Calf injuries are common in sports that involve high speed running, increased running loads and rapid acceleration and deceleration such as in padel. Padel is a racquet sport that combines elements of tennis and squash played on an enclosed court surrounded by glass walls. In calf injuries, the medial head of the gastrocnemius is most commonly injured as the muscle extends over two joints (knee and ankle) and contains a high density of type 2 fast-twitch muscle fibres.1

A padel player in his early 30s presented with acute pain in his right posterior calf after making an abrupt forward step to accelerate after initially running back during a match.

Ultrasound examination was performed 7 days after the injury and demonstrated complete rupture of the distal medial gastrocnemius aponeurosis with extension of the tear into the free gastrocnemius aponeurosis (figure 1). There was also a large intermuscular haematoma and dissociative movement between the medial gastrocnemius and soleus muscle bellies during dynamic plantarflexion and dorsiflexion, compatible …