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Calf Pain

Calf pain is a common presenting complaint and if not managed properly it can persist for months or recur. Common causes of calf pain are:

Muscle Strains

Muscle strains are the most common causes of calf pain. A sudden burst of acceleration such as stretching to play a ball at squash or tennis may precipitate injury. The calf region is also a common site of contusion (local damage to the muscle which results in bleeding) caused through contact from playing equipment or another player. Sometimes people experience episodes of cramping pain in the calf that may be due to recurrent minor calf muscle strains, which are as a result of inadequately rehabilitated scar tissue. Calf pain can also be referred pain from neural structures or from the lumbar spine.


The calf is the most common site in the body of muscle cramps which can be treated by regular muscle stretching, correction of muscle balance and posture and adequate conditioning for the activity. Other strategies implemented at Manchester Physio include incorporating plyometrics and eccentric muscle strengthening into training programmes, maintaining adequate carbohydrate reserves during competition and the treatment of myofascial trigger points. We can advise on adequate fluid, carbohydrate and electrolyte intake with the recommendation of appropriate supplement drinks.


Biomechanical factors may predispose to calf pain. Excessive flat footedness (over pronation) can overload the calf muscles causing muscle tightness and soreness. This can predispose to the development of compartment syndrome (see below). Other causes of calf pain can be vascular or neural which often cause exercise-induced calf pain. The joints of the lumbar spine and also the knee joint may occasionally refer pain to the calf.


Conditions often missed include deep venous thrombosis (DVT) which occurs occasionally in calf injuries. Signs and symptoms include constant calf pain, tenderness, increased temperature and swelling.

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