Why Do I Always Get Tight Sore Calves?

 In Lower Limb

Calf pain is a common occurrence for runners. Runners often present with a history of calf soreness or tightness in clinic. I am frequently asked why calves feel tight or sore and how to stop it from happening. So let’s get to the bottom of it.

Calf pain that is non-traumatic in origin typically develops during a run, often in the later stages and progressively worsens throughout the run. Often a runner is forced to stop and try to stretch out a feeling of soreness or tightness before trying to continue the run. It may become sore enough to stop the runner from completing the rest of their session. Following the run, often there is a bit of soreness yet it often feels more tight then sore walking around. Subsequent attempts to stretch or roll often provide a bit of relief but subsequent runs often suffer from the same pattern, until some short period of rest, cross training or easy running is forced. Typically pain or tightness is in the lower portion of the calf (called your Soleus). The anatomy of the calf is important in understanding the ‘why’ of calf pain and tightness.

Calves

Figure 1 and 2: Has highlighted the Gastrocnemius (outer calf muscle).

Calves

Figure 3 and 4 – Deep to the Gastrocnemius is the highlighted Soleus (inner calf muscle).

The Gastrocnemius attached onto the femur, crosses the back of the knee and inserts via the achilles tendon into the calcaneus (heel bone). The Soleus, as evident from the figures above, begins from the tibia (doesn’t cross the knee) and again attaches via the achilles tendon into the heel. Soleus is well known as an endurance muscle, largely due to its composition of slow twitch muscle fibres and large surface area (1). During ground contact Soleus controls the knee resulting in absorbing forced associated with landing, then it propels the trunk forwards through its plantarflexor function (2) producing vertical forces approaching 8 times body weight (3). The combination of these factors makes Soleus a critical muscle to running.

When runners experience onset of calf pain during a run they are most commonly experiencing fatigue of their Soleus (DOMS, neuromuscular soreness or in some cases a low grade strain). This fatigue to the Soleus is responsible for sore, tight calves. This happens for a number of reasons: it has been overloaded and/or it lacks necessary strength or endurance.

Overload

A sudden increase in workload is a risk factor for numerous running injuries, including the Soleus. If a runner suddenly increases their weekly workload this can increase stress on the Soleus. This may look like large increases in run time or distance in a long run, a big week of volume, addition of extra speed sessions or inclusion of extra hill running. Gradual increases in load are smart, yet what is safe for some runners can be vastly different to others. More can be found here on the best tools runners have to monitor workload. An overload can not just be due to sudden increases in volume, but the other side of the equation; inadequate recovery. Multiple factors can be included here including nutrition, sleep and stress.

Aside from training loads, different biomechanical factors and running technique can also increase work the Soleus performs. Poor ankle range, reduced big toe mobility and weakness through other foot and ankle stabilising muscles may contribute. Side to side differences in calf strength or weakness through muscles that assist the Soleus in absorption such as the glutes and quadriceps, will also result in increased calf and noteably Soleus work. Running variables such as longer ground contact times, large vertical oscillation (bopping up and down) and overstriding can increase fatigue in the calf complex.

Strength and Endurance

Developing strength and endurance in the Gastrocnemius and Soleus is crucial for runners. Weakness in the Soleus has been linked to achilles tendinopathy in runners. Where possible single leg exercises should be incorporated to minimise side to side strength discrepancies. Additional strength exercises that target quadriceps and gluteals will also assist the calf complex (here is an entry level strength program for runners).

Here are some of my favourite exercises to target the calf complex; bent knee calf raises both in sitting and standing (standing not shown), straight leg calf raises, skipping, and single leg bridges (on toes). Heavy isometrics (holding the contraction) for 45 sec duration in both sitting and standing can also be useful for calf strength and developing Achilles stiffness (aka its ‘springiness’).

Calves

Calves

Calves

Run the distance or pace you can that doesn’t lead to calf pain. #performbetter @pogophysio Click To Tweet

Top Tips for Preventing Calf Pain

  • Monitor training loads to minimise large increases in workload
  • Place an importance on recovery, including good quality sleep
  • Ensure good ankle and toe mobility
  • Run smooth (minimise bopping) and run with a higher cadence (5-10% increase in number of steps taken per minute)
  • Commence strength training of the calf, especially the Soleus
  • Where possible include a more comprehensive program for quads and glutes

Top Tips for Managing Calf Soreness:

  • Continue strength within what is comfortable
  • Neural mobility exercises regularly (hamstring stretch with a stretch band, adding in plantar flexion)
  • Incorporate soft tissue massage or foam rolling
  • Run the distance or pace you can that doesn’t lead to calf pain, or incorporate run walk intervals or cross training.
  • Be mindful of cadence when running

 

 

Lewis

Lewis Craig (APAM)
POGO Physiotherapist
Masters of Physiotherapy

Featured in the Top 50 Physical Therapy Blog

 

References:

  • O’Neill, S. (2017). A biomechanical approach to Achilles tendinopathy management (Doctoral dissertation, Department of Health Sciences).
  • Francis C, Lenz A, Lenhart R, Thelen DG. The modulation of forward propulsion, vertical support, and center of pressure by the plantarflexors during human walking. Gait & Posture 2013:1-5.
  • Dorn T, Schache A, pandy M. Muscular strategy shift in human running: dependence of running speed on hip and ankle muscle performance . The Journal of experimental biology 2012;215:1944-1956.
  • Gruber, A., Umberger, B. R., Miller, R. H., & Hamill, J. (2018). Muscle mechanics and energy expenditure of the triceps surae during rearfoot and forefoot running. bioRxiv, 424853.
  • Goldmann, J. P., Sanno, M., Willwacher, S., Heinrich, K., & Brüggemann, G. P. (2013). The potential of toe flexor muscles to enhance performance. Journal of sports sciences, 31(4), 424-433.
  • Fields, K. B., & Rigby, M. D. (2016). Muscular calf injuries in runners. Current sports medicine reports, 15(5), 320-324.
  • Bramah, C., Preece, S. J., Gill, N., & Herrington, L. (2018). Is there a pathological gait associated with common soft tissue running injuries?. The American journal of sports medicine, 0363546518793657.

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