Ruptures of the medial head of the gastrocnemius ("tennis leg"): clinical outcome and compression effect

Abstract

The purpose of this study is to describe the clinical outcome of conservative treatment in patients with rupture of the medial head of the gastrocnemius ("tennis leg") occurring during exercise and training and the effect of the compression treatment.

Materials and methods: Thirty patients (conservative treatment=15; compression treatment=15), aged 30-45 years, with clinically suspected rupture of the medial head of the gastrocnemius occurring during exercise and training were referred for ultrasonography (US) examination. All patients underwent US of the affected and contralateral asymptomatic limb. Follow-up clinical evaluation and US imaging of all patients each were performed at 1-week intervals during the month after injury and at 2-week intervals during the following 6 months. US findings were analyzed with respect to the integrity of the musculotendinous junctions of the gastrocnemius, the presence of a fluid collection, and the union time of the medial head of the gastrocnemius with the soleus muscle. In addition, we analyzed the clinical outcome of the compression treatment.

Results: Of the 30 patients who had an initial US examination after their injury, partial rupture of the medial head of the gastrocnemius muscle was identified in 11 patients (36.7%); the remaining 19 patients were diagnosed with complete rupture. Fluid collection between the medial head of the gastrocnemius and the soleus muscle was identified in 25 patients (83.3%). First union of the medial head of the gastrocnemius with the soleus muscle in the compressive group was significantly rapid than that of the conservative group (4.25 vs. 3.25 weeks; P=.02). Fluid collection between the two muscles after 1 month in the compressive group was significantly smaller than that in the conservative group (8.9 vs. 4.5 mm; P=.01).

Conclusions: Early compressive treatment in patients with rupture of the medial head of the gastrocnemius decreases the hemorrhage amount and can be possible for early ambulation.