Calf Pain/Strain

Calf pain is a common presenting complaint and if not managed properly can persist for months or recur. Common causes of calf pain are:

  • Muscle Strains
  • Cramps
  • Biomechanics
  • DVT
  • Reffered Pain

Muscle Strains
Muscle strains are the most common causes of calf pain. An explosive acceleration such as stretching to play a ball at squash or tennis may cause injury. The calf region is also a common site of contusion (local damage to the muscle which results in bleeding) caused through a direct blow to the muscle. Some people experience episodes of cramping pain in the calf that may be due to recurrent minor calf muscle strains, which are as a result of poorly rehabilitated scar tissue. Calf pain can also be referred pain from nerve tissue or from the lumbar spine.

The calf is the most common site of muscle cramps in the body. These can be treated with regular muscle stretching, correction of muscle balance and posture, and adequate conditioning for the activity. Other strategies implemented at The Physiotherapy And injury Centre include incorporating eccentric muscle strengthening into training programmes, educating regarding maintaining adequate carbohydrate reserves during competition and the treatment of myofascial trigger points. We can advise on adequate fluid, carbohydrate and electrolyte intake with the recommendation of appropriate supplement drinks.


Biomechanical factors may be the underlying cause of calf pain. Excessive flat footedness (over pronation) can overload the calf muscles causing muscle tightness and soreness. This can predispose to the development of compartment syndrome. Fortunately, all our physios are highly trained in assessment of foot and lower limb biomechanics.

Conditions often missed include deep venous thrombosis (DVT) which occurs occasionally in calf injuries. Signs and symptoms include constant calf pain, tenderness, increased temperature and swelling within the calf. It is considered a medical emergency if a DVT is suspected and therefore it is usually best to visit the nearest   hospital Accident and Emergency department to rule this out.

Referred Pain
Calf pain can also be referred from the lumbar spine, usually in the form of a ‘slipped disc’. These pains are usually deep and aching all the time but can sometimes be exercise-induced. The knee joint may also occasionally refer pain to the calf.

Calf Strain

Calf strain ranges from the tearing of a few muscles fibres to completely rupturing the muscle causing a severe pain in the calf area.

What causes calf strain?
The calf muscle is usually strained whilst running or walking as the calf muscle’s function is to control the heel bone and they are therefore most active during the push-off phase of walking and running.

What are the Symptoms of calf strain?
The pain of a calf strain injury can range from a still cramping and tightness during the stretching or contraction of the muscles at the back of the lower leg, to immediate pain and even soreness when touched. In the worse cases, there can be acute stabbing pain and the person will be unable to walk meaning the muscle may have completely torn. Bruising and swelling often occurs.