Stretching of the calf muscle - rupture of individual fibers or muscle bundles as a result of trauma or excessive motor activity. Clinically, the pathological condition is manifested by acute pain, crunch, edema and hemorrhage of various intensities. To diagnose stretching and determine its severity, a number of instrumental studies are performed - MRI, CT.
The effectiveness of treatment and the speed of recovery of the victim depend on the rapid provision of first aid. In therapy, cold compresses, fixing bandages, external means with a cooling effect, painkillers are used. Throughout the rehabilitation period, ointments from stretching, physiotherapeutic procedures, exercise therapy, the absence of loads on the ankle are shown. Surgical operation is performed in case of severe injury, when most of the calf muscle is damaged.
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Most often, stretching occurs in the transition of the calf muscle into the Achilles tendon. The ankle muscles are usually injured in people involved in active sports: tennis, basketball, acrobatics, volleyball, football. At a certain point, they experience a load that they cannot withstand. Even the elastic calf muscles of professional athletes have a certain tensile strength. Exceeding it causes fiber rupture. Sudden movements during running, especially at the start, jumps in height or length lead to injury. Almost all damage to the calf muscles in athletes is considered acute, resulting from powerful contractions of the muscular-tendon apparatus.
The risk group also includes lovers who decide to actively engage in sports, but do not have the necessary knowledge and skills. Injury provokes a complex of factors:
- lack of pre-heating of muscles before a long run or jump,
- low elasticity of muscle fibers, ligaments and tendons, significantly reducing the tensile strength.
Stretching of the calf muscles is often diagnosed in people predisposed to this type of injury. The likelihood of damage increases with flat feet and joint hypermobility associated with improper collagen biosynthesis. During sports, only individual fibers are sometimes torn. The person writes off the arising pain on muscle strain and fatigue. Such microtrauma significantly reduces the functional activity of the muscle. Soon a situation arises when, for serious damage, a small amount of physical activity is enough.
In untrained people, only the extension of the calf muscle is rarely detected. It can be accompanied by violations of the integrity of the bone, fascia, periosteum, partial rupture of the tendon or its complete separation from the bone base.
Clinical picture
Treatment for gastrocnemius distension depends on the severity of the symptoms. Therapy of pathology of the first degree is carried out at home. And when diagnosing damage of the second or third severity, the patient is shown hospitalization for medical care in a hospital. The following symptoms are characteristic of a calf muscle extension:
- first power. Diagnosed with a break of no more than 25% of muscle fibers. Victims do not immediately consult a doctor, as the pain that occurs during an injury quickly wanes. Uncomfortable sensations arise only during walking, making it difficult to fully focus on the foot. The main symptoms occur after 5-12 hours. A strong edema and an extensive hematoma form in the ankle region. The functional activity of the calf muscle decreases markedly: the victim has difficulty trying to lean on his toe, and during movement he is forced to limp in order to reduce the load on his sore leg,
- second power. With this stretch, up to 75% of muscle fibers are torn. At the time of injury, acute pain occurs, the intensity of which decreases slightly in the supine position. Muscle rupture provokes a violation of the integrity of nearby blood and lymph vessels. Blood enters the subcutaneous tissue and soon an extensive hematoma forms in the ankle and ankle region. The edema is so intense that the contours of the foot and ankles change. The injured are not able to fully bend and unbend the foot, ankle joint, and when moving uses outside help,
- the third power. It is detected when more than 75% of muscle fibers are torn or the calf muscle is completely torn off in the area of its attachment to the Achilles tendon. During an injury, a crunch may be heard that resembles the crackling of broken, dry branches. There is so sharp, piercing pain that a person often loses consciousness. Within a few hours, edema and hematoma form. The stability of the joint is completely violated, the range of motion in it is markedly reduced. The injured person is not able to bend or unbend the foot, ankle, climb on toes, move independently.
Stretching of the calf muscle of a high degree of severity in most cases is combined with other types of injuries, usually fractures. At the same time, ligaments, tendons, joint structures are seriously injured. With such damage, the likelihood of hemorrhage in the joint and nearby soft tissues increases. To prevent traumatic shock will help only quickly provided first aid and contact the emergency room.
First aid
First of all, a person needs to be laid down and reassured. To relieve acute pain, you can use analgesics, antispasmodics, but it is best to give the victim a tablet of any non-steroidal anti-inflammatory drug (Ibuprofen, Nise, Ketorol, Diclofenac, Ortofen). What you need to do next:
- limit the mobility of the injured leg. If you have skills, then it can be fixed by applying a tire or elastic bandage. In their absence, a person should be completely at ease. Traumatologists advise raising the limb by 30-40 cm, for example, placing tightly folded tissue under it. This will help to avoid the formation of severe edema and compression of the sensitive nerve endings,
- use cold compresses. The procedure will prevent the formation of edema and hematoma, reduce the intensity of the pain syndrome. It is carried out using a plastic bag filled with ice cubes. A piece of frozen meat or a package with a vegetable mixture is also suitable for cooling. The package must be wrapped in several layers of thick tissue to avoid frostbite. The compress is applied to the calf muscle for 15 minutes. Then you should take a half-hour break.
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If first aid is provided correctly and in a timely manner, then the well-being of the victim will significantly improve. Sometimes he even refuses hospitalization, which is absolutely unacceptable. Symptoms of a fracture, dislocation, rupture of ligaments and / or tendons can be masked as signs of a sprain. To determine the type of injury, it is necessary to carry out diagnostic measures.
Diagnostics
External examination of the patient with a rupture of muscle fibers is uninformative due to the similarity of symptoms of almost all ankle injuries. Differential diagnosis is performed to exclude a fracture of the tubular bone, dislocation or damage to the Achilles tendon. What diagnostic tests can be carried out:
- radiography. With the help of an X-ray examination, fractures and cracks in the bones are detected,
- MRI or CT. The study is informative to establish damage to any connective tissue structures: muscles, ligaments, tendons, soft tissues.
Diagnosis is also necessary to identify the inflammatory process that occurs during trauma, the degree of its intensity and localization. The victim is also shown general blood and urine tests, the results of which make it possible to assess the general state of health.
General principles of conservative treatment
When injuring the first degree of severity, the victim is shown bed rest for 1-2 days. To move around the room using a cane or crutch. At the stage of rehabilitation, rigid or semi-rigid orthoses are used. Wearing orthopedic appliances helps to reduce the load on the damaged muscle and accelerate the recovery of torn fibers. As you recover, the ankle is fixed with elastic bandages or bandages. How else can you treat the extension of the calf muscle at home:
- in the first days, actively use cold compresses or ointments with a cooling and distracting effect, for example Ben-Gay,
- after 2-3 days, external remedies with a warming effect (Finalgon, Viprosal, Kapsikam) are included in treatment regimens to improve blood circulation and accelerate regeneration processes,
- throughout the course of treatment, the use of venoprotectors and venotonics (Troxevasin, Lyoton, Troxerutin) is recommended to reduce the severity of edema and hematoma.
NSAIDs and analgesics should be taken only to eliminate severe pain. Subject to all medical recommendations, the discomfort gradually disappears. Warming ointments have a distracting effect, significantly reducing pain.
Surgical intervention
Treatment of gastrocnemius muscle strain, which is characterized by rupture of most of the fibers, is only surgical. If the victim is promptly delivered to the hospital (within 1-3 days), then the surgeon sews the torn muscle and immobilizes the leg with a plaster cast for 2-3 weeks. After a course of rehabilitation measures, the functionality of the foot is fully restored after 1-3 months.
When the victim underestimates the severity of his condition and does not go to the emergency room, this becomes the reason for shortening the calf muscle, reducing its volume, developing degenerative processes in adjacent connective tissue structures. A man is still forced to seek medical help because of the impossibility of full movement. Since the retraction of the muscle has already occurred, it is necessary to plastic recovery during arthroscopic surgery. The surgeon builds muscle tissue using a graft.
Rehabilitation period
To restore the active functioning of the muscles, the doctor makes up a set of rehabilitation measures. The implementation of all recommendations will significantly speed up recovery. With a mild tension, rehabilitation is started after 2-3 days, at the stage of using warming ointments. In severe injuries, recovery begins after removal of the plaster cast. What rehabilitologists recommend:
- massage, classic or acupressure, to improve blood circulation and microcirculation,
- 5-10 sessions of physiotherapy: laser therapy, magnetotherapy, UHF therapy, which increase the rate of regeneration of muscle fibers,
- medical gymnastics and physical education to restore all the functions of a torn muscle.
From the very beginning of treatment, patients are shown electrophoresis with analgesics, NSAIDs, calcium solutions to reduce the intensity of pain. If the sprain is combined with trauma to the joint or bone, then chondroprotectors are used during physiotherapy.
Traumatologists recommend going to a hospital even with mild pain in the ankle. The victim cannot independently assess the degree of severity of the sprain, to identify concomitant damage to the bones or ligament-tendon apparatus. The lack of treatment will aggravate the injury, the development of serious complications.
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