8 Causes of Calf Muscle Pain & Exercises to Treat it | Pain Care

Calf Muscle Pain – Causes, Treatment, Exercises & Prevention

Calf muscle pain is a common symptom which we experience when we make leg movements such as walking, running, or jumping. Calf muscle pain may occur in any region of the calf and may be so discomforting as to prevent us from carrying out our daily activities.

The calf is made up of skeletal muscles such as triceps surae, gastrocnemius, and soleus muscle.

Calf muscle pain does not always result from problems with these muscles, it may also result from diseases affecting the nerves and blood vessels coursing through the leg.

Causes of Calf Muscle Pain

There are a lot of causes of calf muscle pain, below is a brief look at a few of them:

  • Calf Tear
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    Calf Cramps
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    Muscle Imbalance
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    Deep Vein Thrombosis
  • Nerve Impingment
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    Achilles Tendonitis
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    Bakers Cyst
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    Peripheral Vascular Disease

Calf Tear

The calf muscles may tear as a result of sudden injury or a sudden stretch which often occurs in sports. Such sports involves basketball, running, tennis & some other outdoor sports.

When a person makes a sudden change in direction or sudden movement from a standing position, calf tear can be the result. It is the commonest cause of calf muscle pain. A calf tear is also called a calf strain.

Often, where the pain is felt gives a clue to which part of the muscle is torn. Pain from calf tear is usually of sudden onset and may cause severe difficulty in walking if the tear is severe.

Calf tear is divided into three grades:

Grade 1 involves just 25 percent of the muscle fibers.

Grade 2 involves upto 90 percent of the muscle fibers.

Grade 3 involves 90 to 100 percent of the muscle fibers.

Treatment of a calf tear depends on its severity, mild to moderate tears may be resolved by rest, application of ice, elevation of the affected leg, and compression of the torn area to lower the inflammation.

You may also need analgesics such as ibuprofen to reduce the pain. The pain is also resolved with adequate physical therapy.

 In severe cases, you may need to visit your orthopedic surgeon for advanced treatment.

Calf Cramps

Calf cramps are referred to as “Charley Horse” by Americans.

Calf cramps are involuntary spasms of the calf muscles and it could be extremely painful. Cramps may last for a few seconds to a number of days.

Causes: Calf cramps may be as a result of mineral or vitamin imbalances in the body, muscle fatigue, dehydration, or tightness in the calf muscles from overuse and lack of stretch exercises. 

Although calf cramps may occur in any region of the calf, it often occurs in the upper region.

Treatment for calf cramps includes stretch exercises to make the muscles flexible and strong enough for activity, massage, a diet rich in minerals and vitamins, and a proper-fitting and supportive footwear.

Muscle Imbalance

Muscle imbalance refers to the weakness and tightness that affect muscles after long periods of use.

The tight calf muscle is prone to overuse injuries which may be severe. 

Treatment of muscle imbalance involves adequate calf strengthening and stretching exercises.

Deep Vein Thrombosis

In deep vein thrombosis, a blood clot forms within a deep vein of the leg in the calf area. Commonly known as DVT.

A DVT is a medical emergency because the clot obstructs the return of blood to the heart and flow of blood to the foot.

The real problem with a DVT is that the clots may break off and block blood vessels carrying blood to the heart and lungs causing a heart attack and pulmonary embolism respectively.

The commonest sign of DVT is calf pain which gets worse if you pull your toes upwards. Other typical symptoms of DVT include warmth and swelling in the calf.

DVT is treated as an emergency with blood thinners, pain relievers, and diuretics which reduce swelling in the calf.

Nerve Impingement

Compression or impingement of the nerves of the leg often causes calf pain, numbness, and a burning sensation in the calf.

Impingement of the nerve may occur at the back where the nerves originate or anywhere along its course in the legs.

Causes: Nerve impingement may be caused by trauma, tendonitis, disc prolapse, or some conditions affecting the calf muscles.

Treatment of trapped nerves is with pain relievers, anti-inflammatory drugs, and drugs which stimulate nerve regeneration. In severe cases, surgery may be recommended.

Achilles Tendonitis

Achilles tendonitis refers to inflammation or degeneration of the Achilles tendon, a tough tissue which attaches the calf muscles at the back of the lower leg to the heel.

The Achilles tendon may become vulnerable to damage if the calf muscles are overused and have become tight and inflexible.

Common symptoms of Achilles tendonitis include heel and calf pain, swelling and redness in the calf, and difficulty in walking.

The Achilles tendon has a poor blood supply, so recovery may take several months.

Treatment of Achilles tendonitis includes physical therapy, orthotics, rest, ice therapy, elevation of the foot, and analgesics.

Baker’s Cyst

Baker’s cyst is a common cause of calf muscle pain.

It is an inflammation of the bursa located behind the knee joint, the popliteal bursa. This often results as a result of prolonged exposure of the bursa to damage.

Typical symptoms of Baker cyst include calf muscle pain, swelling, and feeling of a lump behind the knee. The cyst may also rupture causing fluid to drip into the calf.

Treatment of Baker cyst is conservative and include drainage of the cyst, pain relievers, rest, use of anti-inflammatory drugs, ice therapy, and physical therapy.

In rare cases, surgery may be necessary. You may also need knee braces to improve the symptoms

Peripheral Vascular Disease

Peripheral vascular disease, also known as peripheral artery disease (PAD), is a condition characterized by narrowing or obstruction of the arteries that supply blood to the legs and feet.

A lot of times, what causes the obstruction are fat plaques which deposit on the artery wall over time.

Risk factors for PAD include diabetes, hypertension, high blood cholesterol, and cigarette smoking.

Symptoms: Peripheral artery disease presents with calf pain, pallor of the calf, weakness of the calf muscles, and in untreated cases, it may lead to the death of the tissues in the leg. This may necessitate amputation of the foot. 

Treatment of peripheral vascular disease include the use of blood thinners, cholesterol-lowering drugs, and catheter-based procedures to unblock these vessels such as.

Exercises that Help Prevent and Improve Calf Muscle Pain

These exercises are called calf strain stretch exercises, they are aimed at increasing the flexibility of your calf muscles to prevent injury or improve symptoms of an injury.

These stretching exercises include active calf stretch, gastrocnemius stretch, and soleus stretch. They are best performed after the acute phase of an injury.

Active Calf Stretch

You can perform an active calf stretch in the early stages of an injury to the calf.

Active stretches only apply gentle pressure on the calf, so they can be done many times daily.

To perform an active stretch on the gastrocnemius, follow the following steps.

  • Sit on the floor or on a chair and place the leg to be stretched straight out.
  • Pull the toes and foot upwards and backward facing you.
  • Hold this position for a few seconds and relax.
  • Repeat the process up to 15 times.

To perform an active stretch of the soleus muscle, follow the steps below.

  • Sit on the floor or a chair with your knees bent and your feet placed on the floor.
  • Raise the foot and toes up to face you, while keeping your heel on the floor.
  • Hold this position for a few seconds, then relax.
  • Repeat the process 10 to 20 times.

Gastrocnemius Stretch

Gastrocnemius stretch exercise is performed in the following steps;

  • Stand and place the leg to be stretched behind while your hands are placed on the wall at the height of your shoulders.
  • Bend the knee of the other leg and lean forward, keeping your back knee straight.
  • Push the heel of your back leg downwards till you feel a stretch.
  • When you feel the stretch, hold for a few seconds.
  • Repeat the process 3 to 5 times daily.

Soleus Muscle Stretch

To stretch the soleus muscle, follow the steps below:

  • Bend your both knees behind a wall such that the leg to be stretched lies behind.
  • Keep the knee behind bent till you feel a stretch.
  • Hold the stretch for 15 and 20 seconds.
  • Repeat this process three to five times daily.

These exercises are to be done after the acute phase of an injury when pain must have subsided.

After performing these exercises for a while, your calf muscles gain some flexibility and you may begin to perform each of them on a step.

Soleus Step Stretch: To perform calf stretching on a step, do the following:

  • Place your foot on a step and lower your heel off it until a stretch is felt.
  • Hold this position for about 20 seconds and repeat three times.
  • Repeat the whole process thrice to five times daily.

The above process stretches the gastrocnemius muscle, to stretch the soleus muscle on a step follows the same process except that the knee must be bent.

How to Prevent Calf Muscle Pain?

The Following steps keep your calves in good shape and less vulnerable to injury.

1. Calf stretch Exercises

As mentioned earlier, these exercises increase the flexibility and strength of your calf muscles.

The calf muscles are involved in many of our daily activities such as running, pedaling, bicycling, and walking. These activities may weaken the calves over time, making them vulnerable to overuse injuries.

Calf stretches, therefore, are your best bet to keep your calves strong and flexible all day long, all year round.

2. Foam Rolling

Foam roller exercises is a fantastic way of keeping your calves flexible and strong. It simply involves rolling your calves over a foam roller.

It provides deep tissue massage which eliminates and prevents muscle soreness. You could perform foam rolling exercises before a stretch or a workout.

2. Good Fitting shoes

Your calves work in concert with your foot to produce movements.

To prevent sore calves, you need to wear shoes that provide good cushioning and arch support. You should also wear insoles that act as shock absorbers reducing the stress placed on the foot by the floor.

In addition, your shoes should fit your heel and forefoot well so your foot does not slip around. This is because if your feet don’t fit properly, your calves will work extra hard to stabilize your body and this may cause some strain.

3. Know your limits

You should not exercise to the point of feeling intense pain. Avoid strenuous exercises especially if you have not done a proper stretch.

In addition, if you are new to exercises, it is best you begin slowly and for a shorter duration until your calves gain more flexibility and strength.

Your workout shoes should also fit properly and provide a soft cushion for your feet.

Quick Recap

Calf muscle pain is a very common symptom which may cause severe difficulty in moving the legs.

Calf muscle pain often results from muscle strains, tears, nerve impingement, as well as acute injuries. 

Although most cases of calf muscle pain can be successfully treated with conservative measures such as rest, ice therapy, elevation and compression of the calves, surgical treatment may become necessary in some cases, such as calf rupture.

Calf muscle pain is better prevented than treated. The simple ways to prevent calf muscle pain include calf stretch exercises, wearing proper-fitting footwear, foam rolling exercises, and avoiding strenuous exercises

Dr. Sachin

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