Alright, you know what I’m talking about. You’re out there running the same route you’ve done so many times before, just finishing up the last mile when you feel it - that little snap, shooting pain, a small jab, the slightest pop - in the back of your calf. And of course, you try to keep going but it still hurts. So then you panic a little inside, already wondering how you’re supposed to compete in two weeks. Or if you’re going to have to cancel the race (and your trip) altogether. 

BUT WAIT RIGHT THERE. That’s why you’re reading this, right?

Don’t panic just yet. Most athletes fear the worst when they get a sudden calf injury - almost certain that they’ve torn their Achilles or their calf muscle.

But honestly, that’s not usually the case. Most of the time they’ve got a calf muscle strain or tendon irritation. And even though it can still hurt like hell and feel super scary, there’s a lot you can do to make this better. But where to start? Let's dive into calf injuries during running so you know exactly what to do.

Start rehab ASAP if you have a calf injury during running

Please don’t “just wait and see” or “let it rest for two weeks” before getting it looked at by a professional

I always recommend making an appointment with your local sports physical therapist as soon as possible after a potential injury in order to get a jumpstart on your recovery process. 

As Doctors of Physical Therapy we are the movement and injury experts.We are trained to evaluate your injury and determine what kind of treatment is most appropriate, which sometimes means referring you out to an orthopedic doctor or specialist if necessary. If your injury is something that we think will respond well to physical therapy, then we can get you started right away with treatment and often reduce your overall recovery time - this means getting back to running sooner without ruining your training plan. 

PS: are you located in the Tri-Cities area? I'd love to help you out at Game Changer. I'm located Kennewick and specialize in treating athletes! You can schedule a free discovery call to get started.

What if I just push through the pain when I have a calf injury during running?

I wouldn’t recommend it. If you force yourself to continue running through the pain, you’re likely to end up with a more serious injury because of it. The body is pretty amazing - you can absolutely push through pain, but there are consequences. Whether you realize it or not, your body will make compensations and you’ll be running with a slightly different stride, possibly putting more strain on the other leg, further contributing to the problem. It’s possible that you worsen the initial injury or stress another area in your attempt to push through, putting even more distance between you and your goals. You can save yourself a lot of frustration and time by addressing the issue from the start, so you can get back on track in no time. 

My Go-To Starting Protocol for Calf Injuries

1. Massage your calf - Depending on what you have at home, it can be anything from a tennis ball, foam roller, massage gun, or massage roller. Work over the entire calf for about 2 minutes 1-2 times per day at a tolerable intensity to get the muscles to relax. If you’re using a massage gun or massage roller, take a seat in a chair and run the roller or massage gun over the entire calf muscle from inside to outside of the leg and from the knee down toward the foot. If you’re using a tennis ball or foam roller, get down on the ground and place your leg over the ball or roller and roll up and down the calf, rotating your foot in and out (you might have to do the top and bottom half of the calf separately to get the entire area). 

2. Ankle ABCs - Write the entire alphabet with your foot and toes prior to getting out of bed in the morning, before standing up from sitting down, and before going walking or running. This activates the muscles and ligaments in the foot and prepares them for the load of walking.

3. Seated (and progress to standing) alternating heel and toe raises - Sitting in a chair gently raise your heels off the ground, lower them to the ground, and then raise your toes off the ground as far as possible (while maintaining heel contact on the ground), then lower to starting position. Only move through a range of motion that doesn’t increase your pain level. Repeat. Start with 2-3 sets of 10-15 each direction (toes up, heels up). Starting in a seated position will make this exercise more comfortable and reduce irritation. Progress to standing when this exercise feels too easy to do seated. Pro tip: once standing heel raises are feeling easy progress to doing them on the edge of a stair

4. Wear compression socks or compression calf sleeves - Invest in a pair of these to help manage swelling and reduce soreness in the calves. They assist in improving circulation and reduce swelling that can prevent your muscles from working like they should and responding quickly. Or, if you have Normatec compression boots on hand, lay down, relax for a bit, and run a 30 minute cycle on your legs focusing on zone 2 or 3 to help reduce swelling.

5. In the first week if you want to use ice and heat, do this: apply ice after activity, and use heat before activity - Why? Because the ice will cause blood vessels to constrict and reduce swelling which can help you recover afterwards, especially if the leg is elevated while you apply the ice. The heat will cause blood vessels to dilate, increasing blood flow to the tissues and muscles in the calf. Make sure to apply either heat or ice for about 20 minutes, directly over the sore spot in your calf. This is most effective in the first 1-2 weeks after the injury. 

Getting back to running after a calf injury

My rule when getting back to running? Aim to under-do it. - What do I mean by that? You’re going to be feeling better at some point. So I’m basically saying don’t just jump back into it where you left off. Whatever you think you can handle, start with less than that aiming to leave a little gas in the tank. When you start by over-doing it, you increase demand on the tissues beyond what they’re ready for and increase inflammation, further delaying your healing. 

At this point the worst thing you could do is to just “wait and see” what happens.

There’s so much you can do to minimize the effect of this potential calf injury on your training and your body.

Get started with your recovery as early as possible to get the best results.

Start by scheduling an appointment with your local sports physical therapist, someone who works with athletes on a regular basis and understands your goals. Then explore the options I mentioned above in my go-to protocol for early rehab for calf injuries above. This will give you plenty to do in the meantime.

Happy healing!