Serbian tennis player Novak Djokovic cramps up during his semifinal match against Russian Daniil Medvedev at the ATP Adelaide International tournament in Adelaide. (The Associated Press · Posted: Jan 07, 2023 8:25 AM EST) 

If you are an avid pickleball or tennis player, the thrill of the game can be hard to resist; it offers excitement and intensity that few other sports can match. However, it’s important to recognize that older athletes are particularly vulnerable to injuries. While many may be familiar with the term tennis elbow, only a few recognize a significant risk of tennis leg — another common ailment in racquet sports.

What it is

Tennis leg is an acute calf injury, most often characterized by a tear (partial or complete) at the musculotendinous junction of the medial head of the gastrocnemius muscle.

The injury often strikes during pivotal moments of play—when you need to plant your foot down with force, change direction rapidly, or exhibit intense power through your calf. Whether you’re executing a sudden stop, preparing to leap, or pivoting swiftly while running, overstretching this vital muscle can easily result in a painful tear.

Injury risk increases during movements that require forced dorsiflexion of the ankle while your knee is fully extended (see the player Novak Djokovic‘s pic at the top). The consequences can be dire.

Symptoms

• Sudden, sharp pain or cramping, typically in the upper part of your calf
• A sensation of a “pop” or snap
• Swelling in the calf
• Difficulty walking or bearing weight on the leg

Although the condition got its name for its association with tennis, it can occur when a player extends their knee and pushes off their toes while serving; racquet sports aren’t the only activities that can trigger tennis leg as we get older. It can happen in other sports (soccer, sprinting, jumping). Activities that involve sudden movements, such as brisk walking, jogging, or even climbing stairs, can also cause calf strains.

Degrees of strain

A mild strain, with a few stretched or torn muscle fibres, makes walking painful.

A moderate strain, with a greater number of torn muscle fibres, might cause swelling and bruising, in addition to pain. You might limp with either mild or moderate injuries.

A severe strain is different: it’s a tear that rips the muscle in two, causing loss of muscle function. This tear can also involve the Achilles tendon (in the back of the ankle). You might hear a pop or snap when you strain the muscle and feel extreme pain. You’ll have bruising and swelling, and you won’t be able to walk on the leg. You might also see or feel an indentation where the calf muscle or Achilles tendon is torn. This is an emergency and needs immediate medical attention.

Treatment

Your sports medicine specialist would first do a physical examination to assess the severity of your tennis leg.

For mild to moderate strains, s/he might suggest certain conservative measures as an initial line of treatment, such as:

• RICE method: Rest, ice, compression, and elevation are typically recommended to reduce pain and swelling in the acute phase.
• Walking boot: For mild to moderate strains, a walking boot may be recommended to stabilize the muscle and ankle for a week or two.
• Compression sock: Slip a compression sock on the injured leg to keep swelling down. It decreases the feeling of heaviness in the leg. Although it won’t help you heal, it will certainly make you feel better.
• Physical therapy: A rehabilitation program for about six to eight weeks, to help improve your range of motion in the ankle, strengthen your leg and ankle muscles, and regain mobility in the leg muscles. This decreases the risk of future injuries.
• Painkillers: You might be prescribed some nonsteroidal anti-inflammatory drug (NSAID), or acetaminophen, or a topical painkiller, such as diclofenac gel, to help you through pain, swelling and inflammation.

An ultrasound (USG) or an MRI might be required to confirm the diagnosis, rule out other conditions like a deep vein thrombosis (DVT), and assess the severity of the tear. 

Achilles tendon tears might require surgery.

How fast can you get back to an activity you love

It takes 2 to 4 weeks to heal from a mild strain and up to 12 weeks for a moderate to severe strain. Achilles tendon tears take much longer.

Prevention

20% to 30% of people tend to strain the calf again if they skip the proper treatment the first time and don’t stretch and strengthen their calves regularly afterwards. So following are a must:

• Proper warm-ups and stretching before activity.
• Maintaining strength and flexibility in the ankle and leg muscles.
• Allowing adequate rest and recovery between activities.
• Using proper technique during sports and exercise. 

Homoeopathy Helps

A few of the homoeopathic remedies known to give excellent results in sports injuries, muscle strains, and pain, when carefully chosen, are: 

• Arnica montana: Often considered a first-line treatment for physical trauma, bruising, and swelling. It is recommended for injuries resulting from impact or overexertion.
• Rhus toxicodendron: Indicated for muscle aches and stiffness that are worse at rest and on initial movement, but improve with continued gentle motion and warmth. The affected parts often feel stiff and burning.
• Bryonia alba: Suggested when pain is severe and aggravated by even the slightest movement, with a desire for absolute rest. Symptoms might be relieved by cold applications.
• Ruta graveolens: This remedy has a strong affinity for tendons, ligaments, and cartilage, and is useful for strains and sprains from trauma or overexertion.
• Symphytum officinale: Known for promoting the healing of connective tissues and is useful in cases of torn muscles, tendons, or ligaments.
• Calcarea fluorica: Specific for injuries due to muscle strain and overstretching of ligaments and tendons, helping with the repair of tissues. 

These medicines not only give relief in the acute symptoms (pain, swelling, loss of function), but also help recover in strength and form. They provide a safe, gentle and permanent cure without any side effects.

To protect your passion for sports, it is important to understand risks and take proactive measures.

Stay aware, warm up properly, and don’t let a tennis leg hinder your game!