The medial gastrocnemius head has a more distal musculotendinous junction than the lateral head and contributes the majority of the Achilles tendon cross-sectional area. Medial gastrocnemius tears (tennis leg) occur at the musculotendinous junction, producing acute medial calf pain. The medial gastrocnemius muscle belly is used as a pedicled rotation flap for knee and proximal tibial soft tissue coverage.
Ankle plantarflexion via the Achilles tendon; primary contributor to the plantarflexion torque during running and jumping
Medial gastrocnemius musculotendinous junction tears produce acute calf pain during explosive push-off with a characteristic ecchymosis tracking distally over 48 hours. MRI shows the tear with fluid between the medial gastrocnemius and the soleus. Management is conservative: compression, ice, and progressive rehabilitation over 4-8 weeks depending on severity.
Musculotendinous junction tear producing acute calf pain managed with compression and progressive loading rehabilitation.
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