The calf, located at the back of the leg just below the knee, is made up of three muscles: the gastrocnemius, soleus, and plantar muscles.
Trauma from any of these can cause pain in the calf muscle. But conditions that affect the blood vessels, nerves, or tissues around the calf muscles can also be painful.
This article looks at the possible causes of calf pain. It also includes strategies you can try to manage your symptoms and prevent future calf muscle aches.
Types of calf pain
Pain in the calf muscles can be divided into two categories: pain associated with the muscles and pain not associated with it. Muscle pain often occurs as a result of acute or chronic physical exertion. These are types of injuries that commonly occur during sports or other physical activity.
On the other hand, if you have calf pain and are not sure why, you may have an underlying medical condition that requires medical attention. Non-muscular pain can be caused by nerve damage, arterial disease, serious injury, or something else.
Injury to the calf muscle can occur suddenly (acute injury) or over time (injury due to overexertion). Both are quite common in sports that require fast movements, such as tennis, soccer, or sprinting. The types of muscle pain in the calf muscles range from cramps to tears.
Calf muscle spasms
A calf muscle spasm or cramp is a sudden, involuntary contraction of one or more of the calf muscles. They are often called Charlie's horses.
About 60% of adults meet Charlie's horses at night, averaging nine minutes per episode. After that, the calf muscles can hurt for several days.
Calf muscle cramps can be very tense and painful, and there may even be a visible knot or a feeling of spasm. It is not entirely clear what causes them, although there are several theories:
- Calf muscle cramps can be associated with muscle fatigue after high intensity exercise.
- Some medications can cause them, such as clonopin (clonazepam), celebrex (celecoxib), ambien (zolpidem), and naprosyn (naproxen).
- Certain conditions are associated with increased leg cramps, including coronary artery disease and cirrhosis of the liver .
Medial gastrocnemius stretch is an acute injury that occurs when the calf muscle is severely overloaded. This causes small tears in the muscle fibers of the calves.
Gastrocnemius sprains often occur during sports or exercise, including sprinting or jumping. This is one of the most common calf stretches.
Some people hear a clicking noise when they are injured, and you may not feel pain at that time. The pain usually appears after taking a few steps and can be described as a stabbing or tearing sensation.
Swelling and bruising can occur with intense stretching. In some cases, the pain may be too much for walking.
Calf muscle contusion
Calf muscle A bruise , also known as a hematoma, occurs when the blood vessels under the skin break or break. As a result, the blood vessels invade the muscle tissue.
This type of injury often occurs after a person falls, hits something, or hits the calf. Usually a bruise results in discoloration of the skin and severe pain or pain. Swelling can also limit your ability to move normally.
After rest and rehabilitation, the blood under the skin will be absorbed back into your body as the bruise heals. However, bruising can sometimes lead to the formation of a bruise , a pool of blood under the skin.
Most bruises heal on their own. But in severe cases, your healthcare provider may order a surgical procedure to drain the blood, especially if they suspect there is a risk of infection.
Plantar muscle strain
The soleus muscle plays an important role in lifting the heel off the ground. It also stabilizes your posture when walking or running, preventing you from falling forward.
This muscle is especially important for runners; Therefore, stretching the soleus muscle is a common injury caused by overexertion during endurance running.
If you have a soleus strain, you may feel deep pain or tension when you press on the Achilles tendon, stand on tiptoe, or bring your toes up to your shin.
Many runners don't notice any particular incident that causes the soleus muscle to overstress. Rather, symptoms tend to develop over time, beginning with fatigue in the calf muscles. Swelling, bruising, and sharp pain can get worse until running becomes too difficult.
Plantar muscle tear
Plantar muscle tears occur when a large body weight is suddenly placed on the ankle and the knee is extended. If you are injured, you may feel sudden, severe pain in the back of your leg.
Bruising, pain, and swelling can appear minutes, hours, or even days after the injury. Some people may also have cramps in the calf muscle. Fortunately, this injury should heal on its own.
Athletes often experience muscle-related calf injuries. They can appear suddenly or develop over time, and you may not feel pain right away. Most calf injuries will heal on their own with plenty of rest.
Although muscle injuries are the most common cause of calf muscle pain, there are others that can be caused by nervous system problems, knee problems, or foot and ankle conditions. If you have an injury in this category, you are more likely to need medical attention or physical therapy.
Achilles tendonitis or rupture
The Achilles tendon is the largest tendon in the body. It is located on the back of the leg and connects the calf muscle with the heel bone.
When a tendon becomes irritated , usually from overuse, you may feel a burning pain in the back of your leg, usually just above the heel. You may also have pain and stiffness in your calf muscles. This is known as Achilles tendonitis.
A rupture of the Achilles tendon is called a rupture. When a tendon ruptures, you may feel sudden, severe pain in the back of your leg. It may also be difficult for you to carry any weight on your leg. Some people also hear a clicking sound when they are injured.
Certain conditions increase a person's risk of developing a blood clot, for example:
- With age
- The pregnancy
- Lack of physical activity
- Have a recent surgical procedure
A blood clot is a very serious cause of pain in the calf muscle. Without treatment, the clot can sometimes travel to the lungs ( pulmonary embolism ) and be life-threatening.
Baker 's cyst is not a real cyst. This is a collection of fluid from the knee that collects at the back of the knee. This is common in people with arthritis.
If a Baker's cyst ruptures, fluid can seep into the calf and cause pain and swelling in the calf.
Nerve entrapment occurs when the nerves in the lower leg are compressed by surrounding tissue. This is often referred to as a pinched nerve and can be due to overuse or a sudden injury.
The nerve most prone to pinching is the peroneal nerve. When this nerve is pinched, you may feel numbness, tingling, and a sharp pain in your leg or top of your foot.
In severe cases, a pinched peroneal nerve can cause the foot to descend , making it difficult to raise the forefoot due to muscle weakness.
The hamstring runs around the knee joint and connects the femur to the hamstring muscle. The hamstring and hamstring muscles work together to rotate and stabilize the knee.
Popliteal tendonitis occurs when the tendon becomes inflamed, usually from overuse. This causes pain just above the calf, as well as in the back and sides of the knee. Pain is worse when walking or running downhill.
In rare cases, the hamstring can also tear. This is an acute injury, usually caused by an injury such as a direct blow to the inside of the knee. The injury causes pain and bleeding in the knee joint.
Popliteal artery violation
Popliteal artery impingement occurs when the gastrocnemius muscle puts pressure on the popliteal artery, the artery at the back of the lower leg, and the knee. This can restrict blood flow to the legs.
The condition can be congenital (present at birth) or develop over time. This is commonly seen in young athletes as their popliteal artery contracts while their body is still growing.
Symptoms of a pinched popliteal artery can include cramping, tightness, and pain in the calf, especially after intense calf training such as cycling or running.
Peripheral artery disease and lameness
Peripheral artery disease can reduce blood flow in the arteries of the lower extremities , leading to lameness (cramps during physical activity). This is due to narrowing or blockage of the arteries in the middle of the thigh or knee.
If you are flaccid, you may feel pain in your buttocks, hips, thighs, legs, and / or feet when walking short distances. Some people experience leg pain while lying in bed at night; this is a sign that the condition is getting worse.
Shin bone fracture
A broken leg bone (tibia or fibula) can be caused by a fall or a traumatic impact to the leg, such as a car accident.
This injury can cause severe pain in the calf muscle. Also, your lower leg can be very swollen, making it difficult to walk or weighing your leg.
A complete bone fracture can deform the leg. It can also happen if the broken bone does not heal properly. To prevent this from happening, you may need a cast or, in some cases, surgery.
Bone infection ( osteomyelitis ) is rare. This is usually caused by a bacterial infection that spreads to the bones. This infection can start in the bone itself or spread to the bone after an injury, such as a fracture.
With this condition, you may have a constant dull ache in your calf muscles. Your leg may also feel warm, red, and swollen. Some people have a fever.
Diseases that affect the arteries, nerves, tendons, muscles, or bones in the legs can cause pain in the calf muscles. Some non-muscular injuries are life threatening; go to the hospital if your pain starts suddenly for no apparent reason.
When to contact a healthcare provider
If you are not sure what is causing your symptoms or do not know how to treat your condition, you should consult your doctor. Your treatment will depend on the specific cause of your calf pain.
Some signs that you should see a doctor include:
- Inability to walk comfortably on the affected side.
- Injury causing deformity in the lower leg.
- Calf pain that occurs at night or while resting.
- Calf pain that lasts for several days.
- Swelling in the ankle or ankle area.
- Signs of infection, including fever, redness, warmth.
- Any other unusual symptoms
To diagnose calf pain, your doctor will most likely perform a physical exam and ask about your medical history. They may also order imaging tests such as X-rays, ultrasound, or magnetic resonance imaging (MRI). Sometimes blood tests are also needed.
History of the disease
It is recommended that you take some notes on calf pain before visiting your doctor. You can write about when it started, how you feel, and if you have other symptoms, such as numbness or swelling. This information will help your doctor determine the cause.
Your healthcare provider will not only ask you about the specifics of your calf pain, but will also ask if you have any health problems. Make sure to inform them of any recent injuries or injuries you may have.
During a physical exam, your healthcare provider will examine and press (palpate) your lower leg for signs of swelling, pain, warmth, discoloration, or redness. They can also monitor their reflexes and feel the pulse in the leg, ankle, and foot.
Finally, they will maneuver your foot, ankle, and knee to see how well you can move them. They will likely do other special tests if they suspect a specific diagnosis.
An example of a special test that healthcare professionals use to assess pain in the calf muscle is the Thompson test .
For this test, the patient lies on the exam table with the foot on the edge. The doctor will then tighten the calf muscle of the patient. If the patient's toes do not bend downward when the calf is squeezed, the doctor may suspect an Achilles tendon rupture.
In most cases, no blood tests are needed to diagnose calf pain.
However, a D-dimer test may be ordered to help diagnose a blood clot or pulmonary embolism. D-dimers are protein fragments that your body makes when blood clots break down, so a positive test result means there may be a blood clot in your body.
A blood test to measure erythrocyte sedimentation rate (ESR) can be used to detect a bone infection. A faster-than-normal ESR means that your immune system has triggered inflammation.
A blood test can also be used to measure the level of C-reactive protein (CRP), a protein produced by the liver during inflammation in the body.
Healthcare professionals can use a variety of imaging tests to diagnose calf muscle pain. X-rays can reveal many types of abnormalities in the lower leg, ankle, or knee, especially bone and joint problems.
Ultrasound or MRI can be used to evaluate calf tendon damage and rupture. In some cases, imaging tests can also be used to detect blood clots.
If your doctor suspects a blood clot, he or she may order a vascular exam to confirm the diagnosis. This type of ultrasound is used to check blood flow in veins and arteries.
Treatment for calf pain depends entirely on the cause of the problem. Some conditions that cause pain in the calf muscles are easily mistaken for others. For this reason, you should visit your doctor for a diagnosis before starting a treatment program on your own.
Click Play to learn how to treat and prevent right calf pain.
Surgery is rarely needed to treat calf pain, but may be needed for more serious injuries, such as a ruptured Achilles tendon or a blocked popliteal artery that does not heal on its own.
Here are some common initial treatments that your healthcare provider may suggest.
The first treatment, in most cases, is to rest the muscles and allow the acute inflammation to subside. This is often the only step necessary to relieve pain in the calf muscle. If symptoms are severe, walking boots and crutches can be helpful.
Ice and heat
Ice packs and heating pads are some of the most commonly used treatments for pain in the calf muscles or tendons. Depending on the situation, it is better to use one than the other.
Stretching the calf muscles and tendons can help with some causes of calf muscle pain. It is important to stretch regularly and use the correct technique to avoid further injury. Consult with a physical therapist to find out which stretching regimen is right for your injury.
Physical therapy is an important part of the treatment of almost all orthopedic conditions. Physical therapists use a variety of techniques to increase strength, restore mobility, and help patients return to or as close to their pre-injury level of activity as possible.
Non-steroidal anti-inflammatory drugs (NSAIDs) are some of the most commonly prescribed medications, especially for patients with calf pain caused by tendonitis or muscle strain, contusion, or seizures.
Less commonly, a cortisone steroid injection may be used to treat certain sources of pain in the legs or calf muscles.
If you are diagnosed with a blood clot, you will most likely be prescribed a blood thinner , also called a blood thinner. Examples of blood thinners include Coumadin (warfarin) or Xarelto (Rivaroxaban).
These medications prevent the current blood clot from growing and also prevent new clots from forming.
There are some lifestyle habits you can adopt to prevent many of the causes of calf pain, especially those associated with the muscles.
It is important to warm up to prevent muscle cramps and calf sprains. For example, your warm-up might include jumping or jogging on the spot. The point is to relax the muscles, not to start right away.
It is important to cool off after exercising. This means that you should slow down your activity for at least 10 minutes before coming to a complete stop.
When it comes to preventing muscle cramps, one of the best things you can do is stay hydrated . You should also avoid overvoltage, especially in very hot weather or indoors.
Drinking an electrolyte drink or an electrolyte tablet that contains potassium, magnesium, and calcium can help prevent muscle cramps. You should also limit your consumption of alcohol and caffeine. They are both diuretics, which means they dehydrate you.
It is not easy to prevent blood clots, lameness due to peripheral artery disease, and other conditions associated with blood flow. But there are things you can do to minimize your chances of developing them, for example:
- Give up smoking
- keep a healthy weight
- Take your medications as directed
- Visit your PCP for regular checkups and screenings (such as diabetes and cholesterol)
Calf muscle pain can be caused by injuries to the muscles, bones, or tendons, as well as infections or conditions that affect blood flow. Your healthcare provider can diagnose pain with imaging tests or blood tests.
Depending on your diagnosis, they may recommend medication, rest, or physical therapy. You can also prevent sore calf muscles by keeping them warm and cool during exercise, staying hydrated, and choosing healthy lifestyles.
Get the word of drug information
You may be tempted to diagnose calf pain yourself or treat it yourself instead of visiting your doctor. The problem is that some conditions, such as blood clots, are serious and require urgent treatment. Be kind to your body and consult your doctor. In many cases, rest, ice, and a pain reliever may be all you need to get back into your daily routine.
Frequently asked questions
Sciatica pain is often worse when you lie down. Another cause could be leg cramps, known as Charlie's horses, which can occur suddenly at night while you are lying in bed. Medicines can cause these seizures. Talk to your doctor to see if there is a connection.
Yes. Various knee problems can stretch the muscles and tendons that run along the calf. A common problem is Baker's cyst, a complication of knee arthritis. If you have swelling and redness below the knee, this could be a sign of a cyst, which is a fluid-filled sac.
The first step is to follow the RICE method. RICE means:
Do not apply heat or massage this area at first. Don't walk or strain your muscles. If the traction is strong, you will need surgery, so it is best to consult your doctor.