Calf pain is a common occurrence in distance runners. Repetitive stress, increased demands and improper training techniques can all lead to injuries in the lower leg, especially the calf muscles. The calf consists of three muscles collectively known as the triceps surae, which includes the gastrocnemius, the soleus and the plantaris. These muscles run along the back of the lower leg and attach to the heel via the Achilles tendon. Working together, these muscles produce the motion of plantarflexion. Plantarflexion is the act of pointing the foot downward, such as pushing a gas pedal, doing a heel raise or pushing off while running. Injuries to any of these muscles could result in pain and weakness during or after running.

Calf injuries should be assessed by a medical professional and would include physical examination, history of symptoms and possible imaging such as MRI. Injuries to the calf can include muscle strains, tendonitis, delayed onset muscle soreness, compartment syndrome and overuse. 
 

Common symptoms:

  • Sharp pain or soreness behind knee 
  • Sharp pain in lower leg especially with running or jumping
  • On-going soreness with no relief
  • Weakness with push off
  • Tightness behind leg
  • Swelling or bruising behind knee or back of leg
  • Numbness or pressure sensations in lower leg

Common causes:

  • Improper footwear
  • Improper warm-up or cool-down
  • Sudden change in demand or duration during training
  • Over-training
  • Sudden or forceful movement of the foot or knee such as jumping or stepping on uneven ground

Common treatments:

  • Rest, ice, compression and elevation
  • Modifications to weight-bearing such as crutches or walking boot
  • Rehabilitation exercises
  • Progressive return to exercise
  • Anti-inflammatory
  • Heel lifts
  • Cross-training such as biking or elliptical workouts 
Individuals experiencing sudden sharp lower leg pain and weakness, or on-going lower leg pain should be seen by a healthcare provider to further examine the injury. It is important to follow proper recovery and prevention techniques while training for distance runs. Prevention is important, but if an injury occurs, medical attention and treatment is needed to ensure proper recovery and return to training.