Leg Strain

An Overview

A muscle strain is a stretch or tear of muscle fibers. In the leg, muscle strains happen when a muscle is either stretched beyond its limits or forced into extreme contraction. Because the leg has many different muscles, it is vulnerable to several different types of muscle strains. Some of the more common ones are:

Types of Leg Strain

• Calf muscle strain (gastrocnemius strain). The calf muscle typically gets strained when the foot suddenly bends upward, stretching the calf muscle beyond its limits. At the time of injury, you may hear or feel a pop inside your calf — the sound of the muscle tearing or shearing away from the Achilles tendon. Calf muscle strains are common in athletes, especially tennis players and joggers. However, they also can happen during a simple stroll, if your foot flexes upward when you step into a hole in the sidewalk or if your heel slips off the edge of a curb.

• Plantaris strain. The plantaris is a thin muscle that begins at the lower end of the femur (the large bone of the upper leg), stretches across the knee joint and attaches to the back of the heel along with the Achilles tendon. Because the plantaris doesn’t contribute much force in bending the knee, a tear in this muscle may not seriously affect your knee function. However, a severe plantaris strain can cause significant pain, usually at the back of your calf rather than near the knee. A plantaris strain can occur alone or accompany a gastrocnemius strain or a tear of the anterior cruciate ligament (ACL), a major, stabilizing ligament in the knee.

• Hamstring strain (pulled hamstring). Hamstrings are long muscles that extend down the back of the thigh. Because hamstrings work to pull back the leg and bend the knee, they can be injured during running, kicking or jumping. You may feel a pop, usually at the back of the thigh, when the muscle tears.

• Quadriceps strain. The quadriceps is a large group of muscles in the front of the thigh that straighten out the knee, the opposite action from the hamstrings. Quadriceps strain is a common injury in runners. However, it also may occur during a strenuous leg press at the gym. The pain of a quadriceps strain is felt in the front of the thigh. The strain may be described as a groin pull if the tear is fairly high in the muscle.

Symptoms for Leg strain

Signs and symptoms will vary, depending on the severity of the injury, and may include:
• Pain or tenderness
• Redness or bruising
• Limited motion
• Muscle spasms
• Swelling
• Muscle weakness

Causes of Leg strain

Acute strains can be caused by one event, such as using poor body mechanics to lift something heavy. Chronic muscle strains can result from repetitive injuries when you stress a muscle by doing the same motion over and over.
In some cases, however, a serious medical condition may be causing the pain. See your doctor if you’re experiencing severe or persistent leg pain. Getting a prompt diagnosis and treatment for any underlying conditions may prevent the pain from getting worse and improve your long-term outlook.
Some of the more common causes of leg pain are minor or temporary conditions that your doctor can treat effectively.
charley horse.” A cramp usually triggers sudden, sharp pain as the leg muscles contract. The tightening muscles often form a visible, hard lump beneath the skin.

Diagnosis

During the physical exam, your doctor will check for swelling and points of tenderness. The location and intensity of your pain can help determine the extent and nature of the damage.
In more severe injuries, where the muscle or tendon has been completely ruptured, your doctor may be able to see or feel a defect in the area of injury. Ultrasound often can help distinguish among several different types of soft tissue injuries.

Treatment

For immediate self-care of a muscle strain, try the R.I.C.E. approach — rest, ice, compression, elevation

Rest

The primary treatment when a mild or moderate calf strain occurs is rest. Only in severe cases when the majority of the muscle is torn are other interventions, like surgery, necessary. The initial treatment in mild or moderate strains is controlling the pain and limiting any bleeding that is present. Rest means using the calves less frequently for a period of time — even halting use completely if possible.
• Bed rest or activity limits: Rest may specifically involve bed rest but more frequently involves a reduction in vigorous activities, especially those that flex or lift the ankle such as running, jumping, stopping and dashing, and ballet.
• Tall walking boot: It is possible that your physician will prescribe a “tall walking boot” that isolates the foot in a position that does not strain the calf muscle to promote healing.:
Ice.

Even if you’re seeking medical help, ice the area immediately. Use an ice pack or slush bath of ice and water for 15 to 20 minutes each time and repeat every two to three hours while you’re awake for the first few days after the injury.

Compression.

To help stop swelling, compress the area with an elastic bandage until the swelling stops. Don’t wrap it too tightly or you may hinder circulation. Begin wrapping at the end farthest from your heart. Loosen the wrap if the pain increases, the area becomes numb or swelling is occurring below the wrapped area.

Elevation.

Elevate the injured area above the level of your heart, especially at night, which allows gravity to help reduce swelling..

Surgery.

In instances where the muscle has been completely torn or pulled away from the bone, it is important to reconnect the muscle to restore some element of function to the lower leg. This requires emergency surgery. Even after the surgery, you will need repeated visits to your physician and at least six months to obtain a maximal potential function. The objective of the surgery will be to reattach the muscle to a point on the bone so that it might again help flex the ankle and the knee.

Prevention

Regular stretching and strengthening exercises for your sport, fitness or work activity, as part of an overall physical conditioning program, can help to minimize your risk of muscle strains. Try to be in shape to play your sport; don’t play your sport to get in shape. If you have a physically demanding occupation, regular conditioning can help prevent injuries.