Calf impact from rockfall: struggling to find explanation for my symptoms

Hey, while assisting an alpine rescue I dislodged and was struck by a large rock in the back of my calf. Through my pants it made a large (3 inch by 3 inch) abrasive cut, but nothing too deep. The muscle swelled up massively to the point it felt like an overfilled water balloon and looked about double the size and I had to keep using it (albeit not very intensely for about 4 to 5 more hours.

Like most climbers, I've had lots of overuse injuries (fingers, elbows, shoulders, knees) and other common injuries (ankle sprains) for which the recovery has been fairly straight forward but this one is really stumping me. I've been to the doctors and had an ultrasound taken and there was no obvious muscle tear, but stretching my calf (moving my knee over my foot) or exerting it (pressing down with my toes) causes very acute pain in the tendon, well below the point of injury.

I know mountain project is not a medical professional, but I'm having little luck finding information online about impact-induced muscle/tendon problems on your calf and my visits to the doctor have not been helpful either. I'm about 2 weeks post accident and still cannot walk well and certainly cannot bear weight on my injured leg unless it's just on my heel (ie no calf engagement)

Anyone have any experience with something like this?

I've experienced a very similar injury. I was running down talus and scree when I inadvertently started a small rock slide. I came to a stop  but a boulder the size of a small living room end table rolled over my lower leg, squashing my calf into a slab of rock.

I've experienced too much pain in my life already and this injury was was 11 on 1-10 scale. My eyeballs nearly popped out my head. And yet to look at my calf, not a scratch. Could do nothing but scream for about a minute. With my partner's help we self-evaced and drove home. My calf was swollen bigger than my thigh. Dr. said "that's the damnedest soft tissue injury I've ever seen." Comforting...

Recovery was painful for 2-3 weeks - every time I stood blood rushed into my calk and pain went back to 11. It took months to recover. Dr warned me to be aware of blood clots and symptoms. But other than pain meds there was no treatment. I'm ok now, this was a long time ago.

essentially a gigantic bruise

Or compartment syndrome. Did the docs mention that when they looked at it?

https://my.clevelandclinic.org/health/diseases/15315-compartment-syndrome

interesting, mine sounds a little less severe, the pain was all-consuming at the time, was shaking for a good ten minutes afterwards just getting a handle on it, but not 11/10 and certainly not that bad after 1 week. and I do have that issue of the blood rushing back into my muscle and exacerbating it when I exercise (pullups so far) or limp around too much. The main concern is that the muscle doesn't hurt that bad, but the tendon (upper achilles/just below the meat of the muscle) hurts really acutely and I can't tell if I'm stretching it or just exacerbating the issue when I brush up against that pain (especially when I try to press down with my toes) 

Sounds like compartment syndrome, which can happen to various degrees, from an annoyance all the way up to medical emergency. I got clocked by a rock on Spearhead in Colorado in 2005 and had similar symptoms and issues, and my left calf still looks different than the other in front, and I've had more knee-ligament issues on that side as a result of getting nailed. But overall I healed up in 3-4 weeks, from the acute pain.

Yeah Eric, your injury sounds similar but not exactly the same. I literally squashed the entire calf muscle, squeezed it like a balloon. During recovery I don't recall any tendon or ligament pain, it was all muscle. Some years later I broke that ankle in 3 places. I recovered from that too, but not 100%. Then I had lower back issues and guess which leg bore the brunt of that? I have a numb spot in the lower leg, as I type; cumulative insult and injury to my poor leg, due to my own poor judgement. What are you gonna do, right?

I went to a specialist and all he could do was shrug too and recommend a wait and see approach.

I got a massive hematoma (essentially a bruise) in my thigh after whacking a tree skiing a few years back. it took probably three weeks to resolve, and until it healed it was similarly extraordinarily painful, swollen, and painful to touch. The way I understood it, there was maybe a quart of leaked blood, pulverized meat, and various fluids in there that it just took a long time for the body to re-absorb. it was also kaleidoscopically colorful, ranging from deep blacks and purples to bright green, with fun swirls as the blood slowly drained through my knee joint and into my upper calf. But I digress. After the pain went away I had a noticeable dent in my quad for maybe another month before that also went away and now there are absolutely no long-term effects. 

I went to urgent care after the injury and they checked me for compartment syndrome; I think it was a pee test for a certain protein. It might be worth getting a test as compartment syndrome is bad news. 

My injury did not involve a tendon or ligament, though; it was square in the meaty part of the thigh.

I hope the rescue victim is ok, and if he/she is that they get you a nice bottle of wine for your trouble.

Eric - not the same, but I tore my calf skiing about 4 weeks ago.  Because there is a lot of blood supply and I'm on blood thinners the pressure was intense.  The first few weeks were the most pain I've felt in a long time if ever.  However I also healed pretty quickly.  My recommendation is 1) have faith it will get better 2) try and see a PT as soon as you can, the more you use it the right way the better it will heal.  I did a lot of ice, compression and elevation the whole time (not so much on the rest side...).  I had a boot for a week and crutches.  Aqua jogging was great since it wasn't weight bearing and got the circulation going.  

One thing I have learned from multiple ankle injuries is that everything in the leg from the ball of your foot up through your knees, and even up into your hip can be affected by an acute injury to one area. Everything is connected and relies upon the other parts of the chain to function properly and maintain health and stability. With such an extreme trauma to your calf, it doesn’t seem too surprising to me that your Achilles tendon would also be impacted, even though it was not directly impacted. My only credentials in this conversation are personal experience, some PT and the research I’ve done for my own issues. So take everything with a grain of salt. But, I would say if you are just two weeks post injury, I would think there is a good chance that your soft tissues will all heal and go back to normal given more time and physical therapy. 16 months ago I sprained my ankle quite severely, and in a very odd way. I ended up passing out from the pain while lying there on the ground. I damaged a tendon that runs along the arch of your foot and then up the backside of your heel. I had thought that I had blown my Achilles, but did not. However, the pain was in the same area, and for awhile I did experience pain up into my calf as a result, kind of the opposite of what you are dealing with. Intermittently I would even feel pain and instability in my knee. I can definitely understand the frustration of not knowing what the hell is wrong with your body. So far, I have found that even the weird and unexplainable things do heal in time with the primary injury and I hope that will be the case for you. Good luck, hope you heal up completely and soon.