Inclusion criteria:
Amateur athletes aged 18-30 years with a BMI of 18-25.
Pain in the posterior leg muscles (VAS: 3-7) during single-leg movements, affecting the person for at least two weeks.
Local pain and tenderness in one or more points, or gastrocnemius muscle bundles in one leg, as well as at least one of the referred pain symptoms related to the TP or muscle bundle (e.g., muscle pain, tingling, and numbness) in the posterior leg muscles, or posterior medial part of ankle, toes, or behind the knee and thigh during rest or active ankle movement, which have limited the person for at least two weeks.
Loss of ROM with pain and tissue tension in dorsiflexion movement.
No history of systemic disease, especially hypertension, severe liver disease, renal dysfunction, or coagulopathy.
No history of the neurological disease of the central nervous system (e.g., spondylolysis, spondylolisthesis ,and spinal canal stenosis, and epilepsy).
No history of fracture or dislocation in the fibula and tibia bones during the last three months.
No history of FX or dislocation in the ankle bones during the last three months.
No history of tendinitis or Achilles tendon rupture during the last three months.
Patients are physically examined, among whom those with symptoms such as swelling and blackening of the skin, as well as the swelling, stiffness, and pain in the involved vessels were excluded from the study as a case suspected of venous thrombosis.
To enter the study, candidates must be devoid of any suspected symptoms of compartment syndrome, including general hardness in the entire involved muscle compartment, decreased pulse at the treatment site and its end, muscle herniation, and walking pattern with ankle pronation.
Any extensive and painful echymosis and bruises in the cuff muscle along with a history of severe and sudden trauma or activities (were excluded and subjected a more detailed examination of soft tissue injuries in the area such as cuff contusion and strain of the gastrocnemius and soleus muscles).
Patients should have no experience of strong sudden impact or movement along with sudden sharp pain and popping sound in the leg area in the last 3 months.
No inflammation or redness or swelling on the site.
Lack of wound or skin problems in the treatment site.
Lack of active bleeding in the treatment site.
Lack of infection in the treatment site.
Exclusion criteria:
Unwillingness to continue the cooperation.
Receiving drug or physical intervention at the same time as the treatment period.
The patients with MPS who have neurological or atherogenic symptoms such as the symptoms of spinal canal stenosis, and rupture or chronic tendinitis of the Achilles tendon during treatment.
Occurring Contraindications to massage (edema, wound, active bleeding, and infection) or contraindications to the use of shock wave (hypertension, wound, new bleeding, skin problems, severe liver disease, epilepsy, renal dysfunction, or coagulopathy) during the study.
Any feeling of intense heat in the desired tissue, change in tissue color to dark colors along with increased pain, and any symptoms suggesting the possibility of deep vessel involvement is immediately recorded. The patient is excluded from the routine treatment process and evaluated with the necessary tests.
Regarding the patient feeling significant stiffness and hardness in the gastrocnemius muscles along with paresthesia, decreased pulse in the end part of the limb, and other symptoms suggesting the possibility of compartment syndrome during the treatment sessions, the routine treatment is stopped, and the patient is excluded from the study process and subjected to emergency treatment.