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Gastrocnemius Muscle Tear 844.9 S83.90XA

 

synonyms:Tennis leg gastocnemius muscle tear, medial gastroc tear

 

Gastrocnemius Tear ICD-10

  • S83.90XA:    Sprain of unspecified site of unspecified knee, initial encounter

Gastrocnemius Tear ICD-9

  • 844.9 (unspecified sprain and strain of knee and leg)

Gastrocnemius Tear Etiology / Epidemiology / Natural History

  • Generaly middle aged recreational athlete

Gastrocnemius Tear Anatomy

  • Generally caused bya tear of the medial head of the gastroc at the muscle-tendon junction.
  • Gastroc may be prone to injury because it crosses two joints (knee & ankle).

Gastrocnemius Tear Clinical Evaluation

  • Acute calf pain after a sudden move or jump. "Felt like someone kicked me in the backk of the leg".
  • Increasing pain and swelling develop over initial 24 hours.
  • Tenderness localized to the musculotendinous junction of the medial head of the gastroc.

Gastrocnemius Tear Xray / Diagnositc Tests

  • MRI: hemorrhage within the gasctocnemius muscle.
  • Duplex ultrasound: indicated if there is concern for DVT.
  • Comparment pressure monitoring: indicated if pain is out of proportion or any concern for compartment syndrome.

Gastrocnemius Tear Classification / Treatment

  • Isolated Gastoc tear: consider compartment pressure monitoring if there is any consideration for compartment syndrome. Elevation, Ice, Compression stocking. Early gentle active assist and passive ROM exercises, heel lift, crutches prn.
  • Gastroc tear with compartment syndrome: Fasciotomy

Gastrocnemius Tear Associated Injuries / Differential Diagnosis

  • DVT / thrombphlebitis
  • Compartment syndrome (Posterior)
  • Achilles tendon rupture
  • Chronic exertional compartment syndrome

Gastrocnemius Tear Complications

  • Compartment Syndrome

Gastrocnemius Tear Follow-up Care

  • Advance to WBAT. Generally full-weight bearing by 2-3 weeks.
  • 2 weeks: Start strengthening exercises with sport specific rehab
  • 4 weeks: graduated return to sport. Full painfree motion, 90% strength required for full return to sport.

Gastrocnemius Tear Review References

  • Miller W, AJSM 1987;5:19

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