Jackson Toigo

Calf Muscle Tears

A torn calf muscle (gastrocnemius) is similar to an Achilles tendon tear or rupture, but occurs higher up in the back of the leg. A sign of a torn calf muscle is similar to that of an Achilles tendon rupture. You may think you’ve just been hit in the leg and potentially hear a “pop.” There is sudden pain at the back of the calf. Then you’ll experience pain, swelling or bruising in the calf muscle, and you’ll have difficulty walking properly or standing on your toes.

Calf muscle tears usually occur during acceleration or changes in direction (e.g. tennis, squash). However, we have known people to tear their calf muscle by simply walking across the road.

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Calf strain may be minor or very severe. Your physiotherapist will grade the injury accordingly:

Grade 1:

The muscle is stretched causing some small micro tears in the muscle fibres. Recovery takes approximately 2 to 4 weeks if you do all the right things.

Grade 2:

There is partial tearing of muscle fibres. Full recovery takes approximately 4 to 8 weeks with good rehabilitation.

Grade 3:

This is the most severe calf strain with a complete tearing or rupture of muscle fibres in the lower leg. Full recovery can take 3-4 months and, in some instances, surgery may be needed.

Prevention

  • Keeping calf muscles strong so they can absorb the energy of sudden physical stress.
  • Stretching out calf muscles before physical activity, i.e. calf raises. Gradually including weights or additional resistance over time.
  • Learning the proper technique for exercise and sporting activities. This will decrease stress on all muscles, including calf muscles.
  • Undertaking training prior to competition to ensure readiness to play.
  • Undertaking fitness programs to develop strength, balance, coordination and flexibility.
  • Gradually increasing the intensity and duration of training.
  • Allowing adequate recovery time between workouts or training sessions.
  • Drinking water before, during and after play.

Signs and symptoms

  • A sudden pain at the back of the leg, particularly at the muscular tendinous junction.
  • Difficulty in contracting the muscle or standing on tiptoe.
  • Pain and swelling or bruising in the calf muscle.
  • Pain on resisted plantar flexion or contracting the muscles against resistance.
  • If the Soleus muscle is damaged pain might be incurred lower in the leg and when contracting the muscle against resistance with the knee bent.

Immediate Management

The immediate treatment of any soft tissue injury consists of the RICER protocol – rest, ice, compression, elevation and referral to a sports medicine professional. RICE protocol should be followed for 48–72 hours. The aim is to reduce the bleeding and damage in the muscle. The leg should be rested in an elevated position with an ice pack applied for 20 minutes every two hours (never apply ice directly to the skin). A correctly sized compression bandage should be applied to limit bleeding and swelling in the injured area.

The No HARM protocol should also be applied – no heat, no alcohol, no running or activity, and no massage. This will ensure decreased bleeding and swelling in the injured area.

Workstation Position

The goal of ergonomics is to make work more comfortable and to improve both health and productivity. Many ergonomic problems can be fixed by rearranging, adjusting or modifying existing furniture and tools, so don’t be in too much of a rush to go out and purchase the next great ergonomic “THING”.

We know that sitting for long periods can have negative consequences for our health, and that regular breaks along with standing for part of your day can help to prevent and relieve aches and pains when they occur. However, often sitting cannot be avoided, at which times it is important to ensure that your office chair is set-up to provide optimal support for your back.

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Steps for setting up your workspace:

Adjust the chair height so that your elbows are at desktop level (roll your shoulders back and relax them first).

Sit fully back into your chair, adjust the seat back for good lower back support, use a lumbar roll if the back of the chair does not support your lower back.

If your chair seat has a tilt feature, set it so that you are comfortably supported.

If your feet don’t comfortably reach the floor or there is pressure on the backs of your legs, use a footrest.

Locate your monitor so the top third of the viewing area is at or below eye level. Use monitor stand if required. As long as you can clearly view the screen contents there is no specific distance that you need to be from the monitor.

With elbows at the desk level, ensure that your wrists are straight. Use wrist rest if required, and if you have armrests try to adjust them so they support your arms without beings too high or too low.

Position the mouse as close as is practical to the keyboard, so that both elbows are directly under the shoulders while working. If this is not possible you may need to consider purchasing a mini keyboard.

To reduce stress on the neck when working from paper documents, a document holder can be placed between the keyboard and monitor.

Always either put the phone on loudspeaker (depending on your office environment) or use a phone headset if you need to use the computer while talking on the phone, this will help avoid neck and shoulder strain.

Use your mouse pad or another soft surface to pad the edge of your desk. Avoid pressing your hands or forearms against any desk edge.

Adjust screen brightness and contrast for clear comfortable viewing, and clean the screen regularly. Also remember the 20-20-20 rule: look away from the monitor every 20 minutes to a distance of 20 metres for 20 seconds. This helps avoid eye strain.

Finally and very importantly remember to take breaks regularly preferably every 45 minutes to an hour for 1 or 2minutes. Go get a glass of water talk to a colleague etc.

Understanding Plantar Fasciitis

Have you ever woken up in the morning and those first few steps are particularly sore, or have excised and felt your heel flare up forcing you to stop? If you so you may be suffering from plantar fasciitis.

The plantar fascia is the thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes. It can frequently become inflamed and is a common source of heel pain.

Plantar fasciitis commonly results from activities which require increased loading on the foot, which include but not limited to continuous running, hopping and jumping activities. It is very common for people on their feet all day or patients that have high arches or flat feet.

Some effective treatment techniques can include self-releasing the plantar fascia (as seen below) with frozen bottle or golf ball. Calf release work and taping can also be effective to unload the affected area. Also, don’t forgot that weakness in areas further up the body (including hip and knee) can put more strain on the plantar fascia, so it is very important to work out with your physio the underlying cause in order to get to the root cause of the problem.
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If you are affected by plantar fasciitis and want to determine its exact cause, feel free to contact the team at Sydney Physiotherapy Solutions to make an appointment at either our Sydney CBD physiotherapy clinics or at our recently opened Chatswood Physiotherapy clinic.

Brain Awareness Week!

 

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Brain Awareness Week (BAW) is a global campaign to increase public awareness about the progress and benefits of brain research. Brain Awareness Week is from the 14th-20th March 2016 and also aims to increase community awareness of the potential for improving the long-term health of the brain through lifestyle changes and risk-reduction strategies. The Dana Alliance, based in New York, founded BAW 20 years ago, and continues to administer the campaign alongside the American Society for Neuroscience.

For one week every March, Brain Awareness Week unites the global efforts of over 2,200 universities, hospitals, patient groups, government agencies, schools, service organisations and professional organisations in 76 countries in a week-long celebration of the brain. During Brain Awareness Week, campaign partners organise creative and innovative activities in their communities to educate and excite people of all ages about the brain and brain research. Events are limited only by the organisers’ imaginations!

Here are some interesting facts about concussion and recovery in sport…

Rest is the answer to Concussion recovery!

Rest and relaxation remains the best response to a concussion or traumatic brain injury, according to the findings of a recent study from Georgetown University Medical Center (GUMC). The study, published in the March 2016 issue of American Journal of Pathology, shows that more than 24 hours of rest is “critical” to allowing the brain to properly recover and repair neural networks. Failing to take a break and rest could lead to potential brain damage and inflammation that can last for over a year after the initial injury.

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Rest has long been the main recommendation for those who have recently experienced a concussion or TBI. Stimulating the brain through mental or physical activity has been shown to worsen symptoms such as headache, nausea, and fatigue, while rest gives the brain time to properly heal.

However, this practice has come under fire recently with critics calling it “counterproductive.” Specialists argue rest and limitations can contribute to depression and anxiety, which are already common in people with head injuries. This culminated in a group of specialists announcing at a conference that prolonged rest may not be the best treatment.

Whether rest is truly the best treatment will still be debated as more studies are done, but for now it remains the gold standard in brain injury recovery and rehabilitation.