Calf tightness: Should I just put up with it?

Persistent calf tightness is a common complaint amongst recreational running athletes, including distance runners, triathletes, and footballers. A familiar experience for many runners is a history of intermittent aching and/or tightness in the calf muscles which increases with running. Symptoms will often settle with rest but there may be a background feeling of tension in the calves. Often athletes put up with gradually worsening symptoms to the point where their running and sports performance is significantly affected. 

There are several potential causes of calf pain and a diagnosis should only be made following a thorough assessment by a Sports Physiotherapist. Commonly though symptoms can be related to biomechanical muscle overload. This means that current loading habits (i.e. how hard, long and frequently you run) are exceeding the capacity of the calf muscles to withstand this load. Other factors including biomechanics (i.e. how you run) and running surface can also contribute. The exact mechanism of pain is unknown, but it is possibly related to the consequence of fatigue on muscle, neural and fascial tissue.  

Often the onset of calf tightness and pain will have been proceeded by a rapid increase in training volume (training error). Switching from a rear or mid-foot, to a forefoot strike pattern or changing to ‘minimalist’ footwear can also be a cause of calf muscle overload. A previous history of a calf tear without adequate rehabilitation can also be a factor.        

To over overcome this common complaint the solution is to modify loading habits whilst improving calf muscle load capacity. Complete rest from running is often not required. Identifying your current run tolerance (i.e. how far you can run before symptoms develop) and adjusting your training plan accordingly can be enough to reduce pain in the short term. If required, making changes to your running technique can also assist to reduce calf muscle load. However this should only be done following a thorough running technique assessment by an experienced physiotherapist or running coach. A progressive calf muscle strengthening program should then be commenced to improve load capacity. As pain settles and strength improves running volume can then gradually be restored.