I felt a sudden pain behind my knee, like a kick in the calf. What happened?

The three main possibilities

• Calf muscle tear, often called tennis leg: a sudden pull or pop in the upper inner calf when pushing off, common in padel, tennis and squash players in middle age; walking on tiptoe becomes painful and bruising may appear around the ankle days later
• Ruptured Baker's cyst: fluid from a cyst behind the knee bursts into the calf, causing sudden pain, tightness and swelling, often in someone who already has arthritis or a known cyst
• Deep vein thrombosis: a blood clot can produce calf pain and swelling that is easy to confuse with the two above, particularly after travel, surgery or immobility

What to do straight away

Stop the activity and avoid walking on the leg more than necessary. Elevate the leg and apply ice wrapped in a cloth. If the calf is swollen, tight, warm or tender, go to an emergency department the same day for an ultrasound scan, which separates a muscle tear, a ruptured cyst and a clot. If you have chest pain or breathlessness, call 999.

Do not massage the calf or take someone else's blood thinners. A heel raise in your shoe and crutches can help in the first days once a clot has been ruled out.

Recovery depends on the cause

Calf tears usually heal with a graded rehabilitation programme over several weeks, depending on size. A ruptured Baker's cyst settles over a few weeks, but the cause inside the knee, often a meniscus tear or arthritis, still needs attention or the cyst may refill. A clot is treated by the medical team with blood-thinning medication.

Following up with a knee surgeon in Doha

Once a clot is excluded, Dr. Gelber at Aman Hospital can assess the knee if a ruptured cyst was found or if you have ongoing knee swelling, catching or pain. An MRI may be used to look for the underlying meniscus or cartilage problem, and treatment is planned around that.