What is the best course of treatment for a 50-year-old male patient with a primary tear to his calf muscle, who is currently taking lisinopril (angiotensin-converting enzyme inhibitor) for hypertension?

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From the Research

The best course of treatment for a 50-year-old male with a primary calf muscle tear who is taking lisinopril for hypertension should follow the RICE protocol initially: Rest the injured leg, apply Ice for 15-20 minutes every 2-3 hours for the first 48-72 hours, use Compression with an elastic bandage, and Elevate the leg above heart level when possible. For pain management, acetaminophen (Tylenol) at 500-1000 mg every 6 hours is preferred over NSAIDs like ibuprofen, as NSAIDs may interact with lisinopril and potentially worsen kidney function 1. The patient should continue taking lisinopril as prescribed for hypertension management. After the acute phase (3-5 days), gentle stretching and progressive strengthening exercises should begin under physical therapy guidance, typically 2-3 sessions weekly for 4-6 weeks, as recommended by the most recent study on muscle injuries 2. A gradual return to normal activities can be expected within 6-8 weeks for a mild to moderate tear, though complete healing may take 3 months. The patient should be advised to maintain adequate hydration and follow up with their physician if pain worsens, significant swelling develops, or if they experience difficulty bearing weight, as these may indicate a more severe injury requiring additional intervention. Key considerations in the treatment plan include:

  • Rest and protection of the injured muscle to prevent further injury
  • Pain management with acetaminophen to avoid potential interactions with lisinopril
  • Gradual progression to physical therapy for strengthening and flexibility
  • Monitoring for signs of complications or more severe injury It's also important to note that the prognosis and return to play can be influenced by factors such as the location and size of the strain, as well as the presence of intramuscular tendon tears or intermuscular fluid, as identified in a study on MRI assessment of calf injuries 3.

References

Research

Muscle injuries: optimising recovery.

Best practice & research. Clinical rheumatology, 2007

Research

Diagnosis and rehabilitation of gastrocnemius muscle tear: a case report.

The Journal of the Canadian Chiropractic Association, 2013

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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