Tight Calves Beginning Each Run

author : AMSSM

comments : 1

Tightness in the calves is a common complaint amongst triathletes and runners. There are many potential causes of this problem and this article will address some treatment options.

Member Question

I hope you can help me with this: every-time I start a run my calf is tight to point that I have to stop and stretch it.  Last year it only happened during brick workouts by now it's one out of two runs.  I do my stretching and use a foam roller, it does help but it's still a problem. 

Answer from Dan Cushman, MD
Member AMSSM

Tightness in the calves is a common complaint amongst triathletes and runners. The calf muscles (the soleus and gastrocnemius) are attached to the Achilles tendon and work to plantar flex the ankle. As you could imagine, this is a very important muscle group for running.

There are many potential causes of this problem. Many people are simply born with or develop “tight” muscles, prior injuries can predispose them to it, biomechanical errors can lead to it, and rarely there are other issues like chronic exertional compartment syndrome, problems with blood vessels, stress fractures, or pinched nerves causing the sensation. The timing of the problem can lead to finding its cause – did the tightness come on all at once? Has it stayed the same for years no matter how much you run? Is it getting worse? Sudden “tightness” could be a muscle strain, a pinched nerve, or less likely a blood vessel problem. A constant, unchanged muscle tightness is more likely to be from the way you’re built. A slowly worsening tightness could suggest a biomechanical problem or one of the other less common conditions.

First, it’s always recommended to do a slow warm-up before running, as this can help control some of the tightness. I would recommend that as long as there are no warning signs to this chronic problem (radiating pain down the legs, numbness, tingling, severe pain, weakness, or other associated symptoms), a gait analysis by a running expert like a specialized physical therapist would be a great place to start. Runners can have a variety of problems in the way they run that can lead to calf tightness/pain. For triathletes in particular, they have the added element of bicycling before the run; a proper bike fit can often alleviate some of these symptoms that appear during the run as well. Less commonly, swimming technique can play a role as well.

After this, there are still many more options. Anecdotally, several people swear by compression socks, foam rolling, massage, and self-massage. These all have virtually no side effects if performed properly, and may work well. Dry needling of trigger points in the calf, a method of inserting acupuncture needles into knots in the muscles by doctors and physical therapists, has been gaining in popularity as well and appears to have some potential. I’d like to reiterate, however, that if a biomechanical error still exists, these passive treatments will simply be a temporary solution and will not fix the true problem.   If you have concerns about it, or an analysis does not yield a solution for you, then seeing a sports medicine physician would be a wise move.

Finally comes the argument about stretching, and I do mean an “argument.” Stretching to this day remains controversial – there is some evidence that it helps and some evidence that it doesn’t. It most likely does not prevent injuries in endurance events, but a daily stretching program may help slightly with performance. However, for the question of overly tight muscles, it seems to me that it would be very prudent to stretch those muscles regularly. Again, anecdotally, many “tight” people say that after a good warm-up, stretching really helps them run much more comfortably.

Calf tightness is a very common complaint, and ultimately finding the cause can dictate its treatment. A good warm-up is always recommended, and a gait analysis can shed light on biomechanical errors that are causing the problem.

Dan Cushman, MD
University of Utah PM&R Sports Medicine

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date: May 19, 2015