From the Guidelines
Treatment for a gastrocnemius/soleus tear typically follows the RICE protocol: Rest the injured leg, apply Ice for 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. Pain management includes over-the-counter medications like acetaminophen (Tylenol, 500-1000mg every 6 hours) or NSAIDs such as ibuprofen (Advil, 400-800mg every 6-8 hours) for 5-7 days 1. For moderate to severe tears, a walking boot or crutches may be necessary for 1-2 weeks.
Key Considerations
- Physical therapy is crucial for recovery, focusing on gentle stretching exercises after the acute phase (3-5 days post-injury), followed by progressive strengthening exercises like calf raises 1.
- Rehabilitation typically lasts 6-12 weeks depending on tear severity.
- These muscles are essential for walking and running, so proper healing is important to prevent chronic weakness or re-injury.
- Severe tears (grade 3) may require surgical intervention, though this is uncommon 1.
- Most patients can return to normal activities within 2-3 months with appropriate treatment and rehabilitation.
Additional Treatment Options
- Eccentric strength training is a particularly popular and effective option for treating Achilles tendinopathy, which may also be beneficial for gastrocnemius/soleus tears 1.
- Anatomic misalignment can be treated with shoe orthotics to correct overpronation or pes planus problems 1.
- Many patients will benefit from heel lift orthotics to unload the tendon for pain relief 1.
From the Research
Treatment Options for Gastrocnemius and Soleus Tears
- Conservative treatment is often the initial approach for gastrocnemius and soleus tears, and may include rest, ice, compression, and elevation (RICE) 2
- Compression treatment has been shown to decrease the amount of hemorrhage and allow for early ambulation in patients with rupture of the medial head of the gastrocnemius 3
- Vibration therapy and radial pressure waves have been proposed as a treatment for calf strains, including gastrocnemius and soleus tears, and may help to increase muscle strength and flexibility 2
- Surgical treatment, such as proximal medial gastrocnemius release (PMGR), may be considered for patients with recalcitrant plantar fasciitis or other conditions related to gastrocnemius tightness 4
- Ice therapy has been investigated as a treatment for acute gastrocnemius tears, but its effectiveness is unclear and may not be beneficial for functional recovery 5
- Rehabilitation programs for gastrocnemius tears may include stretching, strengthening, proprioception, and conditioning exercises, and can be effective in restoring muscle function 6
Rehabilitation and Recovery
- Rehabilitation for gastrocnemius and soleus tears typically involves a gradual progression of exercises and activities to promote healing and restore function 2, 6
- The use of diagnostic ultrasound and MRI imaging can be helpful in diagnosing and monitoring the recovery of gastrocnemius tears 6
- Patients with gastrocnemius tears may experience a range of symptoms, including pain, loss of range of motion, and loss of strength, and may require individualized treatment and rehabilitation plans 6