Medial Gastrocnemius Strain

What is a Medial Gastrocnemius Strain?

A medial gastrocnemius strain (MGS), also sometimes called “tennis leg”, is an injury to the calf muscle in the back of the leg. It occurs when the calf muscle is stretched too far resulting in a partial or total tear or rupture within the muscle.  

Basically, the calf is made of three major muscles; the medial and lateral gastrocnemius and the soleus. These muscles unite to form the Achilles tendon and attach to the heel bone. The most commonly injured muscle when a calf strain occurs is the medial gastrocnemius as its muscular movement is more than the other two muscles.

MGS typically happens during physically demanding activities and/or sports such as running, jumping, soccer, tennis, etc., where the muscle is overstretched due to sudden changes in speed or direction. This occurs due to the rupture of the medial head of the gastrocnemius muscle or rarely, because of a deep vein thrombosis (blood clot). 

What are the Signs and Symptoms of a Medial Gastrocnemius Strain?

Usually, an audible pop occurs at the moment of the injury. Other symptoms of a medial gastrocnemius strain include:

• Sharp pain in the back of the leg (on the inner side of the knee or calf muscle).
• Swelling of the calf and bruising of the calf down to the ankle.
• Tenderness along the entire medial gastrocnemius muscle.

What if the Condition is Left Untreated?

If MGS is left untreated, the condition may lead to a complete tear of the muscle and serious leg injury due to limping and favoring of the injured leg.

How is a Medial Gastrocnemius Strain Diagnosed?

The doctor may assess the injury report and perform a physical examination that includes palpation to check for tenderness of the entire medial gastrocnemius muscle. 

A diagnostic ultrasound imaging test may be ordered to confirm the gastrocnemius tear and to determine the level of the injury. If a deep venous thrombosis is suspected, a Doppler ultrasound or an MRI might also be used.

How is a Medial Gastrocnemius Strain Treated?

A medial gastrocnemius strain can usually be treated conservatively with rest and activity modifications and the typical "RICE" technique.

• Rest: Avoid activities that cause pain. Crutches may be used for a few days or a week to allow the pain to settle down.
• Icing: Apply ice to reduce swelling and pain and ease the inflammation. The icing is one of the most useful treatments in the early phase of the therapy.
• Compression: Pressure helps to control swelling, support the muscle and reduce spasm. A simple compression sock or sleeve can serve the purpose.
• Elevation: You should elevate the leg above heart level to help decrease swelling.

Once the initial phases of the treatment are completed, the doctor may recommend therapeutic activities and gentle stretching of the calf. Subsequently, strengthening exercises such as isometric exercises can be started and continued until the injury heals completely.

Generally, surgery is not required for a medial gastrocnemius strain. Typical recovery from MGS may take about six weeks.