Brief Outline of Calf Strain

Calf Strain

Failing to warm-up properly can lead to muscle strains. The calf muscles are used when taking off during a sprint, when jumping, changing directions, or when coming out of the bottom of a deep squat. These are usually explosive movements requiring forceful contractions of the calf muslces, which can lead to a muscle strain. Strains can result from incorrect foot positioning during an activity or an eccentric contraction beyond the strength level of the muscle.

Anatomy and physiology

The muscles of the calf include the gastrocnemius, plantaris, and soleus, known as the triceps surae. These muscles attach to the foot through the Achilles tendon. The popliteal fossa at the back of the knee is formed inferiorly by the bellies of gastrocnemius and plataris, laterally by the tendon of biceps femoris, and medially by the tendons of semimembranosus and semitendinosus. The calf muscles are responsible for extending the foot, and rising up on the toes. When taking off or changing direction, the calf muscle must contract forcefully. This contraction can cause tearing of the muscle at the attachment of the tendon. An eccentric contraction, a contraction while the muscle stretches, such as landing from a jump, can also cause a tear if the muscle is fatigued or not strong enough to handle it.

Cause of Calf Strain

Forceful contraction of the gastrocnemius or soleus muscle. Forceful eccentric contraction. Improper foot position when pushing off or landing.

Signs and symptoms

Pain in the calf muscle, usually mid-calf. Pain when standing on tiptoes, and sometimes pain when bending the knee. Swelling or bruising in the calf.

Complications if left unattended

Any strain left unattended can lead to a complete rupture. The calf muscle is used when standing and walking, so the pain could become disabling. A limp or change in gait due to this injury could lead to injury in other areas.

Treatment

  • Anti-inflammatory medication
  • Anti-inflammatory injection
  • Physiotherapy
  • Shockwave therapy

Rehabilitation and prevention

As the pain subsides, a program of light stretching may help facilitate healing. When the pain has subsided, strengthening and stretching will help to prevent future injury. Proper warm-up before activities will help protect the muscle from tears. Strong flexible muscles resist strains better and recover more quickly.

Long-term prognosis

Muscle strains, when treated properly with rest and therapy, seldom have any lingering effects. In very rare cases where the muscle detaches completely, surgery may be required to re-attach the muscle.

Call (+65) 6471 2674 (24 hour) to fix an appointment to treat your Calf Strain today.

Brief Outline of Hamstring Strain

Hamstring Rupture

A hamstring strain, or a pulled hamstring as it is commonly referred to, is a stretch or tear of the hamstring muscles or tendons. This is a very common injury, especially in activities that involve sprinting or explosive accelerations. A common cause of a hamstring strain is a muscle imbalance between the hamstring and quadriceps, with the quadriceps being much stronger.

Anatomy and physiology

The hamstrings are three separate muscles that work together to extend the hip and flex the knee, and correspond to the flexors of the elbow in the upper limb. During running, the hamstrings slow down the leg at the end of its forward swing and prevent the trunk from flexing at the hip joint. The three muscles are the biceps femorissemitendinosus, and the semimembranosus. Any of the muscles can be strained. Commonly tears or ruptures usually pull away from this attachment as well. Excessive force against the muscles, especially during eccentric contraction (when the muscle is stretching against force), can cause stretching, minor tears, or even a complete rupture.

Cause of Hamstring Strain Injury

Strength imbalance between the hamstrings and quadriceps. Forceful stretching of the muscle, especially during contraction. Excessive overload on the muscle.

Signs and symptoms

Pain and tenderness in the hamstrings; very little in a grade 1, to debilitating in a grade 3. May affect the ability to walk, from causing a limp, to a complete inability to bear weight. Swelling with grades 2 and 3.

Complications if left unattended

Pain and tightness in the hamstring will continue to get worse without treatment. The tightness in the hamstring could lead to lower back and hip problems. Untreated strains can continue to progress to a full rupture.

Treatment

Grade 1: Ice, anti-inflammatory medicines

Grade 2 and 3: anti-inflammatory medicines; seek medical help if a complete rupture is suspected or if the patient is unable to walk without aid. Then physiotherapy to promote healing.

Rehabilitation and prevention

Stretching after the initial pain subsides will help speed recovery and prevent future recurrences. Strengthening the hamstrings to balance them with the quadriceps is also important. When re-entering activity, proper warm-up must be stressed and a gradual increase in intensity should be followed.

Long-term prognosis

Hamstring strains that are rehabilitated fully seldom leave any lingering effects. Complete ruptures may require surgery to repair and long-term rehabilitation.

Call +65 64712674 to make an appointment to see our specialist to treat hamstring injury today.

Joint Pain

Brief Outline of Quadriceps Strain

Quadriceps Strain

A muscle strain, which is a forceful stretch or tear of the muscle or tendon in a weight bearing muscle such as the quadriceps, is painful and difficult to rest. The quadriceps are involved in supporting the hip and knee structure to hold the body weight. A quadriceps strain can result from a forceful contraction of the quadriceps or unusual stress placed on the muscles. As with other strains it is graded 1 through 3, with 3 being the most severe tear.

Anatomy and physiology

The quadriceps are composed of four muscles; the vastus lateralisvastus medialisvastus intermedius, and rectus femoris. A strain may occur in any of these muscles, but the rectus femoris is most commonly strained. Due to the force generated in activities such as sprinting, jumping, and weight training, the musclee may microtear, but when the muscle is stretched forcefully under a load such as with high impact sports like football and hockey, it may also pull away from the attachment or completely tear.

Cause of Quadriceps Strain

Forceful contraction or stretch of the quadriceps.

Signs and symptoms

Grade 1: Mildly tender and painful, little or no swelling, full muscular strength.

Grade 2: More marked pain and tenderness, moderate swelling and possible bruising, noticeable strength loss.

Grade 3 (full tear): Extreme pain, deformity of the muscle, swelling and discolouration, inability to contract the muscle.

Complications if left unattended

grade 1 or 2 tear left unattended can continue to tear and become worse. A grade 3 tear left untreated can result in loss of mobility and a severe loss of flexibility in the muscle.

Treatment

  • Anti-inflammatory medication
  • Immobilisation
  • Physiotherapy

Rehabilitation and prevention

After the required rest period, activities should be approached cautiously. Avoid activities that cause pain. Stretching and strengthening of the quadriceps will be necessary. Ensuring a balance strength between the quadriceps and hamstrings is important to prevent a strain. Poor warm-up techniques must be observed to prevent strains and gradually increasing intensity will help as well.

Long-term prognosis

Quadriceps strains seldom result in long-term pain or disability. Surgery is only needed in rare cases where a complete tear does not respond to immobilisation and rest.

Joint Pain

Brief Outline of Muscle Strain (Biceps Brachii, Chest)

Muscle strains are among the most common sports injuries and often result from the sudden extension of a joint beyond its normal range of function. This causes damage to muscle and other soft tissue. The chest muscles (pectoralis major and minor) joint the biceps brachii muscle at the shoulder joint. Weight training, sudden, violent torsion of the shoulder during throwing sports, or a sudden force applied to the nexus of the pectorals and biceps brachii (as when warding off a check in hockey with the arm extended), can produce such injuries.

Anatomy and physiology

The biceps brachii muscle is located on the front of the upper arm, and operates over three joints. Its function is to allow bending of the arm and to support loads placed on the arm. This muscle has two parts, known as the long head and short head, both connected to bone via the biceps brachii tendon.

Along with the pectoralis minor, the large pectoralis major muscle forms the anterior wall of the axilla, and has its origin in the clavicle, sternum, and first six costal cartilages, inserting in the greater tubecule of the humerus bone. The muscle is used for flexion, adduction, and medial rotation. It joins the biceps brachii muscle, meeting at the shoulder joint.

Cause of Muscle Strain (Biceps Brachii, Chest)

Sudden movement leading to a muscle tear. Large physical demand placed on the muscle. Warding off a check in hockey or tackle in football.

Signs and symptoms

Tenderness and pain over the affected muscle. Stiffness. Pain during muscle use.

Complications if left unattended

Muscle strains are usually self-limiting  and repair themselves given proper time off from exertion and allowing time for healing. Insufficient recovery time however can lead to further tearing, increasing the risk of re-injury and lead to degenerative changes in the muscles over time.

Treatment

  • Anti-inflammatory medication
  • Injection
  • Physiotherapy

Rehabilitation and prevention

Stretching exercises follow healing can help restore full mobility in the affected area while strengthening exercises can help prevent re-injury. Stretching and warm-ups, as well as attention to proper athletic technique (particularly in weight training) may help prevent this type of injury.

Long-term prognosis

Muscle strains involving the pectoral muscles of the chest and/or the biceps brachii are common and – given adequate time for proper healing – generally not a serious threat to the athlete, although severe or repeated muscle strains can cause chronic pain and lead to impairment of muscle function.

Call (+65) 6471 2674 (24 Hour) to make an appointment to treat Muscle Strain.

Ruptured Achilles Tendon

Brief Outline of Achilles Tendon Strain

Achilles tendon strains can be very painful and take some time to heal. The Achilles tendon, which gets its name from the mythological Greek warrior Achilles, is located in the back of the lower leg over the heel. An injury to this tendon can be debilitating because of its involvement in walking and even balance during weight bearing. Explosive activities such as sprinting and jumping, and those activities that involve pushing against resistance such as football linemen and weight training, contribute greatly to this injury.

Achilles Tendon Rupture

Anatomy and Physiology for Achilles Tendon

The Achilles tendon is the largest tendon in the human body, being approximately 15 cm long, and 2 cm thick. It originates from the musculo-tendinous junction of the calf muscles, and inserts into the posterior aspect of the calcaneus. The tendon is separated from the calcaneus by the retrocalcaneal bursa, and from the skin by the subcutaneous calcaneal bursa. It pulls the foot downward, extending it when the calf muscles contract. The strain can be graded on a scale from 1 to 3.

Grade 1 strain: A stretching or minor tear of the tendon (less than 25% of the tendon.)

Grade 2 strain: Involves more of the tendon fibres (usually 25% to 75%.)

Grade 3 strain: A complete rupture of the tendon.

Ruptured Achilles Tendon

 

Cause of Achilles Tendon Strain

Abrupt, forceful contraction of the calf muscles; especially when the the muscle and tendon are either cold or inflexible. Excessive force applied to the foot, forcing the foot into the plantar flexion.

Signs and Symptoms of Achilles Tendon Strain

Pain in the Achilles tendon, from mild discomfort in grade 1 strains to severe, debilitating pain in the grade 3 strains. Swelling  and tenderness may also be experienced. Pain when rising on the toes. Stiffness in the calf and heel area after resting.

Complications If Left Achilles Tendon Strain Unattended

A minor tear may become a complete rupture if left unattended. Bursitis and tendinitis may develop from the inflamed tendon rubbing over the heel.

Immediate Treatment to Achilles Tendon Strain

R.I.C.E. Anti-inflammatory medication. Then Shockwave Therapy to promote blood flow and healing. Immobilisation and medical help for complete ruptures.

Rehabilitation and Prevention for Achilles Tendon Strain

Rest is important and a gradual return to activity must be undertaken. Stretching and strengthening the calf muscles is important in rehabilitation and to prevent a recurrence. Warming-up the calf muscles properly before all activities, especially those involving forceful contractions such as sprinting, is essential to prevent strains.

Long-term Prognosis for Achilles Tendon Strain

Due to lower blood supply in tendons, they take longer to heal than the muscle, but with rest and rehabilitation, the Achilles tendon can return to normal function. Complete ruptures occasionally require surgical repair.

Call (+65) 6471 2674 (24 Hour) to fix an appointment to see our orthopaedic specialist for Achilles tendon treatment today.