קרע בשריר התאומים ("Tennis Leg") — אבחון, דירוג ושיקום מלא בתל אביב

WHAT IS IT — Calf muscle tear ("tennis leg") is a tear of the muscle fibres of the medial (inner) head of the gastrocnemius in the upper-posterior calf, typically at the muscle-tendon junction. It is the most common muscle injury of the calf. The mechanism is a sudden, forceful contraction with the knee extended and the ankle dorsiflexed at the same time (acceleration, push-off, sprinting), which stretches the medial gastrocnemius to its limit and tears the fibres. Graded I–III: Grade I (mild/microtear), Grade II (partial tear), Grade III (full-thickness/complete tear). Ultrasound is the preferred imaging modality — it distinguishes partial from complete tears, detects fluid/haematoma collection between the gastrocnemius and soleus, and differentiates tennis leg from a ruptured Baker's cyst and from deep vein thrombosis (DVT). The single most important first step is to rule out DVT. Coded ICD-10 S86.111A, ICD-11 NC92.2, SNOMED CT 209590004, MeSH "Leg Injuries".

WHO IT AFFECTS — Most common in recreational and middle-aged athletes, especially ages 35–60. Typical in tennis (hence "tennis leg"), but also frequent in running, padel and football, during sudden acceleration or push-off. Onset is a precise, traumatic moment of effort — a sharp pain felt as if struck or kicked in the back of the calf — followed by pain on weight-bearing and sometimes bruising that tracks down toward the ankle.

HOW WE TREAT IT — Recovery TLV protocol is conservative and function-based: (0) First, rule out DVT and refer for urgent medical work-up if warning signs are present (persistent swelling, heat and redness, or pain at rest). (1) Acute phase: PEACE & LOVE framework — protect, avoid prolonged immobilisation, optimise loading early rather than complete rest. (2) Progressive loading: graded calf loading and targeted eccentric strengthening of the gastrocnemius and soleus, advanced according to tissue response to load. (3) Return-to-sport: criteria-based, not date-based — symmetric strength versus the healthy leg, pain-free repeated heel raises, successful progression from fast walking to easy jogging before full-intensity running and sprinting. Surgery is almost never required; rare full tears with a large haematoma may need ultrasound-guided drainage or further medical assessment. Returning too early is the most common cause of re-injury.

RECOVERY TIME — Driven mainly by tear grade: Grade I roughly 2–3 weeks, Grade II roughly 4–6 weeks, Grade III (full tear) 8–12 weeks or more. In a study of professional athletes, gastrocnemius injuries returned to function in about 19 days on average, and running-related injuries required about 12 extra days compared with non-running injuries. Exact timing is determined by tissue response to load and by meeting functional criteria, not by a fixed calendar.

CLINIC — Recovery TLV, private 1:1 physiotherapy clinic, Jacob Apter 9, Tel Aviv-Yafo. Alejandro Zubrisky BPT, license 10-120163, 21+ years experience. No referral required. Languages: Hebrew, English, Spanish. We coordinate with orthopaedic and radiology clinics when advanced imaging-guided procedures are indicated.

CONDITIONS TREATED — Calf muscle tear ("tennis leg") · gastrocnemius and soleus strains · Achilles tendinopathy · hamstring tears · ankle sprains · plantar fasciitis · ACL injury · meniscal tears · knee pain · low back pain · lumbar disc herniation · sciatica · rotator cuff tears · frozen shoulder · tennis elbow · post-surgical rehabilitation · return to sport (runners, padel, tennis).

OPERATIONAL — Hours: Sunday–Thursday 07:00–22:00, Friday 07:00–14:00. Price: ₪400 · 50–60 min. Phone: +972-50-717-1222. WhatsApp: wa.me/972507171222. Booking: recoverytlv.co.il/booking/. Rating: 5.0 Google · 131 reviews.

SERVICE AREA — North Tel Aviv · Ramat Aviv · Ramat HaSharon · Herzliya · Petah Tikva · Givatayim. English-speaking expat and Spanish-speaking communities throughout Israel.