had come from. Unfortunately there was no tennis ball just a torn muscle.
Once the calf is torn there will be tenderness over the tear site, swelling and bruising and sometimes you can see and feel a gap in the muscle tissue. People come limping into the clinic, often on crutches, unable to put their heel to the ground due to pain.
Initial treatment follows the RICE principle. Support the calf with Tubiband bandage and attend your PHYSIOTHERAPIST to have Dynamic Tape applied to support the Fascia that overlies the muscle. This helps the muscle heal faster and reduce the pain from the haematoma in the muscle belly. A haematoma is caused when the muscle tears and blood vessels rip, thus allowing blood to be pumped in to the muscle. Physiotherapy should also involve using the BODYFLOW Electronic Device that promotes blood flow and reduces lymphoedema and the healing times (see Bodyflow on the Hinterland Physiotherapy website). Care MUST be taken to ascertain where the tear is. Because of the shape of these muscles, the tear can occur deep in the muscle tissue or where the muscle attaches to the tendon. Early walking or stretching can continue the tear along the tendon, thus extending your injury. Proper diagnosis by a Physiotherapist then managed treatment and graded exercises with slow return to activity and sport is required in order that the injury recovers correctly, without scar tissue developing that may put the athlete at risk of repeated rupture.
Before returning to sport/activity the calf needs to be re-strengthened. Physios will graduate your strength programme specific to the demands of the sport, and return to playing can only be considered when all repetitive testing activities are strong and painfree. A good rule of thumb is that when the leg feels good, give it another week…the injury is possibly one of the most recurrent and annoying injuries we treat.
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