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Calf Pain Overview

by Jaydee Vykoukal, PT, DPT October 30, 2020 0 Comments

Calf muscle pain

Due to the calf’s function and location in the leg, calf muscle pain is common. There are a variety of factors that can play a role in injury, particularly as we age. In this guide, you will learn about what causes calf pain, symptoms, and possible diagnostic procedures so you can start focusing on treatment and recovery.

Understanding Calf Muscle Pain

Calf pain is defined as pain located in the lower posterior (back) leg. There are three muscles that make up the “calf”: the gastrocnemius (the largest), soleus, and plantaris. There may be more than one root cause of pain in the calf.

Common Causes of Soleus Pain

The exact location of pain in the calf can vary depending on the underlying issue. Lower leg pain may be a sign of a potentially life-threatening condition, or it may be easily treatable at home. It’s important to understand the correlation between pain locations and causes of pain.

  • Muscle Cramps

    Intense muscle cramps in the back of the leg are common with high impact exercise, sports, or dehydration. Symptoms of pain and stiffness can be momentarily severe and then usually subside within a day or two. If the cramp is strong enough, it may result in a mild strain.

  • Muscle Strain

    Pain in the back of your lower leg may be a calf strain, which often occurs because of overstretched calf muscles or during a sudden pushing off movement, jump, or sprint. The injury is often described as a feeling of tearing that might be accompanied with swelling or bruising if severe. It occurs most commonly to the inside fibers of the largest calf muscle, the gastrocnemius, near the knee.

    Lower back leg pain resulting from a calf muscle strain or tear may range from mild to very severe resulting in a complete muscle rupture. A grade 1 calf injury does not require professional treatment, but grades 2 and 3 calf injuries do.

  • Tendonitis

    Lower leg (calf) pain is a warning sign that you have an inflamed Achilles tendon (the tendon that attaches your calf muscles to your heel). Tendonitis is a common injury that makes the tendon tear, stretch, or swell. Lower leg tendon pain is often caused by overuse of the calf muscle during physical activity or general deconditioning due to inactivity.

  • Pulled Calf Muscle

A pulled calf muscle is the result of excessive strain on the area, which can result in pain and loss of function. As bodies are pushed to their limits, muscles are stretched and contracted farther than is natural. This can result in a torn or pulled muscle in the calf or leg.

  • Muscle Contusion

    A direct blow to the calf muscle will result in pain, swelling and bruising. This is most common with a fall or high impact sports. The leg will need to be closely monitored for blood clots with this type of injury.

Differentiating Calf Pain

The lower leg contains a surprising number of muscles, blood vessels, and nerves that all pose a risk for injury. Some are more serious than others, so it is best to understand how to differentiate them. Understanding what causes pain in lower legs is crucial to choosing a treatment plan. Always seek medical advice if you’re feeling unsure.

  • Sprained Joint or Broken Bones

    Trauma is the most obvious cause of pain in lower leg bones. If your lower leg pain keeps you from standing or walking, you may be suffering from a sprain or a broken bone. The first symptom after an  ankle sprain is typically pain in lower legs and feet. In the case of a broken bone, pain in the lower leg must be taken seriously. Stop any activity that causes pain, and call your doctor immediately.

  • Shin Splints

    Also known as medial tibial stress syndrome, shin splints refers to pain and inflammation of the tendons and muscles that attach to the tibia. This type of injury occurs due to constant overuse from running or other high-impact exercises. Those with poor body alignment and muscular imbalances are more likely to develop shin splints. Shin splints can lead to compartment syndrome and be a serious injury that leads to nerve damage and loss of leg function so talk to your doctor.

Learn More About Shin Splints Here

  • Varicose Veins

    Those dark, twisted veins are one of the major causes of pain in lower legs. Varicose veins are caused by weak vein walls and valves and come with a dull, aching pain in both lower legs. This type of pain will typically be more superficial in nature as compared to any muscular or deeper blood vessel issues.

  • Blood Clot

    Deep vein thrombosis, or a blood clot, is a medical emergency that can cause significant pain. It is most likely to happen if you are smoking, pregnant, obsese, or inactive for long periods, or taking certain medications. When left untreated, the deep-vein blood clot often detaches into the bloodstream and can reach an artery in the lungs or brain. Symptoms include generalized swelling, redness, and a deep ache in the calf.

  • Sciatica and Stenosis

    Arthritis of the spine is a common cause of stenosis or a narrowed spinal canal. Sometimes, a herniated disc places too much pressure on nerve roots and results in symptoms of sciatica, which include fatigue, weakness, numbness, tingling, and painful lower legs when sitting or standing. If pain is significant enough to cause lower leg pain, you will often notice symptoms along the entire pathway of the nerve throughout the leg rather than a specific location like other leg injuries.

What is Sciatica?

Symptoms of Calf Muscle Pain

When you sustain a calf injury, the symptoms are typically straightforward. The severity will depend on how much impact or overuse was sustained with the injury.

  • Mild to severe pain in knee, ankle and/or lower leg
  • Moderate to severe pain when putting weight through the foot
  • Swelling or redness with mild to moderate bruising
  • Trouble walking without a limp or significant pain

Talk to your doctor immediately if you experience any of the following symptoms:

  • Tightness and lower leg pain at night
  • A significant change in strength in the lower leg
  • Trouble bearing any weight at all through the injured leg
  • Hearing a loud snap or noticing a hard lump in the calf muscle itself

Diagnosing a Calf Injury

A self-diagnosis is not always sufficient for a calf injury that is sudden, severe, or accompanied by swelling. Chronic calf pain is part of a larger collection of symptoms and should be evaluated extensively to determine the underlying cause. Visit your doctor for an accurate diagnosis, so you can begin treatment as soon as possible.

  • Evaluation

    First, your doctor will complete a physical exam to take your history and what caused the injury into account. Certain physical tests can be complete, such as the Thompsons test for blood clots, to rule out more serious issues.

  • Imaging

    If your doctor suspects a bone fracture, sprain, or muscle strain, imaging may be ordered to diagnose the severity. An x-ray is useful for ruling out fracture, while a CT scan or MRI may be needed to assess other connective tissue health.

  • Other tests

    When blood clots or infection are of concern, further laboratory testing may be required. Specific blood tests can assess certain clotting factors and the presence of an infection if necessary.

Recovery Time for a Calf Injury

The healing time for a calf injury and pain depends on the root cause. If it is a fracture or tendon rupture recovery will take a minimum of six weeks but more realistically months. On the other hand, muscle strains and joint sprains will typically take at least a few weeks to recover. During this period, your foremost concern is preventing re-injury and promoting optimal healing.

Treatment options for a calf injury will initially focus on relieving pain. This typically involves modalities like pain medication, ice, and stretching. To gain an understanding of why the injury occurred the first time and expedite recovery, physical therapy might be recommended. The focus will be on regaining strength, flexibility and coordination when the tissues are ready.

Calf Pain Treatments

Dealing with Tight Soleus Muscles

Whether you love playing sports or going on morning jogs, you do not want to be stuck inside your house with calf pain. Getting relief from your lower leg pain will help you enjoy life and boost your quality of life. By sticking to your doctor’s treatment plan, you will be able to stand and walk comfortably again. Be patient as you slowly increase your strength, and pay attention to your body’s warning signs to prevent re-injury.


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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.

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