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Texas Scrambler 02-18-2012 05:02 PM

Need advice with a torn calf muscle
 
Tore my calf muscle (soleus I think) about 3 weeks ago and have reinjured it twice. Agreed, I am not to bright to reinjure but little warning from "Great it is healing" to "Not again, I am just walking".

How have you healed from a torn calf and how do you know how hard to push it. Also, any beneficial physio techniques / thoughts are welcome. I am pretty sure my tear is a Type II and not a total tear. Significant enought to limp around for a couple of days until the healing process starts.

How long does one do RICE? Of course while painful but when to transition back to activity?

Mike Hodge 02-18-2012 05:26 PM

torn calf
 
I had a moderate tear of the gastroc about a year ago. Not a total tear, but serious enough that it was a month without tennis.
After a month, I could play mini-tennis and hit lightly. All in all, it was probably three months -- with fairly intensive rehab (massage, strengthening, stretching, etc.) from a PT --- before I could really go full speed.

It was a long, tough process. Not sure how serious your tear is, but I'd get it checked out by a PT, get a prognosis and a rehab program. Hopefully, your tear is not as bad as mine was.

Chas Tennis 02-19-2012 04:33 AM

Recent thread on calf injury
 
A recent thread on calf injuries

http://tt.tennis-warehouse.com/showthread.php?t=387259

I read that tendons take 2-6 months to heal. ? When and how can you use tendons while they are healing? Consider that stressing tendons while they are healing can lead to chronic conditions. These are complex issues requiring a Dr.

Preventive exercises and stretches are for conditioning healthy tendons to prevent injuries and not for injured tendons where they may cause additional damage.

You should see a Dr to greatly improve your chances of a correct diagnosis and for getting optimal treatment.

Posture Guy 02-19-2012 06:16 AM

I posted the below on the other thread that chas mentioned. this injury really sucks. I came back way too soon and kept reinjuring it. Was told by a PT I really respect that this is a minimum 4-6 week injury, even just a light tear. Take the time to make sure it's completely healed. One note: just because it FEELS well doesn't mean the injury is completely resolved. You've discovered that.

I'll add one thing to what I wrote previously. Once I felt like I was ready to get back on the court, I first started jogging barefoot in the neighborhood park on the grass. Very slowly at first, then building up to sprints over the course of maybe 10 days. Once I was able to do that, then I'd put my tennis shoes on and get out in our street and basically go through tennis motions. Moving forward, back, side to side, insuring that all movements felt ok. Then my first times back on the court I took it easy, didn't play sets, just hit lightly, didn't go hard after balls in the corner or short shots. Took about two weeks until I wasn't thinking about it anymore.

Good luck. Here's what I posted on the other thread, hope it helps.

__________________________________________________ ____

This injury is a bear. I'm recovering from one myself. Did stupid stuff, including coming back from it WAY too soon. Here's a key: just because it feels all healed up doesn't mean the tissue actually IS all healed up. Based on a combination of professional and personal experience, here are a few things I'd do:

1. Go see the best physical therapist you can find and get evaluated. I resisted this but I finally relented, went to someone who is expensive and doesn't take insurance, but also looks at the body in a far more comprehensive way than the typical PT. We found that my gastroc complex as a whole was firing properly but that when the medial and lateral segments of my gastroc were asked to fire independently (by rotating the position of the leg and then doing certain movements), they were almost shut down. I'm an exercise therapist by trade (but not a PT), and she taught me a few very useful new exercises to incorporate into my rehab. You want to make sure all the muscles of your legs and hips are working properly so you don't place undo strain on any one of them. Tennis requires a lot of 'ballistic' movement, much different than just running in plane. We are all well served to ensure our bodies are working in as comprehensive a way as possible.

2. 'The Stick' is a great idea. I also found a very cool company that sells some amazing products for self-myofascial release work. check out www.tptherapy.com. I ordered one of each of their products and I'm VERY impressed. I was using the smaller roller on my calf last night, especially on the soleus, and wow, it just does a much deeper, better job than I can do with a stick roller. and if you do foam rolling, get "The Grid". I already had 3 different foam rollers. Bought this one to try it out and I'm throwing the others away.

3. Use a combo of ice and heat to pump more blood through the injured area. That can help moderately accelerate healing and reduce scar tissue formation.

4. Stretch a lot, walk a lot, but do it to tolerance. Pain is a signal you're doing something your body isn't ready to do. Don't try to run until you can walk without ANY pain for at least 7-10 days. Try walking up steep hills before running, that's a nice test.

5. Once you start running, if you normally run where you contact the ground first with your forefoot (like the Pose technique), you may wish to consider temporarily going to heel strike. That will lessen the demand on the posterior chain of your leg. Then you can migrate back to a forefoot strike as your leg demonstrates it is ok with this demand.

6. Once you can do that ok, do some VERY light jogging backwards. Puts a very unique demand on the calf complex. Then once that's ok, I'd go out to a court and start 'running the lines'. Or you can do it in a park, or an empty side street. Do lateral shuffles, forward movements, backward movements, all that stuff. Make sure that all feels ok. Start REALLY slow and then ramp up. If those are ok, then go to sprints.

7. The zensah calf sleeves are a great idea. Use compression when you come back.

8. Static stretching has its place but not immediately before a match. Use charlie's advice on dynamic warmup. Once you start playing again, get to the court earlier than usual and go through a FULL dynamic warmup routine.

9. Engage in a leg strengthening program that doesn't just strengthen your calves, but strengthens ALL the muscles of your leg. When working your calves, make sure you are working both the gastroc AND the soleus. An exercise that works one does little for the other. Work on the hamstrings, work on the quads, the glutes, the hip flexors, ALL of it.

being out is a bummer but use this time to get your legs into the best shape the've been in for years and you'll come back better than ever. Good luck to you and keep us posted on your journey back.

Torres 02-20-2012 02:09 PM

Quote:

Originally Posted by Texas Scrambler (Post 6335273)
Tore my calf muscle (soleus I think) about 3 weeks ago and have reinjured it twice. Agreed, I am not to bright to reinjure but little warning from "Great it is healing" to "Not again, I am just walking".

How have you healed from a torn calf and how do you know how hard to push it. Also, any beneficial physio techniques / thoughts are welcome. I am pretty sure my tear is a Type II and not a total tear. Significant enought to limp around for a couple of days until the healing process starts.

How long does one do RICE? Of course while painful but when to transition back to activity?

6-8 weeks, and not before.

I tried to come back after 4 weeks, very tentatively, as I was very bored sitting at home, but it was a bad idea. Fortunately, Christmas and New Years holiday period took over which allowed me to stay off until roughly the 2 month mark, but if its a 'pop' / 'twang' type of tear with you not being able to walk properly 2 or 3 days afterwards, or having to walk with a stick, you'll be looking almost certainly at around the 6-8 week mark.

Posture Guy 02-20-2012 02:19 PM

Torres' estimate is sound.

For me, it was the kind of thing where I was limping pretty good that evening and the next morning, but I was able to walk without assistance and go up and down stairs without trouble. After a couple of days I was walking basically normally with very little pain, but could feel it wasn't right. Much less severe than what many here have experienced. It was probably somewhere between a grade 1 and a grade 2 strain. That was a 4-6 week injury. I'd think that if you tear it badly enough that you need assistance to walk, or you're genuinely hobbled for 2-3 days or more, then yeah, 6-8 weeks if not more.

This injury is a real bear.

wao 02-20-2012 03:06 PM

Quote:

Originally Posted by Posture Guy (Post 6338955)
Torres' estimate is sound.

For me, it was the kind of thing where I was limping pretty good that evening and the next morning, but I was able to walk without assistance and go up and down stairs without trouble. After a couple of days I was walking basically normally with very little pain, but could feel it wasn't right. Much less severe than what many here have experienced. It was probably somewhere between a grade 1 and a grade 2 strain. That was a 4-6 week injury. I'd think that if you tear it badly enough that you need assistance to walk, or you're genuinely hobbled for 2-3 days or more, then yeah, 6-8 weeks if not more.

This injury is a real bear.

PG, you where off the court for 4-6 weeks? I strained mine last friday in a match. can walk and feel some minor discomfort.

Torres 02-21-2012 07:38 AM

Quote:

Originally Posted by Posture Guy (Post 6338955)
Torres' estimate is sound.

The credit should go to my physio for the estimate as she came up with it based on how I described the injury occurring. I told her that I would prove her wrong but it turned out that she was right after all! I guess when you see lots sports injuries too tend to know what you're talking about....

Her words:-

"6-8 wks. Need to start treating in 3 days. Inflammatory phase will take 10days. 2-4 wks stability and strength then back to impact. This wk is the most important 2 ensure u get max strength back."

Posture Guy 02-21-2012 10:52 AM

That makes perfect sense.

When I finally wised up and went about it right, basically, I waited to do much of anything until I was relatively pain free. Then I just walked as much as I comfortably could, quitting before the onset of any pain. Did very light foam rolling and massage.

Then as it felt better, I just started working deeper. Walking more, getting weekly sports massage where they'd really dig in and work. I wanted to minimize the formation of scar tissue, make sure the repaired muscle fibers were properly oriented, all that stuff.

Once I was completely pain free and feeling normal, I wanted another 2-3 weeks to start doing any kind of strength work, and even then, started slow. One of the early things I did was stand on the stair step just one step above a landing, and then lightly jump with both feet to the landing and land in a coiled athletic position. Would do that 10-20 times and call it a day, see how I felt the next day. Then if that was ok, would jump down and land on one foot and alternate back and forth. When that was ok, I'd go up to the second step and jump with both feet, then when that proved ok, to the third, then finally up to the fourth and that's as high as I wanted to go.

Then I did some light plyo stuff jumping over stacks of pillows and landing on one leg, then back over to the other leg, box jumps up, more jumps down, then finally light running barefoot in grass, then to sprints, etc...

Crawl before you walk before you run and give yourself plenty of time to ensure the damaged tissue IS in fact healed.

Torres 02-21-2012 11:25 AM

^ My physio would definitely like you - you've described the proper treatment protocol. I went for one session with my physio and then disappeared, never to be heard from again lol. Fortunately, my physio is also a friend of mine but that didn't stop her from voicing her disapproval!

Looking back I do wish I had done more to treat the calf tear rather than just sitting at home eating potato chips. Although I don't have a problem with the calf now, from time to time, I do feel like there's a 'piece of something' (presumably scar tissue) inside the fleshy part of the calf. It doesn't hurt or stop me from doing anything, but it just feels like there's something in there.

beeveewee 02-21-2012 03:35 PM

38 years old, tore mine 6 months ago. Classic 'pop'. I thought I would just take time off and recoup by myself with internet research, etc. but thankfully my doctor talked me into seeing a PT. That was definitely the thing to do. She put me through stretches, exercises, and workouts that I never would have or could have done on my own. It greatly accelerated my recovery and I was playing careful tennis again in 4 weeks and going full out again in 6 weeks. I paid for the PT out of pocket and didn't regret the expense.

Posture Guy 02-22-2012 03:04 AM

Wao.....when I injured my calf the first 3 times (yes, you read that right, 3 times. Because with breathtaking ease I can alternate between reasonably intelligent and mind numbingly stupid), I figured I would wait until I felt no pain walking around, then give it another couple of days and I'd be good to go. I did not appreciate the nature of this injury.

So each time I came back too early, I'd play one match and be ok, then play another and boom, it went again. Was driving me nuts. Finally went to a PT who said what we were discussing above, that this is a minimum 4-6 week injury. So when I treated it as such, then I progressed and got back on the court.

Do NOT come back too soon from this. Once you can walk around without pain, that does NOT mean the injury is healed sufficiently to withstand the severe load demands tennis presents. Just trust that this is so and follow the advice above. If you don't, you'll likely regret it.

Posture Guy 02-22-2012 03:08 AM

The other thing I did in all of this was to use our own (Egoscue) stuff to really insure that the position of the ankle to the knee to the hip was sound, and that this kinetic chain was intact and functioning properly. Too complex a concept to delve into on a message board, but here's one way to think about it. Standing in front of a full length mirror wearing shorts and no shoes. Orient yourself head on to the mirror. Now, close your eyes and march in place for 20 seconds. Then with your eyes still closed, come to rest where your feet feel they naturally want to be. Now open your eyes. Then observe a few things...

1. Are you still facing head on to the mirror or did you rotate clockwise or counterclockwise?

2. Do your feet point straight, or out to the side? Do they do the same thing on both sides, or different?

3. Do your knees point the same direction as your feet?

4. Are your hips level?

5. Are your shoulders level?

These are some simple postural tests you can give yourself. If any of these are off, you're compromised and that will also increase strain on some of your muscles. Getting the body back into sound postural position is a fundamental prerequisite for optimizing athletic performance.

tennis_tater 02-22-2012 02:01 PM

Just curious...for those who have suffered this injury, how many of you have sustained a re-injury of the same calf muscle AFTER going through the proper motions (RICE, Physical Therapy, no tennis for 2-3 months, and incorporating new stretching and leg strengthening exercises to your daily routines, dynamic warm-up and proper hydration pre-match? I've done each of the above, yet have continued to have issues with the same calf after the initial tear in the gastroc.

Also, for those who have made it back to playing tennis within 6-8 weeks, do you feel as good as new on the court and have no problems or hesitation with you pushing off on the injured foot when going to poach or step into a service return?

Posture Guy 02-22-2012 02:08 PM

Knock on wood, I've had no problems since returning.

If you keep reinjuring it, I would take a very close look at what is happening posturally. For example, if your femur is 15 degrees externally rotated so that now your knees and feet point out instead of straight, that completely changes muscle engagement through that entire kinetic chain. Parts of the calf will now receive very little load demand, and other parts will be hyper-loaded.

Good luck, I hope you get it dialed in.

Texas Scrambler 02-22-2012 07:18 PM

I am two weeks in
 
No pain after two and half weeks and starting to amp up the exercises. I discovered swimming the last two weeks with all four strokes. What a great upper body workout.

I am skating lightly (no hockey yet) and riding the stationary bike. All is well so far but danger lurks on the horizon as i am booked for Newks in 10 days and back country skiing in 30 days.

I don't have the will power to forego some of my favorite activities.

Great advice in the above and does the scar tissue eventually go away?

tennis.yellow.balls 02-22-2012 10:29 PM

3 months
 
had a partial tear and it took me about 3 months. reading the posts, the one thing that i agree with is -- you need time for it to heal and even when it seems heal, you really don't know, so always take it slow in the beginning. it's a horrible injury and even though, i feel i can go full speed, there are times, i still feel it :(

Spin Doctor 02-22-2012 10:46 PM

deleted.....

equinox 02-22-2012 10:53 PM

Mate did his in 2004, took years before he was good again.

Texas Scrambler 03-29-2012 01:03 PM

Living Dangerously and Got away with it
 
So after doing everything wrong initially and reinjuring my calf after taking a week off each time, I changed tactics. I took 5 weeks off, swam and jogged in pool, watched lots of TV tennis (aka couch potatoe), and hit yoga 1-2 time a week. Then I eased back in by going straight to Newks and hitting tennis balls for 7 hrs a day. I escaped the penalty box and all is good even now.

I highly recommend the first portion of healing but do not recommend the second part. I ran into EVW at Newks and was quickly in over my head but loving every minute of being back on a tennis court.

Hope all in this chat site are over their torn calf muscle. It is one of the few time where it pays to be lazy.


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