Calf Injury - slow to heal

[missy_c]

Hi, I tore my calf muscle while dancing at the start of July. I rested for 2 weeks then saw NHS physio once I realised it was serious.

He told me ice and rest and gave me an elastic band to pull my toe up and down.

After about 7 weeks it started feeling really good, pretty much back to normal, but I decided to hold off on the exercise anyway and just continue walking and physio.

But then it pulled again whilst walking home from work back to stage 1 where I couldn't put weight on it again.

It now a further 10 weeks from the second pull and it is better but still no where near what my leg originally was. Everyone I speak to says this seems really slow and I should seek a second opinion.

The NHS physio says he can't feel any lesions or gaps and that the second pull was just unlucky but I'm really worried it goes again as it always feels close to "popping" even though I stretch all the time and do my heel raises.

What am I missing?

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[SigMik]

Dear Missy C.

Very sorry to hear about your calf injury... Am I correct if it close to 4 months now, post-injury? If this is correct, then I'm also of the opinion that it sounds like a wee bit slow recovery for a muscle tear. It's a great question you ask - what am I missing? That's a question that should pop up in physiotherapists' heads too sometimes...

When something does not recover within reasonable time-limits, I try to ask myself two things. Was my initial hypothesis correct? What represents barriers to normal recovery?

An "average" muscle strain should be feeling quite okay after 2-3 weeks post-injury following a well managed rehabilitation plan. The chances of recurrence of a muscle strain should be very little for a calf after 4-5 weeks. These are numbers from controlled studies, where interventions are likely to be close to "optimal". For us normal people, I'd add a max of 1-2 weeks on each situation.

Most muscle strains are likely to occur in muscles that crosses two joints. For you calf muscle, that should guide us to the gastrocnemius. The gastroc got's two muscle bulks, and it is usually the innermost that gets strained. It is most likely to strain at the point where the muscle gradually turn into tendon, which should be located close to the middle part of your lower leg. Is this very close to your area of pain? If not, can you describe as good as you can? Muscle strains are usually located within a relatively small area...

A few questions:
1. Did you have swelling, did the calf feel "hot", did you have any color alteration to it initially?

2. Did you or your physio feel a gap in the muscle with the first injury?

3. Did the second episode feel exactly the same as the first one?

4. Are you able to describe, as accurate as possible, what kind of pain you have, the quality of it?

5. How does the pain behave now. Is it only with movement? What level/intensity of movement?

6. Is it painful at night? Is it stiffer in the morning?

7. Any tingling, odd sensations to it when you don't move, has the pain quality or location of pain changed or moved since the first and second injury?

8. Never had previous strains in that area before? Or ankle, knee, thigh, hip, back?

9. Do you have any conditions to your health that might affect your expected healing time? In regard to this injury I'm particularly interested in diabetic or not.

Providing these answers might help me and others to negate or support any hypothesis we make at this point. Obviously, being on an open fora, you provide the information you are prepared to give.

Looking forward to hearing from you again,
Sigurd Mikkelsen

[ANGGA.]

I am having the same problem. I was also diagnosed with a torn calf muscle but mine has not gotten better and its been 14 months.

[Vanc_WA_PT]

I won't repeat SigMik's excellent line of reasoning and questions. I'll just mention anecdotally that deep tissure work to break up adhesions from a fully healed soft tissue injury has helped regain full function in some of my clients. I don't necessarily "feel" the adhesions, but in my mind, if scar tissue is present and a stress is put through the muscle tissue, there is a chance that the inelastic fibrous tissue will fail causing reinjury. The tissue needs to be broken up and resorbed by the body.

[ultracarepro]

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