You laced up your sneakers and headed out for a long, leisurely run — only to hobble home minutes later with an aching calf. Or maybe the pain hit you after you had finished your run and started doing something else around the house. Whether it affects your hip, back, or calf, pain from running can be frustrating. 

Calf pain is a relatively common issue for runners. Although it can be uncomfortable — not to mention irritating — you don’t have to let it derail your running routine, reassures Justin Melson, PT, DPT, a physical therapist at Hinge Health. Here, learn more about what causes calf pain during or after running, how to fix it, and ways to prevent it. 

What Causes Calf Pain After Running

The calves are the workhorse of the lower leg, explains Dr. Melson, so it’s no surprise that they sometimes hurt during or after a run. “Your calves are engaged through your entire gait. They help push your foot off the ground as you step, and they slow down your foot as it lands so that it doesn’t just slap down on the ground.” 

Your calves get a lot of use during movement, which is part of the reason why they’re so strong — they’re designed to help you walk and run. Normally they do their job just as they were designed to do, which is why most people don’t think about their calves as they go about their day. Sometimes, calves get tired, so to speak, and activities like running cause a temporary increase in pain. Other factors that can contribute to calf pain include:

• Having flat feet or high arches. “Part of the reason our feet have arches is to help distribute force when they hit the ground,” says Dr. Melson. Some people are born with either very little arch or very high arch in their feet, which can cause more force to travel up through your leg when you walk or run. If that’s you, know that it doesn’t mean calf pain is inevitable or that you can’t manage it. Pain is always due to a combination of factors, and lots of people with flat feet and high arches never have issues with their calves. It may, however, be one factor in your calf pain and is just something to be aware of as you explore treatment options. 

• Normal age-related changes. Our bodies change as we age. Some people develop wrinkles on their skin or gray hair on their heads. Others lose flexibility and elasticity in their soft tissues, including calves. These changes are not necessarily bad, and they don’t always cause symptoms. In some cases, though, loss of flexibility and elasticity in the calves can make strain and muscle soreness more likely. The good news is that these changes can often be mitigated with consistent, gentle movement as you age.  

• An increase in running mileage. According to a study published in PLoS One, running more than 40 miles per week is associated with a greater chance of injury, including calf pain. But it’s important to know that increasing mileage too quickly is a much stronger factor in calf pain than the mileage itself, says Dr. Melson. That’s why most sports medicine physicians and PTs recommend increasing mileage gradually. If you typically run two miles per day, don’t increase to five miles per day right away — make smaller adjustments. “And if you’re brand new to running, less is really more,” adds Dr. Melson. Otherwise, you may notice pain behind your knee and calf. Consider starting with a walk/jog routine, where you walk for, say, a minute and jog for a minute before tapering off on walking and increasing time spent running. 

• Lack of foot or ankle strength. You’re probably familiar with the song Dem Bones. “The foot bone's connected to the ankle bone. The ankle bone's connected to the leg bone…” So what happens in one part of the body has the potential to affect another. In the case of running, if you have weak foot or ankle muscles, it might affect your running gait and put more pressure on your calves to compensate for stability, says Dr. Melson. This can be especially true if you’re running on a new, uneven surface, like trails or sand.

How to Treat Calf Pain After Running

Although it can be frustrating to experience calf pain during or after a run, that doesn’t mean you need to give up running. There are many steps you can take to minimize discomfort, including: 

• Workout modifications. If your calf pain is really bad, you may want to scale back or cross-train until the worst of your pain has passed. You don’t want to push through unacceptable levels of pain as this could cause a worse injury, says Dr. Melson, but you don’t want to rest completely either. Consider taking a couple of days off of your running workouts and switch to a low-impact or no-impact activity such as swimming or strength training instead. Then, gradually ease back into your running routine. 

• Ice. This can help reduce inflammation associated with some types of calf pain and even minor muscle tears. Ice your painful calf area for 10 to 20 minutes at a time, several times a day. After a few days, you might find that heat feels better, which increases circulation to the area.

• Over-the-counter (OTC) pain relievers. Non-steroidal anti-inflammatories (NSAIDs) like ibuprofen (Advil, Motrin) and naproxen (Aleve) may help relieve inflammation and pain associated with calf strain. It’s important to make sure that it is safe for you to take them, based on your medical history. Just remember that this is a short-term solution. You should not be taking them after every run. 

• Physical therapy. If calf pain persists or recurs, then a course of physical therapy may be in order. “We can do a gait analysis, to see if there are any changes we can make in your running form — such as shortening your stride — to address calf pain,” says Dr. Melson. “We can also look for muscle imbalances or weakness that may be contributing to calf pain.” You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

When to See a Doctor

Most cases of calf pain when running can be treated at home. But if you notice any of these signs, see your doctor.

• You have trouble walking or can’t bear weight on your leg

• You can’t bend your knee

• You have severe calf pain

• You have swelling and/or redness in your calf

How to Prevent Calf Pain

While there are plenty of ways to treat calf pain when it arises, there are also ways you can help prevent it from occurring in the first place, especially if you are prone to calf pain flares. Here are some ways to prevent calf pain when running: 

• Warm-up. A light warmup before you start your run can help since it boosts blood flow to your calves, advises Dr. Melson. Think five to 10 minutes of lunges, squats, and leg swings.

• Cross train. Once or twice a week, consider replacing your run with another form of cardio such as swimming or cycling to reduce your risk of injury, including calf injuries.

• Have “movement snacks.” If you, like so many of us, sit for hours a day at your computer and then jump up and go for a four-mile run, your body might not love that,” says Dr. Melson. Short bursts of activity throughout the day — like walking up and down office stairs, or doing jumping jacks or wall push-ups near your desk — can warm up muscles so they are more ready for your run and less prone to injury.

• Drink water. Staying well hydrated decreases your chances of experiencing muscle cramps, especially in your calves, says Dr. Melson. To prevent dehydration, the American Council on Exercise advises drinking about 20 ounces of water two hours before a run, and seven to 10 ounces of fluid every 10-20 minutes during a workout.

• Strength train. Many runners have strong hamstrings, but weak quads. This makes them more likely to develop injuries and calf pain. You may also want to do exercises to improve your ankle and foot strength. A 2020 study published in the American Journal of Sports Medicine found that runners who followed an eight-week foot and ankle strengthening program had far fewer running injuries than those who just stretched after each workout.

Strengthening and stretching calf muscles is crucial to managing and preventing running-related calf pain. The following exercises are recommended by Hinge Health physical therapists as a starting point. Start by working these into your routine once or twice a week and build up to doing them daily if they’re helpful. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Go Up a Sneaker Size. 

Another way to take care of your calves: Check what size shoe you’re wearing. “If the toe box at the front of your sneaker is too small, it can cramp your foot, which prevents force from being distributed evenly as you run,” explains Dr. Melson. As a result, there’s more pressure on your calves. If you’re due for new running shoes and your toes feel a little cramped, consider going up a half-size or full-size next time you buy shoes to see if that helps. 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here. This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Callahan, L. R. (2023, March 9). Overview of Running Injuries of the Lower Extremity. UpToDate. https://www.uptodate.com/contents/overview-of-running-injuries-of-the-lower-extremity

2. Calf Muscle Injury Common in Runners Over 40. (2022, December 1). Mayo Clinic News Network. https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-common-calf-muscle-injuries-in-runners-over-40/#:~:text=Calf%20muscle%20injuries%20are%20among,about%20six%20to%20eight%20weeks.

3. van der Worp, M. P., ten Haaf, D. S. M., van Cingel, R., de Wijer, A., Nijhuis-van der Sanden, M. W. G., & Staal, J. B. (2015). Injuries in Runners; A Systematic Review on Risk Factors and Sex Differences. PLoS ONE, 10(2), e0114937. doi:10.1371/journal.pone.0114937

4. Pulled Calf Muscle: Treatment, Symptoms & Recovery. (2021, June 3). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21558-pulled-calf-muscle

5. Healthy Hydration. (2009, January 29). American Council on Exercise. https://www.acefitness.org/resources/everyone/blog/6675/healthy-hydration/

6. Taddei, U. T., Matias, A. B., Duarte, M., & Sacco, I. C. N. (2020). Foot Core Training to Prevent Running-Related Injuries: A Survival Analysis of a Single-Blind, Randomized Controlled Trial. The American Journal of Sports Medicine, 48(14), 3610–3619. doi:10.1177/0363546520969205