From the Research
Treatment for gastrocnemius tears should be based on the severity of the tear, with conservative management recommended for partial tears and surgical intervention considered for complete tears, especially in athletes or younger patients seeking full functional recovery. For partial tears, conservative management is recommended, including RICE protocol (rest, ice, compression, elevation) for the first 48-72 hours, followed by pain management with NSAIDs like ibuprofen (400-600mg three times daily) or naproxen (500mg twice daily) for 1-2 weeks, as seen in a case report 1. Physical therapy should begin after acute pain subsides, focusing on gentle stretching and progressive strengthening exercises over 6-12 weeks. A walking boot or crutches may be needed initially to reduce weight-bearing. Some studies suggest the use of platelet-rich plasma (PRP) injections to enhance recovery, with a retrospective observational study showing significant reduction in time to return to walk without pain and to fully return to practice the previous sport activity 2. However, the most recent study 3 highlights the importance of surgical treatment for tendinous injuries or avulsions, especially in patients requiring forceful plantar flexion for their activities. The decision between conservative and surgical treatment depends on the patient's age, activity level, and functional goals, with gastrocnemius tears healing differently based on location and blood supply. Key considerations for treatment include:
- Patient's age and activity level
- Location and severity of the tear
- Presence of tendinous injury or avulsion
- Patient's functional goals and requirements Regardless of treatment approach, gradual return to activities is essential to prevent re-injury, with full recovery taking 6-12 weeks for partial tears and up to 6 months for surgically repaired complete tears, as supported by the most recent evidence 1, 3.