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Injury of nerve at lower leg level

Last edited: 4/15/2026

Overview

Injury to the gastrocnemius muscle at the lower leg level, commonly known as "tennis leg," involves partial tears or ruptures of the medial head of the gastrocnemius tendon, often mistaken as solely a sports-related injury but can occur in occupational settings as well 1.

Diagnosis

  • Clinical Presentation: Pain localized to the lower leg, particularly posteriorly, often exacerbated by activities involving plantar flexion 12.
  • Imaging: Magnetic resonance imaging (MRI) and ultrasound can confirm partial tears or ruptures of the medial gastrocnemius tendon 1.
  • Grading: Specific grading systems for tendon injuries (e.g., according to the Mason-Allen classification) are not detailed in the abstracts 2.
  • Management

  • Nonoperative Treatment: Rest, ice, compression, elevation (RICE protocol), and gradual return to activities as tolerated 2.
  • Physical Therapy: Focus on strengthening the calf muscles and improving flexibility 2.
  • Activity Modification: Avoidance of activities that exacerbate symptoms until healing is adequate 2.
  • Special Populations

  • Occupational Context: Consider work-related trauma as a potential cause beyond athletic activities 1.
  • Age Considerations: More common in older populations compared to younger athletes 2.
  • Key Recommendations

  • Consider Occupational Causes: Evaluate "tennis leg" injuries in non-athletic occupational settings 1 (Evidence: Moderate).
  • Nonoperative Approach: Primarily manage with conservative methods including rest and physical therapy 2 (Evidence: Moderate).
  • Avoid Aggravating Activities: Instruct patients to avoid movements that exacerbate symptoms during recovery 2 (Evidence: Moderate).
  • References

    1 Domeracki SJ, Landman Z, Blanc PD, Guntur S. Off the Courts: Occupational "Tennis Leg". Workplace health & safety 2019. link 2 Blue JM, Matthews LS. Leg injuries. Clinics in sports medicine 1997. link70035-1)

    Original source

    1. [1]
      Off the Courts: Occupational "Tennis Leg".Domeracki SJ, Landman Z, Blanc PD, Guntur S Workplace health & safety (2019)
    2. [2]
      Leg injuries.Blue JM, Matthews LS Clinics in sports medicine (1997)

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