Running Pains – Calf and Achilles Overuse Injuries

MOST RUNNERS HAVE 20170829_124616_Burst01at some point suffered with tight or aching calves – often as a result of a particularly long run or increased speed. Changing to minimalist running shoes or a forefoot strike is also a guaranteed way into some calf tension as the body adapts.  The Achilles tendon is one of the most common sources of pain around the ankle and directly connected to the calf, so it’s important to understand these injuries and know what to do if you get pain in this area.

Sudden calf pain on activity can be a sign of a muscle tear (to be discussed another time!), but with a gradual build-up of pain and tightness your starting point in rehabilitation should be stretching and strengthening exercises. When stretching the calf, it’s essential to understand that the calf isn’t just one layer of muscle; under the two visible bellies of the gastrocnemius muscle lies the soleus, and you must stretch both to help keep injuries at bay. In running terms, the gastrocnemius supplies the power, but the soleus is a stabilizer that’s constantly at work. To specifically target the soleus, just adapt any of your usual calf stretches by bending the knee slightly – this slightly relaxes the gastrocnemius and the stretch will go deeper into the soleus. Try a few different calf stretches and see what works best for you.

  • Stretch the calves regularly.
  • Remember to stretch both gastrocnemius and soleus.

To build up calf strength, the metronome exercise is simple but effective. Bounce on the balls of your feet (preferably barefoot and on a hard surface) to a tempo of about 180bpm – i.e. a perfect running cadence – and build up from a couple of sets of 30 seconds each to eventually doing this for four minutes. Download a metronome app (I use Simple Metronome) to help with the timing, and remember to stretch afterwards!

  • Build up calf strength with exercises such as the ‘metronome’.
  • Alternatively, introduce a jump rope to your box of training tools.

If the calf pain is persistent (rather than simple muscle soreness after a hard session), it’s worth having your running shoes checked and gait analysed in a good running shop or by a knowledgeable coach. Excessive over- or underpronation can load the calves unevenly, but muscles much further up the chain – typically, the glutes – can cause problems in the lower leg too, if they’re not functioning and firing optimally. Many runners with lower leg pain find that compression socks work wonders; they can be worn during long runs, or to help with post-run recovery. A regular sports massage can also help by manually freeing up any restrictions and pinpointing trigger points, which might be causing or aggravating the pain.

  • Over- or underpronation can overload the calf.
  • Make sure your running shoes are right for you; have your gait analysed by a professional.
  • Consider trying compression socks for long runs/recovery.
  • Weak or misfiring glutes can also impact on the gait and the calf and make the muscles of the lower leg work harder.

Achilles tendinosis is an overuse injury often linked to excessive overpronation, weak calf muscles and reduced mobility in the ankle. It causes pain, stiffness and swelling around the back of the ankle and often in the calf too. The initial inflammation soon gives way to microscopic changes in the structure of the tendon and an acute injury can easily turn into chronic pain if it’s ignored. The inflammation should first be controlled with ice and reduced activity and impact, and rehabilitation should focus on building up ankle mobility and calf strength. All the tips above on calf stretching and strengthening will also help you deal with Achilles issues. Crucially, the range in upwards flexion (dorsiflexion) of the foot is key to the health of the Achilles tendon. And another tip: While it may go against logic, researchers at the Sports Performance Research Institute in New Zealand have found that running on a harder surface (so, road rather than grass) actually helps to protect the Achilles tendon.

  • Ice acute Achilles inflammation and temporarily reduce activity/impact.
  • Build up ankle mobility to improve dorsiflexion.
  • Stretch and strengthen the calf.

With calf and Achilles injuries and tightness, a good sports massage therapist will be able to help by reducing the symptoms and providing treatment and support for the rehabilitation phase. Various stretching and strengthening techniques as well as mobilization exercises are useful, as is working on any restrictions in the fascia – connective tissue that surrounds and connects all structures in the body. It’s worth considering that there are lines of fascia running from the sole of the foot all the way up to the head – therefore stretches and massage all along the back line (hamstrings, glutes, and back) will often prove very useful when treating chronic calf and Achilles pain and stiffness. Treatment should also include work on painful trigger points, which are likely to form in and around the Achilles tendon and the calf.

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