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Abstract

CASE HISTORY: A 52-year-old male referred to physical therapy by his orthopedist with complaint of 10/10 achy pain in right (R) calf precipitated by “popping” sensation while cutting during a tennis match 1 week ago. PHYSICAL EXAM: Patient presented ambulating with bilateral axillary crutches weight bearing as tolerated (WBAT). Active Range of Motion (AROM) and Passive Range of Motion (PROM) of R ankle assessed as within normal limits (WNL) with noted increase in R medial calf pain with AROM plantarflexion (PF) & PROM dorsiflexion. Manual Muscle Testing (MMT) was 2+/5 for R plantarflexion and 5/5 for all other motions. Ecchymosis observed on medial calf with presence of edema. Palpation revealed severe tenderness to medial gastroc/soleus complex. Special Tests: (-) Thompson Test, (-) Homan Sign. DIFFERENTIAL DIAGNOSES: Plantaris Strain, Posterior Tibialis Strain and Partial Achilles Tendon Rupture secondary to traumatic mechanism of injury (MOI) and pain/weakness with PF. TESTS & RESULTS: Lower Extremity Function Screen (LEFS) was 19/80. X-ray ordered by physician was negative for fracture. FINAL DIAGNOSIS: Patient diagnosed with a grade 2 medial calf strain by physical exam performed by his orthopedist and physical therapist. DISCUSSION: Patient referred to PT with a grade 2 calf strain by his orthopedist with a recommended dosage of twice a week for 6-8 weeks. Patient received traditional PT treatment in the form of soft tissue mobilization, gentle stretching, AROM exercises, ice and premodulated e-stim to his R calf. He also received a novel treatment with the Phoenix Thera-Lase Class Four Cold Laser (74 watts, 1275nm wavelength) for 15 minutes. OUTCOME OF THE CASE: The patient returned to playing tennis pain free in just 2 weeks, significantly shorter than the typical six-to-eight-week recovery period for a grade 2 calf strain. Key improvements included full pain free range of motion, 5/5 muscle strength in the R ankle, no pain or tenderness in the R calf and a LEFS score of 78/80, suggesting cold laser therapy may have accelerated the athletes return to sport. Although the Phoenix Thera-Lase System has shown efficacy in managing low back pain and osteoarthritis, its impact on acute muscle strains and accelerating return to sport remains unstudied. This lack of research limits our understanding of its potential benefits for acute musculoskeletal injuries and highlights the need for further investigation to enhance treatment options and support faster recovery for athletes.

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