Calf Strain

Experienced a sharp, instantaneous pain in my right calf this past Wednesday while riding one of those Razor kick scooters. Felt like a bullet hit my leg. Could not walk without hobbling and some pain for the next two days. Stopped ice and Alleve on day three but woke up sore the next day and again more pain when walking. Started ice and Alleve again and got a pair of crutches today to baby the calf.

At this point, do the crutches and ice make sense or should I just walk as best I can and accept some pain at points? This is the second time this happened in the last two months although the last it healed much faster and was gone within 10 days. I'm 60 years old and in otherwise good health, except for my back but that's another issue :)

-- Jim

[JainMD]

Hi,
You are having sharp, instantaneous pain in your right calf. You mean to say there is no injury to bone.
Your age and these symptoms suggests that you are having pain from blood stasis, there might be poor circulation in your calf muscle causing pain. Venous insufficiency is what I am talking about.
I think you should get evaluated from a physician and get a Doppler study done of blood vessels of calf.
How the pain did have healed last time?
What measures you had taken last time? Which doctor you had consulted last time?
Did you do any imaging study?
I would be interested to know.
Bye.

[jmjm530]

To clarify, the sharp, instantaneous pain was during physical activity -- driving the scooter forward with my leg. When I stopped the activity,. the sharp pain went away. What is happening now is more of a dull pain when I put weight on it, which causes me to walk with a limp. I self-diagnosed as "calf strain" because my symptons seemed to match up with those symptons very closely.

Last time, the calf returned to normal -- pain free with exercise -- over a period of two weeks. But it was never as bad as this time, except for the initial sudden pain, which was the same. I did not see a doctor at that point so have no imaging stuies, but do have an appointment this Thursday with an orthopedist.I certainly  will discuss blood statis with the doctor.

You mention getting a doppler study. Is this similar to an MRI, which I've read is sometimes used to determine severity of muscle tear?

In any event, thank you for your thoughtul response. Are you an orthopedic specialist by any chance?

Happy New Year,

-- Jim

[JainMD]

Hi Jim,
You are 60 years old, but your sharpness is as good as genius kid.
Doppler study is not similar to MRI study. In MRI study they use magnetic resonance to produce an image whereas Doppler studies determines the flow of blood across the vessels.
MRI study is useful to determine the pathology of soft tissue structures like muscles.
The fact calves returned to normal with exercise suggest there could have sign and symptoms of blood stasis then.
I am a doctor, but a physician.
I would be interested to know about disease progression and regarding your consultation.
Keep me informed.
Bye.

[jmjm530]

Thanks again. I will be sure to mention blood statis and request a doppler at my appointment.

While I'm still leaning toward calf strain, given the sudden onset, your advice is quite prudent, considering my age and also a history of Afib, which I didn't think necessary to mention before, but now I see a potential correlation.

Also, both episodes seemed to come after periods of inactivity,which could point to either calf strain or blood statis, which I assume (from a quick Internet search) is the same as Deep Vein Thrombosis (DVT). I will keep you informed.

-- Jim

.

[jmjm530]

Just came back from the doctor.

He said torn calf muscle and recommended both staying off of it while it hurts -- crutches, etc -- as well as physical therapy 3X week for 4 weeks -- strengtening exercises, stretching, ultrasound, etc. Actually seems contradictory to rest it and exercise it, but that occured to me after I was out the  door :) Exam was less than 10 minutes from "hello" to "goodbye" as is often the case these days.

I asked about getting an MRI and Doppler but he said the MRI was "useless" and the "doppler" unecessary as it didn't present as DVT which would have more swelling, plus it happened during exercise, twice. Personally, I think the prudent thing would have been to order both studies, but he seemed fairly set. I'll probably try PT for a couple of weeks, but if no progress maybe see another ortho specialist.

Thanks again for all you help and welcome any more comments should you feel there is something to add.

-- Jim

[JainMD]

Hi Jim,
Personally, I am happy that your examination is done and now the diagnosis according to your doctor is confirmed.
The so-called torn muscle is an acute injury to the inside (medial) part of the gastronemius (calf) muscle in the lower leg, which is responsible for extending the ankle, such as when pointing the toes.
Immediate treatment would be to follow RICE protocol that is rest, ice, compression and elevation for the first 48 hours. Elevation of the leg prevents swelling. Wearing an elastic stocking is helpful. Resting the leg is important. Ice packs immediately for 20 minutes and then every two hours when awake (the pack can be placed over a bandage). A firm elastic bandage applied from the toes to below the knee, or an adhesive strapping over the calf.
For more severe strains use crutches, which can be continued if the pain continues to be severe and you are unable to bear your weight on the ground.
Painkillers such as paracetamol every 4-6 hours can be used.
Follow-up treatment includes starting of activity, such as walking, after 48 hours of rest. Use the leg as normally as possible, as pain allows.
Limited activity should be done for 3-4 weeks.
A raised heel on both shoes makes walking more comfortable.
Start gentle stretching exercises as soon as possible to the level of feeling tightness in the calf.
This is general line of treatment for calf muscle tear.
I think you should be gentle exercises.
Hope this helps you.
Bye.