Pain in the calf following an injury like a muscle tear can be expected but most of the time runners will complain of calf soreness with no obvious incident of an injury to the area. In these cases like with many running injuries, identifying the cause is the key to rectifying it.

Runners suffering from calf pain will usually notice a pattern where:

  • A dull/achy pain develops as you run.
  • It worsens as the run continues.
  • The calf feels tight and may stop you from going any further.
  • The pain usually subsides a little when you stop running.

However, the calf will continue to feel tight for a day or so after. This becomes a frustrating cycle as you continue training, where the pain comes on much sooner with each run. Eventually you feel like you have to stop earlier in the run. The most common reason for this is fatigue of the calf muscles.

Tight, aching calves are a common complaint amongst runners and for all the stretching they do, they don’t get any better. So why is this?

The calf muscles take up quite a lot of load when running and having stronger calf muscles is a great way to help reduce the chances of injury. In the lower leg the peak loads on the muscles and joints are up to 7 times bodyweight at normal running speed. 

This overuse calf pain is different from an acute tear as a tear is associated with a sudden onset of pain after a rapid push off movement. The symptoms will be noticeable during daily movement, whereas overuse injury is usually only limiting when running.

Factors related to Calf Pain in Runners

  • De-conditioned athletes aged 40-60
  • Change in training load , increased pace or volume
  • Switch to forefoot running or minimalist shoe- increases calf work by 10%
  • History of previous calf injury
  • Calf weakness and Reduced Flexibility
  • Inadequate rest and recovery
  • Weakness in Kinetic chain

Why are my calf muscle becoming Fatigued?

1. The Calf is being overloaded

Every muscle has its own level of strength and endurance. When we exceed that level the muscles become tight and painful. What has changed recently that has coincided with your calf problem? A common mistake many runners make is introducing lots of speed or hill work, increasing training intensity and weekly mileage to quickly. 

A recent change to minimalist running shoe involves landing on the forefoot and loading the calf muscles and Achilles tendon even more.

Another factor is introducing gym exercises while you are running training. If you have introduced gym sessions and running on the same day, or the following day, the calf may already be tired before you start. 

This all leads to a cumulative effect on the calf and the first thing that should be addressed is REST. The dreaded R word runners hate to hear. A few days rest, some stretching and a session or 2 with your physio can work a treat. I would recommend this before you start thinking about addressing any calf weakness – adding more exercises to an already fatigued calf can add to the problem.

  • Are you doing too much with too little rest?
  • A day or 2 rest or reducing your mileage temporarily can help resolve the symptoms. 
  • Your training schedule also needs to be addressed. 

2. The calf muscles are weak or lack endurance

The easiest way to assess your calf strength is to perform a single leg calf raise:

  • Stand on one leg with your fingertips on the wall for balance
  • Push up on your toes and slowly down again
  • Do as many as you can -lift the heel up as much as you can
  • Count the repetitions and compare left to right.

You should be able to do the same amount left and right. A number below 30 left or right may suggest a lack of endurance. You may find the test causes your symptoms, in which case stop.

This exercise is also an effective way to strengthen the calf. Do as many as you can comfortably, rest for 1-2 mins and repeat for 2-3 sets. Aim to work up to 3 sets of 25-30 reps.

You can do this 2-3 days a week on the days you are not running. This can also be done on the edge of a step to allow for greater range of movement by letting the heel drop below the level of the step.

How can Physio help my Calf Pain?

  • Soft tissue therapy: helps relieve soreness and tightness in the calf.
  • Addressing muscular flexibility: reduced flexibility can overload the calves. 
  • Guidance on Training Planning.
  • Calf and Lower Limb Strengthening
  • Correcting Poor Biomechanics : leading to calf overload.

Summary:

Non- traumatic calf pain is often a case of doing too much or having weakness in the calf muscles. Usually a bit of both! A combination some rest, physiotherapy, strength work and changes in your training is usually enough to resolve the problem.