When Should I Be Concerned About Calf Pain?

Normally, we use our calf muscles without much thought. We follow our exercise plan and the lower leg just does its part. That’s why it can be concerning if we feel pain in this area. Unless we’re explicitly working the calf, we usually don’t even consciously recognize that it is there.

So, what if we start to feel pain in the calf area? How do we know whether this pain is something we should be worried about? Answering this question begins with understanding the anatomy of the calf, as well as some reasons pain may arise.

Calf Anatomy

The calf is made up of two muscles: the gastrocnemius and soleus. The gastrocnemius is the larger calf muscle. It sits closest to the skin and provides the shape of the back of the lower leg. This muscle assists with pushing the ball of the foot downward. That makes it important in actions such as running or jumping.

The soleus lies beneath the gastrocnemius. In addition to also assisting with movement, this calf muscle plays an important role in balance and stability. When in a squat position, for instance, the soleus helps keep you from tipping forward.

Though each muscle has a slightly different function, they are known collectively as the calf muscle. That’s how we will refer to them moving forward. Though, keep in mind that there are two muscles in this area.

Causes of Calf Muscle Pain

There are a variety of potential causes of calf pain. Here are a few to consider:

• Overtraining. If you’ve been doing a lot of leg work or running, your calf area may feel sore. This soreness is more likely when starting a new lower leg routine or after ramping up the intensity. Overdoing it can lead to a tight calf, and calf tightness is painful. 

• Dehydration. Do you stay hydrated during your workouts? What about replacing lost water after your exercise sessions? If you are dehydrated, you may experience leg cramps. They also tend to be more prevalent when exercising in hot environments.

• Calf injury. It’s also possible that you have a calf injury. One example is a pulled calf, also known as a strain. A calf strain occurs when the muscle is stretched too far. It might also occur if the muscle is utilized suddenly, such as when quickly changing directions or stopping abruptly. Additional calf injuries can include a muscle rupture or tear. 

• Another lower leg injury. You may even have an injury elsewhere, yet the pain radiates to the calf area. Maybe you had shin splints that turned into a stress fracture. While you will likely feel pain in the front of your leg, you might feel it on the backside too. An Achilles tendon injury, such as Achilles tendonitis, can also cause pain in the back of the lower leg.

• Growing pain. Younger athletes and exercise enthusiasts may experience pain as a result of normal growth. This pain can be felt in various areas of the legs, from the quad to the calf. 

• Restless legs syndrome. If you normally experience calf pain at night versus during physical movement, you may have restless legs syndrome. This syndrome creates unpleasant sensations in the legs, making it hard to sit still. The Mayo Clinic indicates that these sensations can include throbbing, aching, pulling, and itching (1).

• Nocturnal leg cramps. Similar to restless legs, some people experience leg cramps at night. These leg cramps can be especially painful and tend to target the calf area. If this is the cause of your calf pain, you may also experience pain in your feet and thighs. 

When Should I Be Concerned About Calf Pain?

If pain in your calf is severe or doesn’t go away, an injury such as a muscle strain or tear may be present. It’s also possible that the pain is a sign of a major health issue. Two to consider are deep vein thrombosis and peripheral artery disease.

Deep Vein Thrombosis 

Deep vein thrombosis, or DVT, is the medical term for a blood clot within a deep vein. Oftentimes, these clots form in the lower leg. Though, you can also get a blood clot in the thigh, pelvis, or arm. Out of every 1,000 people in the U.S., one or two could develop this condition according to the Centers for Disease Control Prevention (CDC) (2). 

What makes deep vein thrombosis so dangerous is, if the blood clot dislodges, it can travel to the lungs. While small clots can be treated, large clots can prevent blood flow completely. If this occurs, the results can be fatal.

Certain factors can increase your risk of developing DVT. Among them are injury to a vein via accident or surgery, sitting for long periods, increased estrogen in the body, and having a chronic medical illness. If someone in your family has had a deep blood clot, this can increase your risk as well.

Signs of a potential clot include pain or tenderness, swelling, and redness of the skin. Though, the CDC stresses that half of the time, no symptoms are experienced at all. If you are worried that you may have a blood clot, make an appointment with your doctor. They can run some tests to know for sure.

Peripheral Artery Disease

Another consideration is peripheral artery disease. With this disease, blood vessels in the leg become narrow or blocked. This creates leg pain or a muscle cramp when engaged in physical activity. After resting, the pain or leg cramp will generally go away. 

Other signs of this disease include muscle weakness, numbness, or skin that is cool to the touch. All of these could mean that blood flow to the leg is restricted. Risk factors of peripheral artery disease include high blood pressure or cholesterol, smoking, diabetes, and being over 60 years of age. 

Again, if you suspect that your leg pain is related to blood flow issues, a doctor’s visit is in order. Testing can rule out other sometimes less serious circulatory issues that can lead to calf pain, such as varicose veins. A varicose vein is a vein that is enlarged and twisted. This leads to achiness and pain.

If it is determined that peripheral artery disease is the cause of your leg pain, medication may help. If the artery is completely blocked, surgery may be necessary to open it back up.

Calf Pain Treatment Options

Absent a major health issue, you can generally ease calf pain by making a few modifications to your fitness routine. The only exception is growing pain. There’s not much you can do for this, though some have found that heating pads and massages may help.

However, most other types of calf pain have a few treatment options. For instance, if your pain is a result of overuse, it’s important to allow adequate time for the calf to recover between training sessions. If you don’t, the pain will likely stay, if not get worse.

Allow 24 to 48 hours between leg days or after a cardio workout that majorly stresses the calf. Taking this approach can also reduce muscle fatigue and muscle cramping. Staying hydrated helps as well. 

Avoiding pain from injury requires knowing your limits. Don’t push the calf so hard that it screams in agony. Instead, give it enough resistance to strengthen it, then let off. Strengthening the calf can also provide the support the muscle needs for sudden movements. The muscle becomes better able to withstand the additional stress placed upon it.

Corrective Exercises to Improve Calf Pain

Corrective exercises can also help ease pain by improving musculoskeletal alignment and reducing joint restriction. For instance, if the pain is a result of a tight calf, stretching can help. If it’s a result of a weak calf, strengthening this muscle may be best. What calf exercises are good for easing pain?

Stretching-based corrective exercises for calf pain include:

• Wall stretch. If a tight calf is the issue, this exercise can provide relief. To do this calf stretch, stand in front of a wall with one foot in front of the other. Place your hands on the wall about head height. Lean the chest toward the wall while keeping the heel of the back foot on the ground. You should feel a stretch down the back of your lower leg.

• Step stretch. Another calf stretch involves the use of a step or stair. Stand on the step with the balls of your feet, then lower the heels down. Hold for up to 30 seconds, then release.

• Ankle flex and extend. You can ease a tight calf pretty much anywhere with this exercise. While sitting on a chair or the floor, extend your legs and repeatedly flex and extend your ankle. This movement helps release the calf, providing for better movement.

If your calf pain is caused by weakness in this muscle group, here are a few strengthening exercises:

• Heel raise. This is like the step stretch but instead of letting the heel drop below the step, use your calf muscle to raise the heel above it. Once this exercise feels easy, do it while holding weights. This increases the resistance.

• Walking lunges. Lunges are a good leg exercise. Add forward steps to the movement and it’s even more beneficial to the calf. 

• Jumping rope. Jumping rope is a good cardio exercise. It also helps strengthen the calf. If you’re new to jumping rope, start with 30 seconds. Then increase the time in 10 to 20-second increments until you can jump for 3-5 minutes at a time.

Need more? Try this 25-minute calf workout!

Learn More and Get Certified

ISSA’s Corrective Exercise Specialist certification teaches trainers how to create an effective corrective exercise plan while staying within the scope of practice. It also tells clients that you have the knowledge and skill to help ease a variety of pains. 

References

1. Mayo Foundation for Medical Education and Research. (2022, March 1). Restless legs syndrome. Mayo Clinic. Retrieved February 15, 2023, from https://www.mayoclinic.org/diseases-conditions/restless-legs-syndrome/symptoms-causes/syc-20377168 

2. Centers for Disease Control and Prevention. (2022, June 9). Data and statistics on venous thromboembolism. Centers for Disease Control and Prevention. Retrieved February 15, 2023, from https://www.cdc.gov/ncbddd/dvt/data.html