What is Tennis Leg Injury and how does it occur? Symptoms and treatments.
Tennis leg is an injury located in the back of the leg, characterized by a rupture of the inner calf at the level of the distal myotendinous junction with the soleus.
It may occur with or without the appearance of interfascial edema or hematoma between the superficial and deep planes of the affected muscles, which may manifest itself up to two weeks after the rupture.
It is a common injury in people who practice racquet sports such as tennis or paddle, with a higher incidence in middle-aged men.
How is it produced?
Tennis Leg occurs due to excessive stretching of the muscle (eccentric phase) followed by a strong concentric contraction, which prevents the muscle tissue from assimilating the tension and breaking down. This happens when the triceps suralis (calf and soleus) performs a lifting action over the toe.
It commonly occurs at the beginning of the activity, when the muscles are still “cold”, or in the last moments, when they are already fatigued. Movements such as sprinting, jumping or serving in racquet sports can trigger this injury.
Diagnosis
The differential diagnosis requires an ultrasound study, which allows determining the exact location of the rupture, measuring its length, evaluating vascular involvement and detecting the presence of internal hematomas that may require drainage to avoid subsequent clotting.
As in a bone fracture, muscle rupture requires time for healing and absorption of the hematoma. Physiotherapy accelerates this process and optimizes recovery. During the first 48 hours, relative rest is essential to avoid aggravation of the injury.
Symptoms
Patients with Tennis Leg often describe a sudden “stinging or shooting” sensation in the back of the leg, accompanied by severe pain and functional impotence. Clinically, it manifests with a characteristic snapping or popping sound, followed by severe, disabling pain.
In some cases, interfascial hematoma can increase intracompartmental pressure in the leg and lead to compartment syndrome if not diagnosed early.
In addition, in approximately 10% of cases, the lesion may be complicated by deep vein thrombosis, located in the infrapopliteal area and affecting the twin veins.
Treatment
The main objective of the treatment is to prevent muscle fibrosis, favoring a correct realignment of the muscle fibers to preserve the elasticity and functionality of the injured muscle.
Conventional Treatment
Initially, the “POLICE” protocol is followed in the acute phase:
- Protectionand relative rest.
- Progressive load optimization.
- Lightcompression to control swelling.
- Iceto reduce pain.
- Controlby clinical and ultrasound evaluation.
To reduce pain and inflammation in the early stages, physical therapies such as magnet therapy, high-power laser and manual therapy are used. In more advanced stages, progressive muscle strengthening exercises are incorporated.
Advanced Physiotherapy
Techniques used include:
- Percutaneous Intratisular Electrolysis (PIE®): promotes muscle regeneration and the elimination of cellular residues in the rupture zone.
- MicroEPI: reduces inflammation in the affected region.
- Neuromodulation: works on the activity of the nerves involved in the injury.
- Radiofrequency (INDIBA®): accelerates tissue recovery in advanced stages.
Functional rehabilitation is key in the last phase of treatment, including progressive exercises to restore strength and mobility, as well as a functional assessment to identify possible risk factors.
Interventional Pain Treatments and Regenerative Therapy
In cases of extensive muscle ruptures or recurrent injuries, interventional pain treatments such as:
- Platelet-rich plasma (PRP) infiltrations: stimulate the regeneration of muscle tissue.
- Growth factors: promote the repair of damaged muscle fibers.
- Nerve blocks: in cases of persistent pain, to improve functionality and reduce inflammation.
In more severe situations, such as severe fibrosis or chronic compartment syndromes, surgery could be considered, although this is rare.
Conclusion
Tennis Leg Injury is a common pathology in racquet sports that can lead to significant limitations. Early diagnosis and multidisciplinary treatment including advanced physiotherapy, regenerative therapy and interventional pain options can optimize recovery and prevent long-term sequelae.