Experiencing calf muscle strain after playing tennis.

Dynamic-Warmup Tennis
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Question:

I’m a freelance employee so going to doctors etc isnt the easiest thing for me right now. I play tennis and maybe two weeks ago, I could feel my left calf getting kind of stiff but it was still fine to play on, and of course I ignored it…

Exactly a week ago, I was playing again and felt the shooting calf muscle pain, I had to immediately sit down and I left about twenty mins later. So, it has been a week now and I am still limping. There is maybe some yellow colored bruising, but it’s hard to tell. There was swelling I think on my inner calf area, but that seems to have mostly gone away. I don’t think I ever had a pronounced, purple bruise. I have been using a calf compression athletic sleeve and also icing it fairly often and elevating when sitting.

It’s just very sore, I have to limp slowly to get around or use a cane, still having trouble lifting my foot UPWARDS at the ankle (but down is fine) and I can still rarely put my full weight on it and step normally. So any advice you can give me would be great.

My understanding is I just need to try and rest it and the likelihood I’d need surgery isnt high? Should it be concerning that a week later I’m still having so much soreness and trouble walking?

Answer:

Thank you for your question. Without doing an examination, we’re not able to comment on your specific condition. However, calf muscle strains are relatively common in tennis players. In sudden, explosive steps, the calf muscles may fail to exert the necessary amount of power. As a result, some or all of the fibers in the muscle may tear. The muscles involved are typically the gastrocnemius and/or the soleus, the two primary muscles that point your toes downward (I.e. help you push off the ground in walking/running). In these instances, there is pain at the back of the calf which may or may not be accompanied by swelling and bruising depending on the severity of the injury. After a calf muscle strain, it is typical to have significant difficulty performing heel raise exercises or pushing off of your toes during walking or running. Pulling your foot upward at the ankle (dorsiflexion) can also cause pain as it stretches the calf muscles.

Initial treatment will often include offloading the painful muscles by reducing the individual’s activity level and using crutches or a cane to aid in mobility. Ice, compression, and elevation are all good strategies for managing inflammation and pain. In less severe muscle strains, this period of offloading may last only a few days. However, in more severe muscle strains it may be necessary to offload the calf for several weeks in order to allow for optimal healing without overloading the compromised muscle. The healing time for muscle varies based on many factors but is typically between 6-10 weeks.

It is not necessarily concerning that you are still having difficulty walking one week after your injury, but it does indicate that it is likely a more severe muscle strain if that is indeed the injury you have sustained. It is important to offload the injured calf enough so that daily activities are not re-aggravating the painful muscles since this can delay healing. Surgical interventions are typically reserved for cases of complete achilles tendon rupture, in which the tendon of the calf muscles is completely torn. In these cases, there will be a noticeable deformity of the muscle and/or achilles tendon of your calf.

During and after the period of unloading, it is typically recommended that you perform a gradual re-introduction of movement and strengthening for the calf/ankle. Muscular soreness is acceptable while performing these exercises, but pain is considered counter-productive to healing. Exercises following a calf injury typically begin with ankle pumps (moving your foot up and down in a non-weight bearing/sitting position) and progress from double leg heel raises to single leg heel raises, and, eventually, hopping, jogging and other higher-impact movements. It is important to address your ankle range of motion and hip, leg, and core muscle strength during this time in order to facilitate safe return to participation in sports.

Based on the description you have provided to us, we are unable to assess the potential that there is a non-muscular cause of your calf pain. Such causes can be quite dangerous and may include a blood clot (deep vein thrombosis) or dysfunction of your lumbar spine (low back). Due to the severity and duration of your symptoms, it is our recommendation that you seek assessment by a physical therapist. A physical therapist will be able to evaluate the severity of your injury and prescribe specific exercises to promote healing as well as address any underlying deficits in mobility or strength which may have predisposed you to this injury. He or she will also be able to rule out a more dangerous cause of your calf pain and refer you to the appropriate healthcare provider if necessary.

Please note, this reply is for informational purposes only. It’s not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, physical therapist, or other qualified health provider with a medical condition.

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