It felt like a tennis ball hit me in the calf!

[atatu]

Originally Posted by beernutz

Great thread with lots of good information! I just experienced this injury on Monday, 4 days ago, and while I've had some improvement doing just RICE + Advil, I still can't push off with that foot while walking without pain.

Even though this happened in March, it was around 70 degrees at the time we were playing and I wasn't hydrating as much as I normally do as my opponent barely even slowed down on side changes. After playing two long sets, the very first point of the 3rd I attempted to push off quickly to get to a short second serve and felt a pop in my calf. I think I actually heard something pop too but that might've been my imagination. Immediately afterward I could barely stand on that leg but now if I move slowly enough I don't limp but I wouldn't dream of trying to walk fast or run.

At least I've learned my lesson about hydration and I won't let an opponent dictate how long I spending drinking during changeovers after this.

I agree completely that hydration plays a part in this injury, that has not been stressed enough in this thread.

[beernutz]

Originally Posted by atatu

I agree completely that hydration plays a part in this injury, that has not been stressed enough in this thread.

I think there was roughly a 100% chance that poor hydration played a key role in my injury. As I said before, I was thrown off my normal hydration routine by an opponent who rarely stopped to drink and also because...it was March! Who dehydrates in March? Well I do apparently, but it won't happen again if I can help it.

It has been a week since my injury and I can now walk pretty much normally (without a limp) but still no running or tennis. Hopefully in another week I'll be back playing if I'm lucky.

[Morgan]

Originally Posted by Jenks10

I was pushing off at the baseline for an easy shot & I stopped immediately & said "Did I just get hit with a tennis ball?" I was in such shock when my friend said "No". Our coach helped me off the court & immediately started ice.

As I sat there in shock, I knew this was more than just a simple calf strain. I reviewed the last 45 minutes - knowing I was completely warmed up (had just played a set of singles in 75* weather) How did this happen?!

I am 41 years old & very active. I grew up playing soccer & only started tennis a year & 1/2 ago. I fell in love with this sport and have been hooked ever since. Ironically, I am the person that encourages others to stretch before tennis and actually incorporated a yoga DVD into my regiment a few weeks ago.

After seeing an orthopedic doc the next day, he diagnosed me with a calf tear/strain. I cannot walk or put weight of any kind on my leg & am in a boot and on crutches. The strange thing is he pushed on my calf forcefully in many areas & to my surprise - No Pain! But, pressure from trying to walk is a different story.

If you have had an injury similar to this, I am interested to hear about your recovery. I have been faithful with Rest, Ice & elevation and am taking an anti-inflammatory. Doc also prescribed physical therapy 3 days a week for 4 weeks.

One lesson that I've already learned is one of compassion. This injury has touched my soul in the fact that I will reach out to those I know that become disabled with more than an "I'm so sorry". Although this injury can't begin to compare with the devastation of a permanent disability; the love, meals & visits from friends are what make this more tolerable.

48 yr old here-
Going through my second calf strain in 3 yrs. Same leg/location. I neglect to stretch as I should, but I'm not so sure that had any affect on causing the re-injury.

I'm curious what you're doing to prevent reinjury. I used to run 3 miles every other day but stopped it for the last month before the injury and I wonder if that lack of exercise had anything to do with it. Was it poor hydration on my part?

I'd hate to give up tennis, but I can't have this happen every year. It's totally incapacitating - crutches for a few days, pain, etc.

I know what you're saying about having compassion - I definitely have more empathy for what others with injuries go through now.

Wonder what you're doing to prevent re-occurrence.

[charliefedererer]

Originally Posted by Morgan

48 yr old here-
Going through my second calf strain in 3 yrs. Same leg/location. I neglect to stretch as I should, but I'm not so sure that had any affect on causing the re-injury.

I'm curious what you're doing to prevent reinjury. I used to run 3 miles every other day but stopped it for the last month before the injury and I wonder if that lack of exercise had anything to do with it. Was it poor hydration on my part?

I'd hate to give up tennis, but I can't have this happen every year. It's totally incapacitating - crutches for a few days, pain, etc.

I know what you're saying about having compassion - I definitely have more empathy for what others with injuries go through now.

Wonder what you're doing to prevent re-occurrence.

Stopping your running program may have had an influence. But you don't have to exlcusively run to build up your legs. Squats and deadlifts can actually build muscle. Cycling can be a less "pounding" alternative instead of always running.


Most "strains" represent microscopic tears in tendon or muscle. That heals with scar tissue [rather than regrowing true muscle or tendon tissue], and places you at increased risk for reinjury.


Before any tennis play always do a dynamic warm up, rather than static stretching.

Stretching after play, and in the morning and night can help maintain flexibility, and might help prevent a recurrence.

[Morgan]

Thanks for the advice.

Yesterday I purchased a few different kinds of compression wraps and if anyone has this injury, I highly recommend get out and purchasing them (McDavid Brand). I injured my leg a week ago and initially used a neoprene wrap that helped, but these compression sleeves help drastically and have allowed me to walk much better with the support.

I canceled my appt w/ an MD the day after injury since this was the second time and I'm pretty much self-diagnosing the problem. I probably would be better to get into see physical therapy but I'm bypassing that as well. Probably not a great idea, but I'm used to not using the medical system unless absolutely necessary.

[baoshuxiong]

Suffered Tennis Leg here, Day 5, Going Thru R.I.C.E.; Went to a doc and he prescribed pain killer and rubbing lotion. Question: should I put on the calf sleeve 24 / 7? or just when I go outdoors?

[Say Chi Sin Lo]

Just found this gem of a thread regarding calves/achilles injuries. And I have a question.

So I believe I'm developing early signs of insertional achilles tendinitis. It doesn't affect my performance on the court but when I shut it down, there's significant pain behind my heel. After dealing with post-play discomfort for a few months, I decided to shut it down completely and just let it heal. And here is my question:

I plan on doing as much RICE therapy for the next 2-3 weeks, just to get the inflammation to subside. Then your usual stretching and strengthening once the inflammation is gone. During my recovery, will cardio workout such as the elliptical and stationary bike hinder the healing of the achilles? And I'm going to assume running isn't going to help my cause.

In case you were wondering how I injured it, I wish I can recall a precise event, but I can't. I'm sure I took a hard and wrong step somewhere on the tennis court (probably on an stomp volley). What I can tell you is, it's my left achilles, and I'm a righty, so it's my landing foot when I serve.

Thanks!

[charliefedererer]

Originally Posted by Say Chi Sin Lo

Just found this gem of a thread regarding calves/achilles injuries. And I have a question.

So I believe I'm developing early signs of insertional achilles tendinitis. It doesn't affect my performance on the court but when I shut it down, there's significant pain behind my heel. After dealing with post-play discomfort for a few months, I decided to shut it down completely and just let it heal. And here is my question:

I plan on doing as much RICE therapy for the next 2-3 weeks, just to get the inflammation to subside. Then your usual stretching and strengthening once the inflammation is gone. During my recovery, will cardio workout such as the elliptical and stationary bike hinder the healing of the achilles? And I'm going to assume running isn't going to help my cause.

In case you were wondering how I injured it, I wish I can recall a precise event, but I can't. I'm sure I took a hard and wrong step somewhere on the tennis court (probably on an stomp volley). What I can tell you is, it's my left achilles, and I'm a righty, so it's my landing foot when I serve.

Thanks!

Sorry to hear you are having problems.

As you undoubtedly know, inflammation is the first stage of healing. Indeed without inflammation, no healing will occur.

Inflammation represents that the greatest number of chemicals (cytokines) is present at the site to attract and activate the fibroblasts which will produce the protein strands that will heal the microscopic tendon tears that are likely present.

Pain is a side effect of those chemicals (cytokines) being present and irritating sensitive nerve endings.
(It is unclear if this is just coincidence or whether this evolved as a warning signal to our forebears that an injury was in the process of healing, and that decreased activity was needed to let the injury heal.)


RICE clearly improves the symptoms of pain and swelling.
Nerves don't conduct pain optimally at cold temperatures.
Compression clearly reduces swelling.
And it is clear that on occasion our immune system can run amuck and produce more inflammation at a site than will optimally lead to healing.
It is just hard to know in your situation if other than Rest, RICE really will alter the underlying inflammatory process in a productive way.



It takes many, many weeks for the protein fibers in connective tissue to interconnect and become really strong.





There is no foolproof way to know when exercise can begin, or how fast to advance our exercise level.
We tend to use pain as a guide - return of pain indicates inflammation is beginning again because of reinjury.
So sometimes it is two steps forward and one step backward.
The danger in a "go-getter" like you or Nadal is not to make it one step forward and two steps backward by doing too much exercise too soon.


At least you are doing the best thing now by resting, so that the process of healing can occur as straight forward as possible, instead undergoing multiple episodes of partial healing and tearing, partial healing and tearing that leads to fibrosis and tendon degeneration.

[charliefedererer]

Originally Posted by baoshuxiong

Suffered Tennis Leg here, Day 5, Going Thru R.I.C.E.; Went to a doc and he prescribed pain killer and rubbing lotion. Question: should I put on the calf sleeve 24 / 7? or just when I go outdoors?

Most put on the sleeve soon after getting up and leave it on throughout the day, then remove it at bedtime.

If it feels way too tight, it IS TOO TIGHT - so take it off right away.

Beware of ankle swelling. If the ankle swells, it means you should be wearing a compression stocking that includes the foot and ankle areas as well as the calf.


"C" in RICE stands for compression, and that is what the calf sleeve is attempting to do. Compression reduces excess swelling, and often supports muscle so that it is less painful.
Unless the area is very swollen, if the pain is much better, then perhaps you are getting close to no longer needing the compression, although obviously I would defer to the advice of your doctor who has examined you and better knows your condition.


Outside of the REST, there is little evidence that RICE, rubbing lotion and pain medications actually speed the healing process. So if the area is feeling much better you may be getting closer to no longer do this therapy - again with your doctors advice being still the best.

[baoshuxiong]

Thanks charliefederer for your reply. It's very helpful.

I couldn't walk during Day 1-3 due to severe pain; but now I can walk for like 45 mins with calf sleeve and walking stick. It's a very humbling experience.

I only had mild swelling but still can't stretch my calf (even in normal walking stand). I'm also using heat lotion (will try Voltaren once heat rub runs out) & warm clothe 4 times a day. It seems to help just a tiny bit.

It's embarrassing to use a walking stick at my age, but I'm gonna stick to it till I can walk w/o pain in my calf. The only side effect right now is twitches on my upper calf (every 10 mins or so) when I walk .

Question: What's my next step? Stretching? When can I start stretching ? When I feel no pain when I walk?

Thx for your reply in advance

[Say Chi Sin Lo]

Hey Charliefederer, thanks man. But I still want a few questions answered:

1) Once the inflammation subsides, is the elliptical and stationary bike low impact enough so it won't hinder the healing?

2) Over the past few months where I've been managing this minor injury, I observed no loss in stamina and strength in the tendon. Also, it's asymptomatic while I'm playing. However, once I shut it down, it's like a raging storm on the back of my heel. Why is that?

[charliefedererer]

Originally Posted by baoshuxiong

Thanks charliefederer for your reply. It's very helpful.

I couldn't walk during Day 1-3 due to severe pain; but now I can walk for like 45 mins with calf sleeve and walking stick. It's a very humbling experience.

I only had mild swelling but still can't stretch my calf (even in normal walking stand). I'm also using heat lotion (will try Voltaren once heat rub runs out) & warm clothe 4 times a day. It seems to help just a tiny bit.

It's embarrassing to use a walking stick at my age, but I'm gonna stick to it till I can walk w/o pain in my calf. The only side effect right now is twitches on my upper calf (every 10 mins or so) when I walk .

Question: What's my next step? Stretching? When can I start stretching ? When I feel no pain when I walk?

Thx for your reply in advance

Well there is stretching and STRECHING!!!

Gentle stretching should be fine when there is no pain when you walk.

At first, you are just slowly trying to get closer and closer to a full range of motion.

The amount of stretching can increase slowly over time.


[I know answers like this can be less than satisfying, but how vigorous one is stretching is hard to quantify.]

[charliefedererer]

Originally Posted by Say Chi Sin Lo

Hey Charliefederer, thanks man. But I still want a few questions answered:

1) Once the inflammation subsides, is the elliptical and stationary bike low impact enough so it won't hinder the healing?

2) Over the past few months where I've been managing this minor injury, I observed no loss in stamina and strength in the tendon. Also, it's asymptomatic while I'm playing. However, once I shut it down, it's like a raging storm on the back of my heel. Why is that?

1. Eventually the elliptical bike are great ways to get back in shape without the pounding in running.
I can tell for you the hard part will be holding back and not going full tilt too soon.
Slow and steady wins the race - to full health.


2. It is amazing that after a warm up, even areas that are quite sore often feel much better.
I don't know exactly what is happening, but I suspect it could be a combination of factors.
Warmed up muscles are more elastic and supple. More force can be absorbed by the long muscle body, rather than being transferred to the tendon ending, especially if some degree of "spasm" is present in the muscle.
Exercise leads to increased blood flow and greater exchange of the [interstitial] fluid that bathes our tissues. The chemicals [cytokines] that are regulating the inflammation (and irritating the sensitive nerve fibers) are being "washed away" faster than new cytokines are being generated at the site.

[TimeToPlaySets]

I love charliefedererer's posts. They are on another level. Are you a doctor?
I agree with charliefedererer's questioning the efficacy of ice.

I do not believe in icing or heating any injury.
Not so sound like a new-age idiot, but the healing body inflames, swells, or heats the injured area for a reason.
Why would you want to interfere with that?

What is "ASTYM treatment" ???

[TimeToPlaySets]

I was at the baseline when the other side hit a drop shot.
I took a sudden step forward, and felt a snap/pop in my calf.
It wasn't a terrible pain, but was uncomfortable enough to not be able to play anymore. I knew I had pulled it.

Next morning, the calf has tightened up significantly and I have a pronounced limp. It is not as bad as others who needed crutches or a boot. But, it looks like I will be watching movies all weekend.

There is no visible sign of any injury.
No swelling. No discoloration.
I assume this is only a mild tear.

It looks like I will not be doing tennis for a while.
Maybe I will wait until Spring, to play it safe.
In the meantime, I will resume my fitness routine after about a week of rest (Plyo/bodyweight/bootcamp, weights, yoga, Pilates, etc)
My job also involves a lot of walking, so that should avoid total stagnancy.

[Mick3391]

Originally Posted by Jenks10

I was pushing off at the baseline for an easy shot & I stopped immediately & said "Did I just get hit with a tennis ball?" I was in such shock when my friend said "No". Our coach helped me off the court & immediately started ice.

As I sat there in shock, I knew this was more than just a simple calf strain. I reviewed the last 45 minutes - knowing I was completely warmed up (had just played a set of singles in 75* weather) How did this happen?!

I am 41 years old & very active. I grew up playing soccer & only started tennis a year & 1/2 ago. I fell in love with this sport and have been hooked ever since. Ironically, I am the person that encourages others to stretch before tennis and actually incorporated a yoga DVD into my regiment a few weeks ago.

After seeing an orthopedic doc the next day, he diagnosed me with a calf tear/strain. I cannot walk or put weight of any kind on my leg & am in a boot and on crutches. The strange thing is he pushed on my calf forcefully in many areas & to my surprise - No Pain! But, pressure from trying to walk is a different story.

If you have had an injury similar to this, I am interested to hear about your recovery. I have been faithful with Rest, Ice & elevation and am taking an anti-inflammatory. Doc also prescribed physical therapy 3 days a week for 4 weeks.

One lesson that I've already learned is one of compassion. This injury has touched my soul in the fact that I will reach out to those I know that become disabled with more than an "I'm so sorry". Although this injury can't begin to compare with the devastation of a permanent disability; the love, meals & visits from friends are what make this more tolerable.

Check if it's a ruptured plantaris muscle, I had that in both calfs, every painful, can't walk down stairs. Took me months on and off for it to work itself out.

[Mike Hodge]

I had a moderate tear of the gastroc. Tough injury. I remember going to the PT who told me I'd be out a couple months? I was skeptical. Weeks? The PT glared: "Just be glad you'll play again."

It was 2,3 months. Depending on the tear, it can be a serious injury.

[TimeToPlaySets]

When is the ideal time to start stretching and working the calf so scar tissue does not build, yet not too soon to impede healing of torn fibers? It is now 2 weeks after my calf strain. It was mild, and I was walking perfectly within 7 days. I have rested for 2 weeks, and it's totally fine. I understand that it is only superficially healed, and I run the risk of re-injury. I will not be "active" on this calf for 2 months to be safe. However, I am worried about this scar tissue from underuse. Since it's a tear, you don't to stretch the calf b/c you are just damaging the partial heal. But, when is it safe to stretch/strengthen the calf, and not worry about impeding recovery and healing?

Cliff's Notes: When is the ideal time to start stretching and working the calf so scar tissue does not build, yet not too soon to impede healing of torn fibers?

[baoshuxiong]

Originally Posted by Mike Hodge

I had a moderate tear of the gastroc. Tough injury. I remember going to the PT who told me I'd be out a couple months? I was skeptical. Weeks? The PT glared: "Just be glad you'll play again."

It was 2,3 months. Depending on the tear, it can be a serious injury.

I totally agree with your PT, it's been 4 weeks for me and I can only walk (still not in perfect form) 30-45mins and then my injured calf will be worn out & started twitching.

I'd just be happy to meet the healthy old me again by summer, even if it means staying off tennis for months.

It's the kind of injury that cannot be rushed or else the chance of long term / more serious injury is bound to occur.

Concerning when 1 should start exercise, I'd say when you can walk w/o pain. How much exercise? The muscle will tell you to stop, don't push it. And rest alot after you exercise. What can be done to improve the healing process? Do whatever you can to increase the blood flow to the calf area - massage, hot water, ... etc.

[40_Love]

Trying to sort out the shoe-gastroc tear connection...

I am a fit 40 yr-old woman with a midlife love affair with tennis. I have been playing 4-5x a week for about 18 months with the only injury being some (predictable) knee tendonitis related to a chronic IT band issue after years of running a lot and stretching very little. I fixed the tendonitis w/ PT. And recently, I changed shoes in an attempt to address pronation, also an issue in my knee.

I went from T22s to a Barricade (5.0) and immediately got crazy sore feet and a minorly sore lower calf. Added insoles and the foot soreness went away but sore calf continued. Saw PT and got the okay to play as long as warmed up, etc. Two days later, Grade 2 strain of the gastroc--the kind of bang! and you immediately can't walk injury. Am on the slow road to recovering from that, with plenty of good PT, etc.

As I recover, want to address the shoe question. I'm curious if anyone has else experienced added strain with the added traction of a tournament grade hard court shoe. The traction from the Barricade is amazing--I'm a squeaky animal out there, but could it be overkill for me?

Thoughts and reactions welcome...as are thoughts on footwear that combines pronation, high arch issues and reasonable traction?

See this note from the Atlanta Sports MEd Ctr:
"due to the superior foot traction a tennis player obtains utilizing good tennis shoes and playing on a specifically-designed surface, it is not uncommon for sudden and abrupt changes of direction to bring about a tear in the calf muscle."