Part One: How I tore my calf
My name is Shaun Miller and I’m a physiotherapist at Prana Physiotherapy & Health. At 32 years of age, I pushed my body too far and tore my calf. Follow along to find out how it happened, and my rehabilitation journey.
I was trialling for a soccer team, which I was eager to impress. 105 minutes in, I pushed hard off my right foot to take the ball away from a defender and pass back to a teammate when I felt an impact to the inside of my right calf. It felt like I had been kicked hard by someone. No one was close by and as soon as I tried to put my right foot back down, the most intense, sharp pain took hold in that exact spot. Oh no…
With my experience as a Physiotherapist I am fortunate that I can self-assess my injuries and have a good idea of what has happened. My first instinct was to check my achilles; present, intact, not painful. Next was my soleus muscle; present, intact, a little tender about ¾ of the way up on the inside. Lastly, my gastrocnemius muscle (the two headed calf muscle); present, swelling fast, very sore over the inner portion about halfway up my calf.
Conclusion: I’ve torn my calf.
I’d be lying if I said my pride hadn't taken a hit from being the first player to leave the field due to injury. I required assistance to leave the pitch and was able to limp (with support) to the car and luckily my dad was able to drive me home.
Then I started my plan of action:
Get home, compress the calf, elevate it and see if ice helps the pain
Sleep and recover
The following day, assess the extent of damage by looking for swelling, bruising and gauging painful and pain free movement
Get some crutches if needed
Use appropriate medication for pain relief and further swelling management
The following 48 hours were awful, even with my best laid plans. I was in a lot of pain, I didn't sleep well and had poor mobility. I had to take a day off work and make arrangements to compensate for my newfound lack of mobility. I booked in to see a Physiotherapist three days after my injury (no, we don’t tend to treat ourselves because we’re far better at treating others, and yes, it was one of my colleagues). I was looking at a 6-8 week recovery period and rehab that would continue for a further 4-6 weeks. So a minimum of 10 weeks off the field.
And so began my rehabilitation journey. A follow up appointment was booked with the physiotherapist later in the week and I continued my care at home.
Part Two: Rehabilitation begins
Three days after my injury my physiotherapist announced a clear prognosis and recommended an ultrasound scan to assess the degree of tissue damage. I had the ultrasound scan at seven days post injury which revealed an acute 6cm tear of the medial gastrocnemius musculotendinous junction. At this stage I was walking around with only one crutch and could bring my foot to flat but couldn’t stretch my calf any further due to pain and stiffness. I was pleased with the progress I had already made and had hope that I was heading in the right direction.
I’m a strong advocate for moving as much as you can when injured, whilst listening to your body. Having worked closely with many patients during acute injury phases, I have learned that the pain you experience doesn’t always reflect the amount of tissue damage that has occurred. A great example of this is when you stub your toe without breaking it, or getting a small papercut that stings quite bad.
In my situation though, it was quite clear that the sensation of an impact/snap and the subsequent loss of function meant that something was damaged. I could not walk without crutches, I couldn’t stretch my calf, and each of these were instances of pain telling me to stop.
My physiotherapist was able to give me a clear plan of action for the rehabilitation of my calf muscle. I was prescribed exercises for my calf to perform whilst sitting and attempt to walk as much as I could with only minimal pain. Over this period of time, the treatment that gave me the biggest relief was manual therapy. My physiotherapist was able to gently flush my calf using a specific type of massage cream. This helped reduce the pain I was experiencing with walking and also settled the injury enough that I could stretch a little bit easier. The quality of my movement also improved.
It is important to point out that massage does not magically heal a tear, but, via various mechanisms, it can improve how your injury feels and how the muscles function.
During weeks one to three post injury I really learned to value the use of manual therapy (massage) to supplement my rehabilitation. It was crucial in giving me the ability to move and perform my rehabilitation exercises to the degree they were required. During this period of time I progressed from non-weight bearing exercise to standing exercises and I was able to return to normal walking patterns by the end of the third week.
The next step was to return to running and return to soccer.
Part Three: Returning to Sport
Five weeks post injury I was able to return to playing soccer and also start running again. This wasn't a timeline chosen by random, but by carefully managed rehabilitation that was planned out by my Physiotherapist.
When my treatment began, my Physio identified the local structures that required rehab and the targets I needed to achieve before returning to sport. Initially I needed to be able to perform 30 x heel raises off the edge of a step. Then, to build up the function of the muscle, my next target was hopping for 30 seconds continuously without pain. After a few weeks of neglect the adjoining muscle groups and structures needed a bit of attention as well including my quads, hamstrings, glutes, core and toes.
Next step was returning to soccer. The important thing to note is that I did not just jump straight back into a 90 minute soccer match at my pre-injury level. That would have been a recipe for disaster. With the help of my Physio, we mapped out a graded return to matches, allowing me to build back up to a full match.
Receiving an individualised plan and guidance from a professional gave me incredible confidence in achieving a full recovery and return to activity. What has surprised me the most during my rehabilitation is that when you have an injury that limits your function it can be easy to get stuck in a rut and get frustrated. I don't think I would have recovered as quickly as I have without a clear plan and reassurance from my Physiotherapist. I was also offered:
Guidance on how and when to begin my rehab (strength and function) exercises
Recommendations on how many to begin with and progress to over a certain timeframe
Manual therapy for the odd pain relieving “circuit breaker”
Stretching with guidance
Support through actively listening to my concerns and appropriate reassurances
Working as a Physiotherapist myself, it can be easy to forget just how incredibly helpful a Physio can be when it comes to acute injury and rehabilitation.
If you have sustained an injury playing the sport you love, book in with one of our experienced Physiotherapists to discuss a plan to get you back on the field. Please call (02) 9436 2565 or book an appointment online.