Adding to this thread - I feel like we could use some injuries "Mega Threads", as there are always a lot of scattered useful information around.
Good resources used:
This site has a lot of good info:
https://www.frankgilroyphysiotherapy.co.uk/ankle/patient-exercises-ankle/calf-injury-rehabilitation/
FC Barcelona releases some
great procedures to tendon and muscular injuries.
Here is the link to their Muscle Injury Guide (2019).
Also the link to their Tendon Injury Guide (2021)
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Had a
Grade 3 Calf Strain ("Tennis Leg") on Dec 5th (7 weeks ago). Was playing for 45min, felt like I got hit with a tennis ball when serving, and was done (this was at noon). Immediate swelling. Sent a message to my PT, and he could see me at 5PM. He thought it was bad. The orthopedist still was at the clinic, and he looked at me. Thought it was bad, ordered an MRI. The PT sent me home with pneumatic boots, that I used for 6 days 5x/day in 20 minute sessions (along with RICE). That helped a lot with the bruising and swelling.
Got the MRI done 2 days later. Grade 3 strain. Complete rupture of the medial gastrocnemius, small tear of the lateral gastrocnemius, tear in the free gastrocnemius aponeurosis (2cm tear). Was on walking boots for 2 weeks, as it was impossible to put any weight in that leg for the first days, and the only way I could walk was with the boot.
Had PT sessions weekly (twice per week in the first 2 weeks, and after that once per week). After the first 10 days, was told to do light stretching - moving my foot forward and backwards (with the stretched leg), to make blood flow (3x15). Also "leg raises" with the knee at 90 degrees (3x15). Starting a strenght exercise with a theraband (3x30, plantar flexion). In the end, using a towel to hold a firm stretch, 2x 30s. That was daily.
Day 14 - We repeated the same exercises, but he applied a "tourniquet" with a band in the injured calf in order to accelerate blood flow upon release. More stretching (Standing Calf Strech, Standing Soleus Stretch, Hamstring stretch in lying), and we started some isometric exercises (Single leg standing, Lunge kneeling). Light cycling (10minutes). Bought a compression sleeve, ordered to use it daily.
Day 21: Kept doing everything else, and started to do double leg calf raises. Single leg was still a "no no". There still was bruising and swelling, descending to the ankle. Around this time was the only time where I felt a sharp pain in the injury spot after removing the walking boots: tried to save a 5 year old from falling from a bike. He fell. I almost reinjured myself. Next time I need to make sure just to tell him "don't get the adults bike", only watching, and using the words "I told you so", instead of making a sudden move trying to stop the devil from falling.
Day 30: Had a consultation with a specialist. He basically made me do a single leg calf raise (hadn't done it yet). It was possible, no pain. He "inserted" the finger in the lesion point, and the pain was "dull", nothing sharp, so it showed progress. With the extent of the injury. he said it was 45 days before the injury was healed, and 90 days before returning to play competitively. The bruise as gone by day 25 or so (it had descended to the foot).
Day 40: Started strenght training and had an acupunture session (with electroshock, that I wasn't expecting) one day after the PT session. Zero pain. The following days, though..... Could barely walk, but exclusively due to the DOMS, no pain on the injury spot. Returned to pedal on Zwift (I have a smart trainer). Felt some pain in the calf the day after a 30km session, but it was muscular, and not on the spot of the injury.
Day 45: Started with some agility and ladder drills during PT. Zero pain. Got fully back into the gym to to additional strenghtening. Zero issues handling weight in squats or anything else.
Day 55: Had an ultrasound done. Everything better than expected, healing faster than expected, the doctor almost couldn't identify the injury spot.
Day 60: Got on court, for a light hitting session, 4 people on court, only using half of it, and just hitting down the middle. If I had to stretch or make a sudden change of direction, I didn't go for the ball. 45 minute session. Felt just a little bit of soreness in another part of the calf the next day. Everything completely fine.
Day 77: First practice session. 55 minutes. Still going easy, just hitting, volleys and serve returns. No serving. Zero pain during or after.
July 29th: I have been playing pain free, since day 77. Still using a protection in the calf, but that is more moental than anything. Obviously I have been taking care of volume, the most I have played is 4 times/week, usually it's 2-3 sessions per week. Results in ranked matches haven't been kind to me since the return but well... They weren't kinf before neither. So, as an ending update, everything fully functional, zero issues.
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We have a "tennis specific wall" at my mom's place. I have to say I did use it from day 20 and on. Now, I didn't use the term "hit" because I didn't move. It was almost a "Muster experience". Since then I have been moving more, but not nearly with the usual intensity, change of direction, etc. Never dared to serve or doing anything abrupt. As with every progression I made, "pain" is our friend. If I felt any slight discomfort trying to make any progression, I would stop immediately and don't try it for another week (that happened only once, with the single leg calf raise).
Will try to update this post until I'm actually back into playing without pain, so it can serve as a resource for anyone facing the same injury.
