Calf Tightness/Pain

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Painful calf tightness causes worry before a triathlon

Member Question: 
This happened to me a couple of years ago, when I started training and since then I have been very careful to foam roll/stretch/massage and all that and it has worked well. I have been training more seriously and often this year and haven't had a problem.... until now.


Last week after a 5k at a record pace for me, the pain came back in both calves. Next day was a brick scheduled. Got through it but could not walk without pain after that. Stopped running (no problems biking or swimming) for a few days and increased the foam Rolling, etc. Pain disappeared in 2 days Yesterday I tried running again and I could feel the tightness and slight discomfort after only 10 minutes. I stopped running for fear of hurting myself. What do I do? race is in 10 days (sprint). Do I stop running until then or will it be better if I run?  
The pain is not that great and I am sure I could get through a 5k without having to slow down too much, I am quite happy to do that during the race and have to rest after but I don't want to make it worse before the race. 

Answer by Anna Monroe, MD
Member AMSSM


It sounds like you have strained your calf muscles. This microscopic muscle tearing and damage often happens after increases in speed (your 5K) or volume (running more miles). Almost all of the time, muscle strains respond to rest, massage, and stretching. You are on the right track! 

However, let’s get to the twist in your question: a time deadline.

Spend some time thinking about the importance of your upcoming race. It sounds like you could finish the race, but you might have some pain. You are unlikely to permanently damage your muscles by competing, but you could prolong your recovery which would mean more time off after the race than if you had not participated.

Is this race the culmination of your season, or are you hoping to compete in other races? Are you willing to rest from running for weeks after the race? Whether or not to race is a personal decision, and it requires weighing your personal pros and cons. That being said, I have a few ideas for you!


  1. Foam rolling and massage: Keep up the good work. Spend at least 1-2 minutes working on each calf. If you find hard knots or especially tender areas make sure to roll up and down as well as side to side (like a see saw). You can roll several times per day, but back off if you are developing bruises or worsened pain.

  2. Stretching: Stretch after you roll to improve the effects of stretching. One easy and effective stretch is to stand at the edge of a stair and let your heels gently drop. Hold for 10 to 30 seconds before switching sides. Perform 3 repetitions per side, and then repeat the sequence this time with your knee slightly bent. This bent knee stretch reaches the soleus muscle better while the first version hits the gastrocnemius.

  3. Compression: You might consider wearing compression socks. These can be worn before or after workouts, and the theory behind them is that they speed recovery by improving the circulation of venous blood (deoxygenated blood) back to the heart for a hit of oxygen.

  4. Heel lifts: Temporarily using a heel lift, a wedge that fits into your shoes to lift the foot, can help with calf strains. You can find heel lifts at pharmacies or even running stores. The idea behind a heel lift is that it elevates the heel and decreases the stretch on the calf musculature. Less stretching in the area results in more rest of the muscle and hopefully aids healing. I would not use the heel lifts while running, but you can use them in the shoes you wear throughout the rest of the day.


Some running shoes have what’s called a “zero drop” meaning that they don’t elevate the heel. This fit is closer to what it would be like to go barefoot. If you have been running in a shoe with a low or absent drop, you might want to temporarily consider a shoe that elevates the heel a bit. Most traditional running shoes do so, and it’s not hard to find one.


  1. Professional massage, body work, or physical therapy: Sometimes it’s helpful to get a professional involved. Look for someone skilled in sports massage to help you “work out the kinks” better than you can on your own. A physical therapist can also assess whether there are other issues leading to your calf injury. Since it has recurred, you might want to eventually consider having a physical therapist assess your injury. Often “upstream” muscle weaknesses or inflexibilities can lead to “downstream” effects.


Good luck with your decision about racing as well as your recovery. It’s frustrating to be hurt. I hope you feel better and enjoy many more races to come!


Anna Monroe, MD


Dr. Monroe is a primary sports medicine trained emergency medicine physician who also loves competing in triathlons herself.

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date: September 28, 2017

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The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

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The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR

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