Are you a “weekend warrior”? When you run, do you feel pain in the upper center portion of your calf that is unrelieved by stretching? Does that pain feel like a solid rock? If so, you may have a medial gastrocnemius strain. Read below to learn how to obtain relief.

What is a medial gastrocnemius strain?

● A medial calf injury that affects the musculotendinous area in the medial head at the gastrocnemius muscle that results from an acute forceful push off with the foot.
● Occur in more men than women
● Can occur with any activity
● Occurs in sports that involve running, jumping, and tennis
○ Called “tennis leg” because it is mostly seen in this sport


● Age and activity level:
○ older adults
○ common in weekend warriors
● Previous injury
○ Athletes with recurrent calf strains
● Unstretched calf muscles

Presentation in the clinic

● Patients will complain of pain in the calf that radiates to the knee or the ankle.
● Report having pain with range of motion (ROM)
● May have a swollen leg that extends down to the foot or ankle with bruising
● Some patients may describe an audible pop when the injury to the medial calf occured.
● May also report feeling like a stick struck his her calf

Diagnosed clinically

● Labs are done to rule out deep vein thrombosis (DVT).
● X Rays are done to rule out fracture (avulsion) when the patient describes an audible pop.


The injury can last 1-12 weeks depending on the degree of tissue damage.

● Rest
● Ice
● Compress
● Elevate
● Weight bearing as tolerated
● Use crutches and bilateral heel lifts
● Physical therapy
● Active foot and ankle range of motion
● Continue treatment until pain free with full symmetry ROM and full strength has been regained
○ then can resume activities


● Scar tissue formation that results in chronic pain caused by functional shortening of the muscle tendon unit
● Can lead to frequent reinjury
● Formation of DVT caused by inactivity


● Regular physical activity with maintaining flexibility in the gastrocnemius muscle Prognosis
● Good (if treatment is followed)


● Good (if treatment is followed)

Figure 1: Gastrocnemius Strain


Hsu D, Chang KV. Gastrocnemius Strain. [Updated 2022 Jun 5]. In: StatPearls [Internet]. Treasure Island
(FL): StatPearls Publishing; 2022 Jan-. Available from:

Pepermpron. (2022). [Illustration]. Calf Pain leg back muscle blood vessels nerve acute sport damage
arterial trauma tennis soccer tear Cramp spasm Charley horses medial fiber bruising run walk tendon Clot deep vein pull torn up sprain.

Saglimbeni, A. (2018). Medial Gastrocnemius Strain Treatment & Management.

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