Tennis Leg

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Man holding his calf in apparent pain, possibly due to tennis leg injury

Tennis leg is a sports related injury that causes acute mid calf pain and is experienced mainly by middle aged persons. You can get this injury while participating in many different sports or other activities besides tennis. However, it was first clinically described in 1883 in a tennis player.

Tennis leg symptoms normally  include a pop or snap in the calf muscles accompanied by a sharp burning pain. You will experience difficulty walking or running and may be forced to limp.

Although it is an unpleasant injury, tennis leg does not normally require surgery. Instead, it is usually treatable at home by resting and icing the calf muscles. Doctors can also suggest other conservative steps you can take to control pain and inflammation.

Causes Of Tennis Leg

The calf has two large muscle groups that control lower leg movement. The soleus is the smaller of the two and sits beneath the other muscle (the gastrocnemium) and farther from the skin.

The gastrocnemius is the larger of the two muscles and sits closer to the skin, making it the superficial muscle. It is also a two headed muscle and spans two joints (the ankle and the knee), making it what is called a biarthrodial muscle.

As a biarthrodial muscle, the gastrocnemius can be subject to forces at both ends from two independent joints. As a result, it is sometimes subject to higher forces than other muscles and is more likely to suffer tearing.

Sports medicine professionals originally believed tennis leg to be a result of the rupturing of a small muscle behind the knee. However, it is now generally recognized that the injury is a result of the rupturing of the medial head of the gastrocnemius muscle.

In middle aged men, this (and other muscles) is usually in the initial stages of atrophy and degeneration. It is therefore more likely to suffer damage when subject to higher forces than normal. In tennis, these forces can be a result of the frequent need to “push off” the ground when serving. They can also be a result of the sudden stops, starts and changes of direction that tennis players have to make.

Another factor is modern sports footwear, which  is designed for superior traction performance.  This can actually increase the forces on the calf muscles while making the stops, starts and turns required in the game.

However, it should be noted that other sports can also cause tennis leg if they too require sudden stops, starts or direction changes. Examples may include basketball and soccer.

Tennis leg is actually a special case of the more general class of injuries known as calf strains.

Tennis Leg Symptoms

If you suffer this injury, you are likely to experience the following:

  • A pop or snap in the calf area;
  • Burning pain in the calf area;
  • Bruising and swelling in the same area;
  • A calf area that feels “tender to the touch”;
  • An inability to walk normally, if at all. If you are able to walk, you will likely only be able to do so on your toes. This will keep your ankle from bending upward and stretching your calf muscle, which would cause more pain.

Many victims of tennis leg report a feeling akin to that of being shot in the leg.

It should be noted that in many cases of tennis leg, it is found that deep vein thrombosis is an accompanying factor. Hence, if you think you have experienced the symptoms above, you should consult a doctor urgently.

Treatment Of Tennis Leg

As we have mentioned above, this is actually a special case of a calf strain injury. As such, it can usually be treated in the same way, i.e.:

  • By protecting the calf muscle and allowing it to recover naturally by keeping weight off it for a few days or more. You can do this by sitting down whenever possible. Crutches may also be effective in keeping your body weight entirely off the calf;
  • Icing the painful area of your calf at intervals of 2-3 hours and for 20 minutes at a time.You can also use a cold compress for this purpose if that is more convenient.  Avoid direct contact between the ice or compress and your naked skin. That may cause skin injury;
  • Use pain relieving medication such as Tylenol if necessary. To reduce swelling and/or inflammation, you can also try a non steroidal anti inflammatory drug like Advil;
  • Apply compression to your calf using a tensor bandage or calf compression sleeve;
  • Elevate your calf above heart level whenever possible;
  • Once your injury starts to heal, you should start on a physical therapy program to strengthen your calf muscles. This will help you to reduce the risk of future re-injury.

For more information on treating and preventing tennis leg injuries, please see our page on calf strains.

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