Calf Strain

[CFSupport]

Hi, im in a position with the Canadian Forces that makes me responsible for re-conditioning programs for injured military. unfortunatly due to my isolated post I am without the standard base physio or physician. The result is Im getting referals (from a "physicians assistant") with vague or inappropriate diagnosis. I plan on picking the collective Brain tof this forum for possible guidance. I recently recieved a referal that indicated "calf strain", it is up to me obviously to determine what exactly it is that is strained. The strain is grade 1. The patient reported pain at the MT junction during active dorsi flexion in full knee extension, less in plantar flexion. the same results with passive flexion in both directions. Little pain with active and passive flexion in full knee flexion.......So im thinking Grade 1 strain at the MT junction of the gastroc...........then he reported much more pain during resisted seated calf raise (suggesting soleus) and much less during standing calf raise, resisted and body weight....... The symptoms span the entire MT junction when present......any thoughts on diagnosis.......Im a kinesiologist and diagnosis is not within my scope. thanks

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[redgilyn]

Hi,

Am just wondering if your patient is well already. Have the strain healed already? by this time I'm assuming you're in the stretching/strengthening phase already?


just curious..
redg

[Physio Dace]

Sounds more like an issue with achilles tendon itself rather than the gatroc/soleus. Could also be a compartment syndrome - both are common in the military.

To help we need more info first - when/how did it happen? Immediate or gradual onset? Where exactly is the pain location? Any other symptoms (swelling, tingling)? What is the most aggravating functional activity? Can you or the patient palpate the exact spot? Does it ease or worsen with exercise?

There's much more but thats a start.


Cheers
Additional Comment I forgot:
Whoops just checked the date of the original post - I'm assuming your enquiry has been resolved.

[CFSupport]

Sounds more like an issue with achilles tendon itself rather than the gatroc/soleus. Could also be a compartment syndrome - both are common in the military.

To help we need more info first - when/how did it happen? Immediate or gradual onset? Where exactly is the pain location? Any other symptoms (swelling, tingling)? What is the most aggravating functional activity? Can you or the patient palpate the exact spot? Does it ease or worsen with exercise?

There's much more but thats a start.


Cheers
Additional Comment I forgot:
Whoops just checked the date of the original post - I'm assuming your enquiry has been resolved.

As a matter of fact it hasnt been resolved. The patient has been on training on the other side of the country........He came back recently and reported that it felt really good after a couple weeks of rest.......The pain spans the musculotendinous jucntion of the entire calf......i.e. well below the belly of the gastroc........it occured gradually, and is exacerbated by exercise and relieved by rest. I have suggested taking time off of running, hill walking.........also suggested RICE and mild stretching.......The patient claims to be doing everything, but insists on introducing running as soon as symptoms cease......the result is "soreness"

[redgilyn]

It could be also possible that it is a referred pain. try checking for overuse syndrome to the plantar fascia..

R.

[CFSupport]

Thats intresting. The patient plays squash 4-6 days per week and wears orthotics for plantar fascititis. However, the patient is not currently suffering any foot pian....do you have any referances where i could learn more about this association? Thanks again

It could be also possible that it is a referred pain. try checking for overuse syndrome to the plantar fascia..

R.