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Reason for tenderness in calf following injury for many years?

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I seem to have an injury to my calf that happened over 20 years ago and is still tender. The tenderness is at the upper calf area behind near the knee. It was the result of a compression to that area by contact with an Automobile bumpers. There was also a contusion to my shin just below the knee cap. Over the years the tenderness has become less and also periods when I get a dull achy feeling has become less. I am curious what the reason might be for this tenderness if it can be explained?

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
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Thank you for your query at

Tenderness persisting after 20 years of an injury is unusual. 

If that injury resulting in tenderness did not progressively worsen and there was no restriction of knee movements in the initial period of injury, it would have been a minor soft tissue injury which would have healed on its own.

It seems to me that the occasional tenderness and the dull achy feeling you have, are simply a soft tissue strain. After the injury, perhaps the ligaments and nerves in that area have become more sensitive to stresses. If your work involves a lot of standing or moving about, these symptoms can occur.

You can regularly perform muscle strengthening exercises for the legs and increase their endurance.

Overall, as long as it is only mild and does not impede your daily activities, and you remain physically active, there is nothing to worry.

If there is severe calf pain, where the calf is painful to even light pressure, it may indicate Deep Vein Thrombosis(DVT) which is usually seen in people with pre-existing venous disease of legs(varicose veins etc), bed ridden individuals, in patients who are immobile especially after surgeries, and rarely in women taking OCPs etc. However, this is unlikely in your case if you do not match any of the patient characteristics mentioned above. Also, given the long standing nature of your symptom it is unlikely to be DVT.

I hope that was helpful.

Feel free to ask queries.

Thank you.

Patient replied :

Well that was a concern but I really did not think that was the case. A few things I forgot to mention and also did not return to the ER with this concern. After leaving the ER and returning home I stopped at a store. While in the store I felt someting in the area behind my knee like a bump or lump that protruded for a few seconds and the receded. Also before going to the ER while sitting it felt something like fluid leaking within the area behind the knee and calf area. The doctores I saw regarding the injury sort of cut me short while trying to explain what happened. As far as exercise I do not think there is any kind of exercise that help strengthen anything that will help with the tenderness. Recently I decide to try a supplement knoown as DHEA which I am carefully or sparingly using. It seems like I got some result regarding the tenderness from this but not a whole lot. So regarding these few things I have added what do you think now? Thanks for any help you might be able to give about this.


I have noted the additional history. From your symptoms, it is likely that what you had at that time was a soft tissue injury. This would have healed on its own but the nerves supplying that area would have becom hypersensitive following the trauma. The tenderness you are experiencing could be a neuropathic pain.

DHEA supplements are not going to help with this. Instead, you can take Vitamin B12 (Cyanocobalamin) supplements. If the tenderness persists, you may require drugs like Pregabalin or Gabapentin for relief. If your symptoms become unbearable, you can consult your doctor for a prescription for the same.

I hope this was helpful.

Thank you.

Patient replied :

Can you be any more specific as what soft tissue injury might refer to? Would it possibly be something to do with how the tibia and femur are attached? Actually I am thinking the posterior cruciate ligament may have a slight tear. I think I read something about injuries to the posterior cruciate ligament are sometimes left alone? A doctor I saw had an MRI done and said it looked like there was a small tear in the meniscus but was not very specific and seemed like he wanted me elect for surgery without a specific reason, Is the meniscus a anterior or posterior area of the knee or both? I may as well add this back around early 2002 I was having some tenderness and in a squatting position I sort flexed my knee. Shortly after I think the next morning my knee was swollen like a grapefruit. The swelling went down within a day or so and has not happened again. I have made sure not to do that flexing again.


When I said soft tissue injury, I meant injury to the the tissues under the skin such as the muscles, fascia or the subcutaneous layer.

If you had an injury to the structures within the joint between the femur and tibia, or around it such as a ligament or a meniscus injury, it would not have persisted for so many years. Small tears in these structures heal within a few months.

The swelling of your knee after flexion, back in 2002, could have been due to a ligament sprain. Once the swelling and the pain recede, the sprain would have healed by itself too.

Menisci are somewhat circular cushion like structures present between the thigh bone-femur and the large leg bone-tibia. They are present within the joint between these two bones.

If you are worried about an injury anywhere in your knee, I suggest that you please consult an orthopedic surgeon and have your knee examined. This will be reassuring for you.

I hope this was helpful.

Thank you.

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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