Plantaris muscle tear/rupture is commonly known as tennis leg. The tear usually results from a sudden muscular action such as reaching forward to hit the ball while playing tennis. Plantaris is a thin cord like muscle with a long tendon which runs along the Achilles tendon on the back side of the calf. It arises from the lateral side of femur and runs beneath the major calf muscles and on the inner side of Achilles tendon and gets attached to the medial side of heel bone (calcaneus). Plantaris muscle flexes the knee and the ankle and it helps you to stand on your toes and to point with your toes.

How do You Know If You Have Plantaris Muscle Rupture?

Sudden forward lunging is the most common reason for plantaris muscle injury. This is an extremely common sports related injury and here are the most common symptoms:

• Cramps in the calf
• Sudden, severe pain in the calf muscles which is not getting better
• Swelling or bruising of the calf muscles

If the injury is more severe, it can lead to Achilles tendon rupture as well and this must be ruled out. The pain and swelling in Achilles tendon rupture is more severe and if you have Achillies tendon rupture you will not be able to point your foot downwards. Plantaris muscle rupture alone does not lead to this complication.

The leg can appear swollen and bruised in plantaris muscle rupture. A blood clot in the calf can also present with same features. An ultrasound scan of the calf or an MRI is the best way to identify the exact cause of calf pain and swelling. 

How to Deal with It

1.     First Aid

In case of sudden swelling and pain in the calf muscle the best thing is to contact a healthcare provider to rule out any serious condition like DVT or Achilles tendon rupture. The most immediate steps which need to be taken after plantaris muscle rupture are:

• Immobilization of the affected leg, give it some rest and do not put weight on the swollen leg.
• Ice packs are very helpful to reduce the swelling and to sooth the aching muscles. Be careful and never put ice directly over the skin, if you are concerned you can place a towel or washcloth between the icepack and your skin. You can keep the leg under a cold water tap to cool the affected area.
• Application of a compression bandage is also very helpful but be careful and don't wrap it too tightly.
• Keep the leg elevated, you can place a pillow under your calf while sleeping.

2.     Recovery

To ensure the best recovery after plantaris muscle rupture follow the steps given below after the pain is settled.

Stage 1: To improve normal function

• Start putting weight on your foot and try to walk normally after a couple of days of the injury. By this time the pain is usually settled but if you are finding it difficult to walk you can use crutches.
• For first couple of weeks after the rupture you can place small heel lifts in shoes. They will reduce the workload on calf muscles leading to speedy recovery.
• Thirty minutes of cycling or swimming every day is also very beneficial.
• Exercise is the best way to restore the muscle function and strength. After plantaris muscle rupture, the best exercises are calf muscle stretches and strengthening exercises for the foot muscles. For long calf muscles stretch, stand with the non-affected foot a bit forwards than the affected one. Keep the heel of the affected foot firmly on the ground and keep the knee straight. Shift your weight on the front leg and push the heel of the back foot on the ground. You will feel the calf muscles stretching. Wait for ten to fifteen seconds then let go and repeat for three four times.
• The short calf muscle stretch is similar to long calf muscle stretch; you only need to bend the knee of the affected leg as well.
• For strengthening of foot muscles, the best way is to sit in a chair and move the foot tracing alphabets or any simple shapes in the air.

Stage 2: Re-building the muscles

• When you can perform these above mentioned exercises easily and the pain is settled you can start walking and after sometime resume your normal daily routine.
• You can return to your favorite sport soon enough with proper muscle re-building. Continue with the calf stretches and try to stand on your toes for ten to fifteen seconds.
• Jogging can be helpful and once the pain is settled you can start with a light jog and gradually build up incorporating light runs and sprints.
• When you can easily perform all these exercises and have no pain in your calf you can start jumping exercises as well.

Stage 3: Returning to the game

• When the plantaris muscle rupture is fully recovered you can get back to the tennis court. Start slowly and practice with a wall.
• If there is no pain and you can play comfortably. You can start practicing volleys, service and overheads.
• When you feel comfortable with your footwork and there is no pain or stretch while playing you are ready for a practice match.
• After two weeks of playing practice matches without any problem you are fit for the actual matches.

3.     Preventing Re-injury

To avoid any future trauma or recurrence keep these simple things in mind: 

• Gradually build up your stamina so your body is well adapted before you start playing.
• Always do warm up exercises before a match, for at least ten to fifteen minutes. Calf muscle stretches are very helpful, but it is important to follow the correct technique.
• Make sure that your shoes are well fitted and comfortable.
• Always wear proper clothing. If your muscles are cold they are more likely to snap or sprain.
• If the calf muscles feel tense and hard you can massage them with any oil.
• Maintain the strength of calf muscles with exercise and follow the advice of your trainer.