Sports Medicine/Calf Muscle Injury

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Question
Dear Dr. Arthur,

I read your bio.  Very impressive!

I am a 40 y/o active male.  I was playing tennis (which I do very regularly) and after suddenly changing direction my calf muscle felt pain.  I don't know if it was a pull, a strain, or what have you.  I was able to complete my match.  I couldn't run as well and it hurts a bit to walk on.  It never felt worse nor better during the rest of the match and hours later at home.  7 hours later I got on the treadmill.  I'm able to run but it hurts more when I run.  I can't feel it all when sitting down, but I can when I move the muscle or walk.  It feels like a giant knot down there.

Based on the above do you have a clue as to what this is?  Is this what a "pulled" muscle might feel like?

Secondly, how do you recommend I treat it?  Massage it out?  Ice?  

I thank you very much for your help!  :)

Sincerely,
James

Answer
Good Afternoon James!

Don't you just hate it when things in the body go haywire, and it affects your Life?? Well, we're talking about your leg, and no matter what you do now, it will remind you of an injury in the soleus muscle.

With a sudden, foot-planted movement, an adverse amount of stress is put on your calf at the time.  If the muscle wasn't ready for it, it will stretch, and possibly tear the small fibers around the attachment areas.  I believe this is what happened at the time. It's a little bit like a "charley horse", but takes a little longer to heal.

For you, I would treat it conservatively.  By that I mean to take it easy for about a week, and treat it with cold. By that, I mean a getting a small baggie(zip lock), put about 4 pieces of ice in it, zip it, and wrap it in a damp wash cloth (IMPORTANT!). Place this wash cloth over the swollen area, and leave it on til the ice melts.  I would do that every time you sit down for any length of time.  Do not, run, jump, or otherwise put any undo pressure on that calf.  If you are up and about, get a wide ace bandage, and wrap the calf from the knee down and over the pain, which will give it support.  Wrap it tight, but not too tight, so it doesn't cut off the circulation.  

So, to reiterate, use the ice/damp cloth, and the elastic wrap when up and walking, for about a week.  You may, when sitting, pull your foot up towards your head as you sit in the chair or lie in bed.  Not hard, but just enough so you feel only slight tenderness.  Hold the position for about 5 seconds, and repeat as needed.  Massage might be good to break up the lactic acid accumulation one gets with a soft tissue injury.  Don't have the Massage Therapist dig into the area as that will cause more injury.

If this conservative treatment doesn't seem to clear it up in two weeks, then it might be best to see a recommended Sports Medicine Physician.  Refuse steroids, please, and also narcotic meds.  Maybe a couple non-steroidal, anti-inflammatory meds might make you feel better, but won't make the injury heal any faster.

The fact I am telling you to treat this conservatively, is the fact you can sit without pain, but the second you move that muscle, you feel it.  If it's a STRAIN, than it would be the tendon you pulled in back of the knee.  If it's a SPRAIN, you pulled the muscle fibers in the belly of the muscle. Does it feel like a knot, or is there no swelling?  Give it a couple days before you go to the MT, and if he/she is good, they will be able to define what it might be.  But, the best thing you can do is get the ice on it.....NO HEAT......and then wrap it to give it support if you are on your feet for any length of time.

Thank you for writing, and if you have questions or concerns about the care of your calf, please do not hesitate to contact me.

Best wishes,

Dr. Patricia Arthur

Sports Medicine

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Dr. Patricia B. Arthur, DC, MRC, CST

Expertise

As a 30-year practicing Chiropractic Physician, my specialty was Sports Medicine. For 8 years I had the distinct pleasure of working with the USOC, and traveled the world to care for the athletes in the Pre-Olympic venues for the Summer Games. When I wasn't traveling, I had a private practice, and a hospital practice, in Kamuela, Hawai'i. Questions I couldn't answer usually dealt with pharmeceuticals. This was not my expertise, but the simple questions pertaining to familiar drugs I was able to digress, or refer to someone that was knowledgable in that field. Most Sports Medicine field injuries were familiar to me, but I always aired on the side of caution. In my office practice, I would tend to see more patients with the weekend injuries who would try to self-treat, only making the injury worse than it should have been! Nevertheless, I never took anything for granted, and so it was my conservative approach to the "cause-and-effect" mechanisms that were vitally important to the healing process.

Experience

Following my competitive nature, I knew Sports Medicine would always be a part of my life. After graduation from Palmer University in Iowa, the old adage taught at the school dealt only with the spinal column......anything connected to the spine was outside our scope of practice. To me, this was too simplistic, because the complex body also had arms and legs! From this point, I developed specific technigues which would encorporate the body as a whole rather than haphazard segments. There is nothing traumatic that happens to a single ligament, tendon or joint that doesn't effect a secondary, or possibly a tertiary element in that area. In order for that space to heal, all the factors must be addressed. Volunteering my time teaching referrees, coaches, and interested parents about the realities of probable sports injuries was worth a thousand words!j

Organizations
American Chiropractic Association; Local Emergency Response Committee; Hazardous Materials Response Team; Urban Search and Rescue Team - Operations and Planning; Federal Corps of Engineers Committee; Earthquake Advisory Board; Big Island Wildfire Committee

Publications
Papers published focusing on the importance of proper care of sports injuries; Authored medical columns for the syndicated magazine "The People's Doctor "; Published papers in professional journals on Head Injuries in Sports; Published papers on Drug Abuse in Sports.

Education/Credentials
Robert Packer Hospital - Certified Surgical Technician - CST; Palmer University - Doctor of Chiropractic - D.C.; Wright State University - Masters in Counseling/Psychology; Wright State University - Masters In Couseling of the Severely Disabled.

Awards and Honors
Selected US Olympic Physician -1988; Graduated Wright State University with a 3.75 GPA; Graduated Palmer University with a 3.5 GPA; Faculty Appointment - Palmer University Post Graduate Education; Faculty Appointment- Hawai'i/Kapiolani Community College - Skills Team Tester;

Past/Present Clients
Cincinnati Bengals Football Team pre-season training; Summer Olympic Athletes worldwide; Kona Ironman Triathletes - Finish - line physician

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