Reoccuring Calf Pain

I have been suffering from a reoccurring lower calf pain for the last three years. The Pain mainly occurs in the upper centre of the left calf but it has happened to the right calf too. I have repeatedly rested until I no longer feel any pain and then I slowly build up my training but the injury reoccurs within a month or two whilst in the middle of a run. The pain is instant and sharp and tends to die down once I have stopped running but I can feel a dull ache for a few days afterwards. I have also seen a couple of physio's and they tend to give me strengthening exercises and deep massages which clears the problem and then they do not know where to go when the problem comes back. Has anyone have any experiences of this or any advice?

Many thanks.


  • Hi griffinj9,
    I've got a very similar problem. I suspect mine's a tear, which keeps re-tearing. Sounds like it could be the same for you? You seem to be doing all the right things, maybe mix that up with some experiments to see if it helps any further, to see what you can do to mitigate further episodes? Try changing your stretching routine. Either stretch before if you don't now or stretch after (which I always have done) instead. Or both. Think more about your technique, I tried consciously lifting my thighs in my upstroke to take out some of the downward impact on my calves. Also you can lengthen/shorten your stride, be aware of planting your foot on the heel instead of the forefoot, (or the other way around) make sure you roll through your toe as you lift off etc. There are definitely some things that we do that make this re occur, with a bit of experimentation we might make some changes for the good.
    Hope this helps and good luck!
  • I have a similar problem too, I had it in my left calf and now it's in my right? But mine feels swollen on the outside of the calf, It just keep coming back image
  • Must be the season for calf problems.  I'm going to see a physio this weekend.  The pain i have is on the inside of my right leg, a very acute pain that i can push with my fingers. I cant generate the power to hop nor can i get a decent stretch in it.

    I had RICED, seen a GP (who wasn't much help), stretched, foam rollered, low impact exercise in the gym and after a few weeks it had felt better, no pain. But this weekned/week after two runs (4 miles each) i'm right back where I started.

     Looks like my spring half is a pipe dream...

  • Difficult as it is to swallow, I think we have to stop running for longer.
    Eberkneesaregood, there are also summer halfs. Luke, I bet it doesn't come back if you wait longer. I'm going to take some of my own medicine... Good luck to all of you.
  • What sort of rehab did you guys have?

    Did you do specific endurance work for the calf?
    Did they include plyometrics?

    If the calf wasnt fully strengthened it is at risk of further injury once you increase distance or speed again
  • Go on Tom...
  • For example

    Single leg calf raise on a step (targets gastroc muscle)
    Work through range roughly 15-25 reps or to fatigue (although stop if painful)
    Rest around 1 minute between sets
    Repeat 3 sets
    Also as above but with knee flexed to around 30 degrees (targets soleus muscle)

    Can do a similar exercise on the leg press, flexing the foot to push the weight away. Again leg straight for gastroc, bent for soleus. Reps would be the same, gradually increase the weight until its challenging to complete 15-25 reps.

    Plyometrics is a bit more tricky to explain. Essentially for this you'd do repeated hops forward ina straight line, focussing on a quiet controlled landing. Should be painfree.
    Start with around 10-20 and gradually increase to approx 40 in a session. Do seperately to weights though so not to work when calf is fatigued.

    Does that make sense?!
  • Also the plyometrics is consecutive hops so hop, hop, hop not hop and stop then hop again. I told you it was hard to explain!
    Plyo builds strength really well and is excellent for end stage rehab plus essential for running.

  • Where have you been all our lives Tom?
    Seriously, thank you for these suggestions. I will happily do any additional exercises/stretches/routine if it means my calves don't buckle. Plyometrics, here I come. But I take your point; end stage rehab. As in, body has had time to repair properly...
  • No worries, glad to help.

    Just make sure you have a reasonable level of strength before you start plyometrics e.g. You should be able to do 10 consecutive single leg calf raises. Otherwise there's a risk the plyo will flare it up.

    Feel free to drop me an email if you need any more help
  • Tom, some really useful stuff which backs up what my sports physio said.

    I had a 30 min session where she confirmed a grade 2 calf strain and worked on breaking up the scar tissue in my calf (very painful) followed by some ultrasound. Since then my calf has not been painful and I am easing into strengthening exercises, calf raises (on floor) and single leg squats and also doing lots of stretching.  I am giving myself five weeks of this as I don't want to risk rushing back.  I am think of low intensity static bike (with bent knees - so i don't aggravate the gastroc) and rowing machine to melp with general fitness levels.

    At what point could I consider use of an elliptical trainer as I've heard/read that they can hinder the rehab?

  • 5 weeks is a good time frame. Muscles usually heal in 6-8 weeks and you can expect to see significant strength improvements by week 6.

    I cant see any issue with the eliptical trainer as long as it's pain free while you do it. Keep the resistance low and your heels in contact with the foot plates. You can let them lift a little if comfortable but the calf will have to work harder if you're on your toes.
  • Rehab has being going well until today.

    Over the last two weeks I've been strengthening and stretching and combining some low impact cardio work.

    Today I've been trying to stretch the affected leg and really struggled to get a decent stretch from it, I also have some mild pain/inflammation in the lower calf/soleus area. I'm icing, elevating, resting and taking nurofen.

    Any ideas / tips on stretch issue?

  • Hi,
    What stretches are you doing at the mo?
    Does it still feel tight? It might be that you have good flexibility now, from your rehab, but the area still needs strength work. Can you single leg calf raise now?
    Are you doing any heel drops on a step?
  • Hi Tom I'm doing two stretches to target the lower and upper parts of my calf. I'm doing one where you brace your foot against a wall at 45 degree angle and lean in to feel a stretch in the gastroc (holding once for 90 secs). The other is a bent knee wall press to target the lower calf. It didnt feel tight when I posted but since then I've done some foam roller work which has left it feeling sore and a little tight. I've been doing three sets of fifteen calf raises every other day followed by single leg squats (3 x 15), all with no issue/pain. Not been doing heel drops. I've also been using the elliptical trainer three times per week. Should I back off the stretching? I had been doing 3-5 times a day? Thanks
  • Sounds like you're doing a good job on your rehab, just needs some adjustment.

    With this injury stretching is to prevent calf tightness and encourage healing. Do too much though and it's going to slow healing by breaking down new collagen formation. The same applies to the foam roller a little. So it sounds like you're over doing it. Try checking your calf flexibility and comparing to your good side. You can do this with the knee to wall test. Place a marker on the floor around 25cm from a flat wall. Rest your big toe on this marker and bend the knee over the toes as far as comfortable. Keep the heel on the ground and don't lean your body forward. Use a tape measure/ ruler to measure how far from the wall your patella is at the end of your range. Repeat with the other leg and compare. It's a crude measure in some ways but it'll give you an idea of calf flexibility.

    If left and right are nearly the same it tells you that maybe you've got the flexibility side of things sorted. Also stretches usually only need to be held for around 30 seconds.

    Rehab wise I would progress to heel drops now. They include the eccentric part of the movement which is essential for gaining strength.

    Hope all that makes sense - not always easy to describe this rehab stuff!
  • Thanks Tom for all your advice so far it is very much appreciated.

    I did the knee to wall test, got to 14-15 cm from the wall before my knee touched. More importanlty even in both legs so I don't think flexibility is an issue.  I've laid off the stretching since my post the other day.  I'm continuing to strenghten and I'll include the eccentric heel drops/calf raises from now on. How should they performed, in sets of reps or as continous timed activity?

     I can hop now, however, when doing this I get some mild discomfort on the side(inside) of the affected leg around the soleus area, is this just because it still requires strengthening?

  • With the hopping, yes it does still need strengthening. Hopping and plyometrics should be pain free so I wouldn't do that just yet.

    With the heel drops I would start with doing just as many as confortable on one leg (or if too painful start on 2 legs). Build up to 3 sets of 10 as comfortable. Rest a minute between sets. Once you can easily do 10 aim towards working the muscle to fatigue. This may take upwards of 15 reps depending on your calf endurance. The reps and sets aren't set in stone, it's very individual.

    Classic Heel Drops just involve the lowering part. I'd try to do both the calf raise and lowering part on the step as one exercise.

    You can use your good side as a measure of your normal endurance by counting reps to fatigue.
  • Hi Tom

    Tried those eccentric heel drop / calf raises tonight,.. my word they're hard by the time you get to the 12/13th rep!

    Can these be done every day or is it best to do every other day?

    My continuing thanks for your advice!
  • You can do them every day if not too sore but every other day is usually ample.
    Up to you!
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