Ruptures of the Medial Gastrocnemius Muscle (“Tennis Leg”)

  • Joseph Yu
  • William E. GarrettJr.

In 1883, Powell1 first reported in The Lancet on the “lawn tennis leg” (rupture of the medial head of the gastrocnemius). He described a 41-year-old healthy man who had sudden, sharp pain when reaching for the ball while playing tennis. Pain, tenderness, and swelling rapidly developed, but the patient was able to return to sports in 4 weeks. In 1958, Arner and Lindholm2 surgically explored five of 20 patients with tennis leg. In each case, a transverse rupture of the medial gastrocnemius at the musculotendinous junction was found.

Ruptures of the medial head of the gastrocnemius muscle have been documented in patients ranging from adolescents to the elderly. The incidence is greatest in the middle-aged, as reported by Millar,3 who reported a mean age of 42 years for men and 46 for women, which suggests a degenerative process analogous to a rupture of the long head of the biceps, the rotator cuff of the shoulder, the Achilles tendon, or the attachment of the rectus femoris.4Ruptures...


Compartment Syndrome Gastrocnemius Muscle Medial Gastrocnemius Posterior Compartment Ankle Dorsiflexion 
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  1. 1.
    Powell RM. 1883; Lawn tennis leg. Lancet 2:44.Google Scholar
  2. 2.
    Arner O, Lindholm A. 1958; What is tennis leg? Acta Chir Scand 116:73–7.PubMedGoogle Scholar
  3. 3.
    Millar AP. 1979; Strains of the posterior calf musculature (“tennis leg”). Am J Sports Med 7:172–4.PubMedCrossRefGoogle Scholar
  4. 4.
    McClure JG. Gastrocnemius musculotendinous rupture: a condition confused with thrombophlebitis. South Med J 77(9):1143–5 Google Scholar
  5. 5.
    Hutchinson MR, Laprade RF, Burnett QM. 1995; Injury surveillance at the USTA boys’ tennis championships: a 6-year study. Med Sci Sports Exerc 7:826–30.Google Scholar
  6. 6.
    Froimson AI. 1969; Tennis leg. JAMA 209:415–6.PubMedCrossRefGoogle Scholar
  7. 7.
    Brewer BJ. Mechanism of injury to the musculotendinous unit. In: Instructional Course Lectures, vol 17. St. Louis: CV Mosby, 354–8 .Google Scholar
  8. 8.
    Nikolaou PK, Macdonald BL, Glisson RR, et al. 1987; Biomechanical and histological evaluation of muscle after controlled strain injury. Am J Sports Med 15:9–14.PubMedCrossRefGoogle Scholar
  9. 9.
    Gilbert TJ Jr, Bullis BR, Griffiths HJ. 1996; Tennis calf or tennis leg. Orthopedics 19:179–84.PubMedGoogle Scholar
  10. 10.
    Shields CL, Redix L, Brester CE. 1985; Acute tears of the medial head of the gastrocnemius. Foot Ankle 5:186–90.PubMedGoogle Scholar
  11. 11.
    Thompson TC, Doherty JH. 1962; Spontaneous rupture of the tendon of Achilles: a new clinical diagnostic test. J Trauma 2:126–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Durig M, Schuppisser, Schuppisser JP, et al. 1997; Spontaneous rupture of the gastrocnemius muscle. Injury 9:143–5.CrossRefGoogle Scholar
  13. 13.
    Jarolem KL, Wolinsky PR, Savenor A, et al. 1994; Tennis leg leading to acute compartment syndrome. Orthopedics 17:721–3.PubMedGoogle Scholar
  14. 14.
    Straehley D, Jones W. 1986; Acute compartment syndrome (anterior, lateral, and superficial posterior) following tear of the medial head of the gastrocnemius muscle. A case report. Am J Sports Med 14:96–9.Google Scholar
  15. 15.
    Jamadar DA, Jacobson JA, Theisen SE, et al. 2002; Sonography of the painful calf: differential considerations. Am J Roentgenol 179:709–16.Google Scholar
  16. 16.
    Menz MJ, Lucas GL. 1991; Magnetic resonance imaging of a rupture of the medial head of the gastrocnemius muscle. A case report. J Bone Joint Surg [Am] 73:1260–2.Google Scholar
  17. 17.
    Noonan TJ, Garrett WE Jr. 1999; Muscle strain injury: diagnosis and treatment. J Am Acad Orthop Surg 7:262–9.PubMedGoogle Scholar
  18. 18.
    Anouchi YS, Parker RD, Seitz WH. 1987; Posterior compartment syndrome of the calf resulting from misdiagnosis of a rupture of the medial head of the gastrocnemius. J Trauma 27:678–80.PubMedCrossRefGoogle Scholar
  19. 19.
    Severance HW Jr, Bassett FH 3rd. 1982; Rupture of the plantaris—does it exist? J Bone Joint Surg [Am] 64:1387–8.Google Scholar
  20. 20.
    Hamilton W, Klostermeier T, Lim EV, et al. 1997; Surgically documented rupture of the plantaris muscle: a case report and literature review. Foot Ankle Int 18:522–3.PubMedGoogle Scholar
  21. 21.
    Helms CA, Fritz RC, Garvin GJ. 1995; Plantaris muscle injury: evaluation with MR imaging. Musculoskel Radiol 195:201–3.Google Scholar
  22. 22.
    Allard JC, Bancroft J, Porter G. 1992; Imaging of plantaris muscle ruptures. Clin Imaging 16:55–8.PubMedCrossRefGoogle Scholar
  23. 23.
    Johnson EW. 2000; Tennis leg. Am J Phys Med Rehabil 79:221.PubMedCrossRefGoogle Scholar
  24. 24.
    Leach RE. 1988; Leg and foot injuries in racquet sports. Clin Sports Med 7:359–70.PubMedGoogle Scholar
  25. 25.
    Kwak HS, Lee KB, Han YM. 2006; Ruptures of the medial head of the gastrocnemius ("tennis leg"): clinical outcome and compression effect. Clin Imaging 30:48–53.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Joseph Yu
    • 1
  • William E. GarrettJr.
    • 2
  1. 1.Department of OrthopaedicsNevada Orthopedic and Spine CenterLas VegasUSA
  2. 2.Division of Orthopaedic SurgeryDuke University Medical CenterDurhamUSA

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