Got Calf Pain? Here Are 6 of the Most Common Culprits

Got Calf Pain? Here Are 6 of the Most Common Culprits

Like many people, you may not think all that much about your calves until you experience pain in them. Suddenly, every step (and accompanying pain in the back of your calf) is a reminder of this quietly hardworking part of the body. Calf muscle pain can literally stop you in your tracks — so what’s most often behind it? And what can be done about it? We’re glad we asked on your behalf!

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Causes of Calf Pain

calf pain - man holding calf

Reasons for pain in your calf vary from intense exercise and inadequate hydration to life-threatening medical conditions. While only a doctor can provide a diagnosis, here are some of the potential sources of calf muscle pain.

1. Post-exercise muscle soreness

If you’ve ever experimented with a new type of exercise or dialed up the intensity of your workout, you’ve likely experienced delayed onset muscle soreness (DOMS). Characterized by stiff or achy muscles, DOMS is thought to be caused by microscopic tears in muscle.

Symptoms typically kick in 12-48 hours after a workout, and can linger for a few days. DOMS may trigger soreness in the back of the calf, especially in runners and cyclists, but it can manifest in any overworked muscle.

2. Muscle cramp

Also known as a “Charley horse,” a calf cramp occurs when the muscle contracts involuntarily. Calf muscle cramps can strike during exercise, after a workout, or while you’re sleeping, causing temporary yet intense pain. Melepura explains that calf muscle cramps are likely due to muscle fatigue and dehydration.

3. Muscle strain

This pull or slight tear in the calf muscle is one of the most common causes of calf pain, according to Febin Melepura, M.D., interventional pain physician at Sports & Pain Institute of NY. “A pulled calf muscle happens when the knee is suddenly extended with the foot pointing upward, such as during a sprint or jump in athletes and runners,” he says. This type of injury is typically marked by a sharp pain in the calf.

4. Peripheral arterial disease and claudication

“Lower-leg peripheral artery disease (PAD) — when there is reduced blood flow to the arteries of your lower legs — can give rise to the walking-calf pain of PAD, which we call ‘intermittent claudication,'” Melepura explains. PAD occurs when fatty plaque builds up and hardens in the arteries of the legs, ultimately restricting blood flow.

5. Venous insufficiency

Certain conditions, including obesity, pregnancy, chronic constipation, and tumors, can cause blood to pool in the legs rather than flowing back to the heart. Over time, this venous insufficiency causes veins to become painfully enlarged, making prolonged sitting or standing uncomfortable.

6. Blood clots

Deep vein thrombosis, known as a blood clot, usually occurs in the lower limbs. This thickening of the blood is one of the most serious causes of calf muscle pain, explains Melepura.

“If not addressed in time, the clot can break off and travel to an artery in your lungs, leading to a life-threatening condition called pulmonary embolism,” he says. “This clot blocks the blood flow, causes severe difficulty breathing, and may even result in sudden death.” Signs of a blood clot in the calf muscle include cramping, swelling, tenderness, redness, and warmth.


How to Manage Calf Pain

Staying hydrated, wearing appropriate footwear, and warming up properly for exercise can go a long way toward preventing cramps, sprains, and DOMS. But if you do find yourself dealing with activity-induced calf muscle pain, there are a few simple self-care techniques you can try at home.

If it’s DOMS

Time is truly the only remedy for DOMS, but massage, stretching, foam rolling, cold compression immediately after exercise or heat between workouts can make the process more bearable. Also, while it’s tempting to post up on the couch and wait for DOMS to run its course, active recovery exercises (e.g., walking and bodyweight movements) may offer some relief.

If it’s muscle cramps

Prevention is key here. Stretch before and after exercising and stay hydrated — electrolyte imbalance is believed to trigger calf muscle cramps. If your calf muscle does seize up, try loosening it with gentle massage and stretching.

If it’s a muscle strain

If you think your pain indicates something more serious than post-workout muscle soreness or cramping, you’d best get it checked out. While you wait for an appointment, Melepura recommends employing the RICE protocol.

R: Rest your calf muscle.

I: Ice the injured area. Melepura suggests doing so for 15 to 20 minutes every two to three hours for the first 48 hours following injury.

C: Compress your calf muscle by wrapping it. This can help reduce painful swelling.

E: Elevate your calf above your heart to further reduce pain and swelling.

Once you’ve been cleared to resume exercise, resist the urge to pick up where you left off. Start slowly, doing high-rep workouts with lighter weights to increase blood flow to the area and gently rebuild strength.


When Should You See a Doctor?

calf pain - woman holding calf

Again, if your calf muscle pain feels any more serious than post-workout soreness or cramping, consult a professional. Especially if it doesn’t heal in three to six weeks, Melepura says.

Same goes for muscle soreness that doesn’t lessen with 72 hours, as it could be more than DOMS. Other symptoms that warrant immediate medical attention include:

  • Calf muscle pain that you can’t attribute to a specific cause (e.g. strenuous exercise, a long hike, a fall, etc.).
  • A leg that is swollen, cold, pale, and numb.
  • Leg swelling that is accompanied by difficulty breathing.
  • Intense calf pain that occurs after long periods of sitting.
  • A leg ulcer, or a break in the skin of the lower leg or foot.


Should You Stretch for Calf Pain?

Stretching on its own isn’t sufficient treatment for muscle calf pain caused by serious medical conditions like PAD and venous insufficiency, which need to be diagnosed and treated by a vascular specialist. And, of course, if you show any signs of a blood clot in your calf, seek medical attention immediately.

That being said, stretching before and after you hit the gym can help prevent injuries that lead to calf muscle pain. And, in most cases of muscle cramps and DOMS, stretching can help alleviate pain in the calf.