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Identifying the Cause of Calf Soreness
Calf pain after an injury is expected, but many runners complain of calf soreness with no history of trauma to the area. In these cases, like many in running, the key is identifying the cause and rectifying it. Non-traumatic calf pain usually follows a predictable pattern. The pain develops when running and gradually worsens as the run continues. The calf may feel tight and even stop the runner from going any further. After running, the pain subsides a little, but the calf often continues to feel tight for a day or so. Commonly, when not running, symptoms are minimal.
There are a few potential diagnoses for this, including superficial posterior compartment syndrome and ‘sciatica.’ However, the most common reason I see clinically is simply fatigue of the calf muscles. This leads to the question of why are my calf muscles becoming fatigued? Every muscle has a different level of strength and endurance. Exceed that level, and it will usually start to become painful and tight. The answer to why this happens usually has two parts to it:
Overloading the Calf
The first question here may be, what’s changed recently that coincides with your calf problems? Common causes can be introducing hill or speed work, increasing weekly mileage, increasing training intensity, or transitioning to barefoot running. Running barefoot often involves landing on the forefoot, which usually loads the calf muscles and Achilles tendon more than running in shoes. Another factor is the exercise you do in addition to running. If you’ve started to introduce gym sessions and running on the same day, or the following day, the calf may already be somewhat fatigued before you start.
There is a cumulative effect to exercise that can be quite subtle. If you run regularly, you might be quite accustomed to running on heavy tired legs. You can become unaware of just how fatigued muscles are getting. The first answer when you have been overloading your calf is often rest. A few days of rest, some stretching, and a session or two with the foam roller will often work wonders. 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. Secondly, you may need to think about your training schedule. Are you doing too much with too little rest? Adding a rest day or reducing your mileage temporarily can help resolve symptoms, allowing you to progress again.
Assessing Calf Strength
The easiest way to do this is a single calf raise:
- Stand on 1 leg with your fingertips on a wall/table for balance (not to push up from).
- Push up onto your toes and slowly down again.
- Do as many as you can (going right up, not just lifting your heel a bit!).
- Count the repetitions and compare left and right side.
You should be able to do the same amount left and right, and it should feel equally easy on both sides. Clinically, I like to see runners achieving 40+ reps on each leg, though I have no research to support this number. Below 30 reps might suggest a lack of endurance. You may find this test causes your symptoms, in which case, stop. Don’t push through the pain.
The single calf raise is very effective for strengthening the calf. Do as many as comfortable, rest for 1-2 minutes, and repeat for 2-3 sets. Aim to work up to 3 sets of 25-30 reps. Do this 2 or 3 days a week on days that you aren’t running. The exercise can also be done on the edge of a stair to allow for a greater range of movement by letting the heel drop below the level of the step.
Addressing Calf Tightness
Calf flexibility is also important and should not be overlooked. Gently stretch the calf dynamically prior to running using mini squats, lunges, wall presses, etc. anything that stretches the calf a little in a comfortable, controlled way. After running or doing strength work, use your static calf stretches and, as mentioned previously, the foam roller can help to release tight calves, although it may be painful to use.
Final Thoughts
Non-traumatic calf pain is often a case of doing too much or having weakness in the calf muscles, or a bit of both! A combination of a little rest, some changes to your training, and some strength work is usually enough to resolve the problem.
If you have any additional symptoms such as severe pain, swelling, skin redness, pins and needles, or numbness, consult your GP or healthcare professional. As ever on RunningPhysio, if in doubt, get it checked out.
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