BACKGROUNDThis case is important because we have found no previous report of injury to the distal biceps tendon while playing hockey, although this injury is seen in sports that involve explosive running and fl exion of the knee joint.This case is also unique in that the patient had a proximal hamstring biceps tendon avulsion while playing hockey in 2008, which was surgically repaired, followed by a subsequent distal biceps femoris tendon rupture 2 years later also while playing hockey. Both injuries occurred in the same leg and involved the same muscle. Such a case of these consecutive injuries has never previously been reported in the literature. We reviewed the literature in order to fi nd guidance as to how to best manage the distal biceps femoris tendon rupture in light of the previous proximal tendon avulsion and repair. However, we found no reports or guidance. Therefore, we felt that it was essential to report this case and how we managed it in order to document, Unusual presentation of more common disease/injury Biceps femoris tendon injuries sustained while playing hockey SUMMARYA 42-year-old female nurse presented in March 2008 with a left proximal hamstring tendon injury sustained while playing hockey. At surgery, the proximal biceps femoris tendon and semitendonosus were found to be ruptured and were repaired. The patient made a good recovery but sustained a further hockey injury in January 2010 involving a complete tear and rupture of the biceps femoris tendon distally. This was managed conservatively and the patient was able to return to playing hockey 10 months later. Biceps femoris tendon injuries have been reported in sport but this is the fi rst documented case of the injury occurring while playing hockey and is also the fi rst reported case of a biceps tendon rupture proximally (hamstring tendon) followed by distal biceps femoris rupture at the knee in the same leg.

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We report on a case of isolated tear of the medial head of gastrocnemius tendon. The patient presented with a painless lump in the right calf and denied any prior history of trauma or strain to the leg. A longitudinal split of the tendon was demonstrated at ultrasound and magnetic resonance imaging (MRI). There were no other abnormalities and the gastrocnemius muscle was normal. There are no reports in the literature of isolated gastrocnemius tendon tear. To date the calf muscle complex injury described in this area is tearing of the medial head of gastrocnemius muscle, sometimes referred to as "tennis leg". We conclude that an isolated tear of the tendon to the medial head of gastrocnemius should be considered in the differential diagnosis of a lump or swelling in the upper medial area of the calf and we recommend ultrasound or MRI as the investigations of choice.