Calf pain can be a common issue for anyone who is on their feet for long periods of the day. Sudden, sharp pain from the calf muscle when running/walking; and then pain when weight-bearing is most commonly a muscle strain or spasm. It can be classed as an overuse injury and is normally caused by an increase in activity, change in activity/footware or weakness/tightness in the foot and calf muscles.
Depending on severity First Aid (P.O.L.I.C.E. protocol) is the most appropriate initial treatment. Complete muscle or Achilles tendon rupture (extreme pain and an inability to point the toes or lift heel) can occur ‘without warning’ and will need immediate referral to a doctor.
A program of pain-free calf stretching and strengthening should be started after the initial symptoms of a muscle strain settle down. Deep tissue massage can speed up recovery.
Achilles Pain
Pain and tenderness to touch on the Achilles tendon is an over-use injury. It’s can be called Achilles Tendinitis or Achilles Tendinosis but the treatment is very similar.
Blood supply into the micro fibres within the Achilles tendon is relatively poor so once damaged they can be slow to repair. Studies have shown tensile (stretching) forces help stimulate optimal growth and repair of tendon fibres. The best calf strengthen exercises use a combination of isometric and eccentric loads. All exercises need to be progressive. Give the tendon time to get stronger. It can’t be rushed or skipped!
One remedy I do recommend for Achilles pain is icing the tendon on a stretch after exercise or when warm (see photo below). Applying ice directly to the skin around the tendon produces an analgesic effect, while the tension from the stretch accelerates the optimum healing effect on the tendon. Keep the ice in a suitable holder and move up and down the tendon to prevent an ‘ice-burn’. If this doesn’t work (or makes the pain worse) then your Achilles pain is probably not tendonitis. Its more than likely referred from the calf. In this case a deep tissue massage of the calves would probably be the best treatment.
CASE STUDY Mike was a regular marathon runner, he had entered the Marathon des Sables and it was just 3 weeks before the race. 156 miles across the Sahara Desert! He came to our clinic with niggling Achilles pain in his right leg. Increasing his mileage had made it worse and he was worried he may have to pull out the race. He started our calf stretching program and managed to complete the race. “I did the stretches every night during the race as well. I didn’t have a problem – it was brilliant!”.
Chronic or recurring pain can be a sign of muscle contracture or trigger points in the calf. Perform calf stretches at least twice a day if not painful. A structured treatment and exercise program for weak calves should be implemented.
Pain at the top of the heel in children could be Sever’s disease. Calf pain can also be referral pain from the spine, stress fractures, compartment syndrome or neuro-vascular compression. Constant calf pain (even when resting) needs medical attention to rule out serious injury such as DVT.
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