# Gastrocnemius (calf) muscle tear

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: Gastrocnemius Strain - StatPearls - NCBI Bookshelf (NBK534766) - https://www.ncbi.nlm.nih.gov/books/NBK534766/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class LD49.01 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care
- Gastrocnemius (calf) muscle tear - disease-level clinical article (gastrocnemius-tear-clinical.txt)

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
GASTROCNEMIUS (CALF) MUSCLE TEAR
Sources: Gastrocnemius Strain - StatPearls - NCBI Bookshelf (NBK534766) -
         https://www.ncbi.nlm.nih.gov/books/NBK534766/ · ICPC-3 (WONCA International Classification
         of Primary Care, 3rd edition) class LD49.01 - condition scope only, no dose · No dose -
         referral pathway, no medicine given in primary care
Review status: REVIEWED against No dose - referral pathway, no medicine given in primary care,
               Gastrocnemius (calf) muscle tear - disease-level clinical article
               (gastrocnemius-tear-clinical.txt)  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (2)
    - A sudden pop or tearing feeling in the upper calf follows a forceful push-off such as
      sprinting or jumping
    - Patients struggle to bear weight and prefer walking on their toes, with pain worse on active
      plantarflexion or passive dorsiflexion
  SIGNS - what you find (3)
    - Exam shows swelling, bruising, and focal tenderness of the upper calf, sometimes a palpable
      gap in the muscle  [bruising]
    - Patients have trouble performing a single calf raise on the affected side
    - The Thompson squeeze test stays negative, with normal plantar flexion on calf squeeze, unlike
      an Achilles rupture
  TESTS (1)
    - MRI is the gold-standard soft-tissue study but is reserved for cases where the diagnosis stays
      unclear
  IF NOT THIS - what else fits (7)
    - Plantaris strain is milder, with pain sitting more distally near the mid-Achilles rather than
      the upper calf
    - Soleus strain follows overuse from distance running, with deep calf pain worsened by knee
      flexion or dorsiflexion, as on hill running
    - Popliteal tendinopathy causes lateral knee or posterolateral calf pain worse on downhill
      running, tender at its femoral condyle origin
    - Popliteal artery entrapment gives claudication-like symptoms with repetitive ankle motion that
      eases with rest, and pulses drop on plantarflexion
    - Achilles tendinopathy causes gradually increasing pain 2 to 6 cm above the heel from overuse,
      unlike a sudden gastrocnemius tear
    - Chronic exertional compartment syndrome gives bilateral deep calf or shin pain in runners that
      resolves 10 to 20 minutes after stopping
    - DVT causes worsening calf pain and swelling usually without an injury history, with diffuse
      swelling and no focal tenderness
  Source  StatPearls "Gastrocnemius Rupture" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    Sudden calf muscle tear during push-off ("tennis leg") or a related Achilles tendon
            injury; mild strains are managed conservatively with analgesia and rest, but a suspected
            Achilles rupture needs urgent orthopedic referral. - Refer, with advice
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      Sudden calf muscle tear during push-off ("tennis leg") or a related Achilles tendon
            injury; mild strains are managed conservatively with analgesia and rest, but a suspected
            Achilles rupture needs urgent orthopedic referral.
   Caution  Positive calf squeeze test / suspected Achilles rupture, inability to plantarflex the
            foot, calf swelling raising concern for DVT.
            No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.
            RED FLAG - Acute Compartment Syndrome (tense muscle compartment, pain out of proportion
            to physical exam) is an urgent red flag requiring emergent surgical consultation.
            Deep Vein Thrombosis is a red flag, either as a complication or as a differential
            diagnosis (generalized calf swelling and worsening pain without focal mechanical
            injury).

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
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