Calf Pain When Running
Calf pain when running is a relatively common complaint, and even more so if there is a history of trauma to that area. However, sometimes it can occur where there is no known prior injury or damage.
In many cases, the onset of painful symptoms is that whilst running, the pain may get progressively worse during the run and the calf itself may feel tight and stiff. The calf pain can prevent the individual from continuing to run any further but as soon as they stop, there may be few or no symptoms at all.
Calf pain is common during distance training such as marathon running, although, there are several possible causes of calf pain whilst running – pain may be acute or become chronic.
Calf Strain & Muscular Tears
Injury, strains, and tears to the calf muscle are a common cause of pain which will typically worsen during running. Symptoms may include a sudden or sharp pain at the back of the lower leg accompanied by bruising or swelling in some cases, as well as tenderness at the point of the injury. A muscle tear may feel like a sudden, sharp pulling pain that is further aggravated by exercise. The main causes of strains and tears are muscle overload and weak muscles.
Muscle overload is the most common cause of strains and pain felt within the calf whilst running. This is typically a result of increasing exercising intensity by running more frequently or for greater distances and subsequently increasing the load on the muscles.
A change in running surfaces and route can also add to muscle overload. For example, if there has been a recent introduction to hill running or running on harder and more jarring surfaces such as concrete, as this can all put a greater strain on the calf muscles.
Any changes in foot pronation (arch collapse) can impact the calf muscles. Running more on the mid foot or forefoot or stepping with the toes, something more likely during hill running, will increase the load on the calf muscles and can cause pain related issues if introduced suddenly.
The development of tight calf muscles is often gradual, occurring over time. It may get worse whilst running and sometimes muscles may present as bumps on palpation where the fibres have tightened up.
If the calf muscles are exceptionally weak then this can make injury or inflammation more likely to occur during intense bouts of exercise such as running. The cumulative effect of exercise can take its toll as muscles become increasingly fatigued and more prone to injuries.
Calf Muscle Cramps
Cramps can occur at any point in the body, however when running they often manifest in the region of the calf muscles. Cramps are more likely to occur at the end of a long training session and being dehydrated or deficient in certain minerals can make this more likely. To relieve a cramp, it may be helpful to try to stretch the muscles out gently to release the spasm. A running buddy or partner can help with this.
Inappropriate Footwear and Poor Posture
Investing in the correct type of footwear can make a massive difference to running performance and related injuries. Inappropriate footwear and subsequent poor biomechanics are responsible for a number of aches and pains including discomfort in the calves.
Issues in the lower back can sometimes cause problems in the lower limbs. Pain in the lumbar and tight muscles in the buttocks can radiate to other areas of the body through the legs and into the knees and calves, causing stiffness and discomfort when running.
Sometimes ongoing calf issues during running are the result of a previous injury such as a fall or a direct blow to the back of the legs.
Fibula hairline fractures are a type of overuse injury that can on some occasions, cause pain in the calves.
Rarer Causes of Calf Pain
Deep Vein Thrombosis
DVT is a blood clot in the vein that typically appears in the legs, and it causes constant pain usually felt in the calf or back of the legs. It is more likely to occur following surgery or after long flights and requires immediate medical attention.
This is a rare and more serious cause of calf pain that occurs when there is a sudden build up of pressure within the muscles, which can lead to a decrease of blood flow within that area. The restricted blood flow causes painful symptoms and is a medical emergency. This is usually associated with trauma, but can also occur due to large calf muscles.
Specific Muscle Strengthening Exercises
There are a number of specific calf-strengthening exercises that can help improve the muscles and support tissue healing. Strengthening the entire body and the core will also help to improve posture and stability, reducing the strain on the calves.
Specific Flexibility Stretches
Stretching the calf muscles prior to running and afterwards can reduce the risk of painful strains and tears to the muscles, as well as aiding recovery from overload to the muscles. Improved flexibility and regular stretching can also minimise the risk of cramps.
Gait Analysis & Footwear
An observation of gait provides an insight into how an individual is walking or running as poor biomechanics can contribute to pain in the calves as well as other areas. Identifying any issues in the way the body moves during physical activity can help to reduce calf pain and improve overall running performance.
Flat feet (pronation) can cause the foot to roll inward excessively, by contrast, a high arch and stiff foot can lead to calf strain. Ensuring that you have the correct footwear that properly fit and are designed to counterbalance any structural anomalies of the foot, will help to reduce the risk of calf pain during running.
Ice or heat therapy is useful in the management of a number of musculoskeletal pain related issues including calf pain.
During acute episodes of calf pain, it is a good idea to rest and avoid activity. Ideally, the calf should be in an elevated position and once symptoms have begun to ease, specific exercises should be performed to aid recovery and rebuild strength.
Pain Relief Medication
Over the counter pain medication such as paracetamol or ibuprofen can help to relieve pain, allowing easier movement.
Massage therapy can be used to stimulate the flow of blood to the affected muscles, promoting healing as well as helping to release any areas of muscle spasm.
Compression socks are often used to relieve calf strains, by promoting better circulation, reducing pain and inflammation, and encouraging tissue healing.
Physiotherapy and Treatment for Calf Pain
Physiotherapy provides a comprehensive treatment and management plan for calf pain issues. The initial consultation and assessment will enable the physiotherapist to devise a tailored plan to encompass a range of different therapies from specific exercises and stretches, to hands-on manipulation and massage therapy. This is in addition to gait analysis and useful advice on training including techniques and how to adapt a running schedule, when to rest, pain relief medication, the use of ice/heat therapies, and when to use splints and compression socks.
We offer a wide range of physiotherapy and related services including treatment for calf pain when running. Get in touch to find out how we can help.