The calf is the muscle component in the back of a person’s lower leg. It is comprised by two named muscles: gastrocnemius (main part) and the soleus. When a person says “I tore a ligament in my calf” he really means that he tore, or ruptured, his Achilles Tendon—since this is the primary ligament that controls the calf. Torn Achilles tendon is a fairly common sports injury, and usually occurs when someone pushes off their heel with an explosive force: leaping high to grab a rebound in basketball, or sprinting in the backcourt to hit a forehand during a tennis match, as examples.
Anatomy and Definitions
As mentioned, the gastrocnemius (also called ‘gastroc’) is the primary muscle of the calf. At the base of the gastroc, the muscle converges to become the Achilles tendon, which courses down and attaches to the back of the heel bone—called the calcaneus. The Achilles tendon is composed of dense fibrous tissue, and is about 6 to 7 inches long in the average size male. There are two types of Achilles tendon tears:
- Complete rupture—this is when the tendon is completely severed across its width; this is more severe, and takes longer to heal from
- Partial tendon tear—only about 20-50% of the Achilles is ripped; this is easier and faster to recover from
Discussion of ‘Symptoms and Signs’ will mainly focus on the complete Achilles rupture, as that is the most common type of ligament tear.
Symptoms and Signs of an Achilles Tear
These are the common signs seen when a ‘weekend athlete’ suffers a ruptured Achilles tendon: (See Reference Textbook)
- A sudden and sharp pain, either in the back of the calf or at the Achilles area (patient may say “I feel like I got whacked back there.”)
- Noticeable swelling on the back of the leg, between the calf and heel
- Difficulty walking on the affected leg, especially to go uphill or climb stairs
- Unable to stand on tiptoes with the affected leg
- A ‘snapping’ or ‘popping’ sensation when the injury first occurs
- When the patient palpates along the Achilles, he will likely feel a crevice or soft spot—this is the location of the tear
- If injury is on the right Achilles, she will be unable to push down on the gas pedal of her car
If a patient experiences any of the above symptoms, he should seek medical attention to get thoroughly examined for a possible Achilles tear.
Management of an Achilles Tear
According to Dr. Jacobs in the June 24, 2009 issue of Medscape Journal, first-aid treatment for an Achilles tear should consist of the following (R.I.C.E. is the acronym to remember):
- Rest: keep off the injured leg, as walking or weightbearing can cause more damage
- Ice: apply an ice pack to the swollen area; this is key especially during the first day of injury
- Compression: wrapping the lower leg and ankle with an ace bandage will help minimize the pain and swelling
- Elevation: keeping the affected leg elevated (higher than the hips) will also reduce swelling
An athlete with a suspected Achilles tear should see a physician as soon as possible, preferably an orthopedic surgeon or podiatrist. Once the specialist confirms the diagnosis, she will discuss options for treatment, which include surgery (sewing back the torn tendon), or nonsurgical treatment (wearing a leg brace or cast). Most cases heal within two to three months, but slow healers can take up to six months for full recovery.