Lower Leg Muscle Strains

Diagnosis/Definition

• A muscle strain is a partial tear of muscle fibers caused by forceful stretching of an already contracted muscle. Suboptimal flexibility is thought to be a predisposing factor. The gastrocnemius, because it crosses two joints, is especially vulnerable.

Initial Diagnosis and management

• History and physical examination.
• Plain films if necessary
• Encourage active range of motion.
• Appropriate restrictions of activity.

Ongoing Management and Objective

• Rest is individualized depending upon severity
• Immobilization is contraindicated in minor injuries however crutches should be used if ambulation is painful.
• A significant gastrocnemius tear is sometimes treated with long leg cast immobilization with the knee flexed at 60 degrees and the ankle in neutral for 3 weeks. This is followed by another 3 weeks with a boot cast and the ankle plantarflexed 10 degrees. Compete tears may require surgical repair.
• Ice for 10 to 15 minutes with hourly reapplication.
• Elevate leg frequently with compressive wraps.
• Slow and sustained active stretches

Indication a profile is needed

• Any limitations that affect strength, range of movement, and efficiency of feet, legs, lower back and pelvic girdle.
• Slightly limited mobility of joints, muscular weakness, or other musculo-skeletal defects that may prevent moderate marching, climbing, timed walking, or prolonged effect.
• Defects or impairments that require significant restriction of use.