Sharp Pain in Calf

author : AMSSM

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I started my journey this month to lose weight with a goal of 100 pounds and completing three sprint triathlons. My beginning weight was 321 and it is now down to 307.

Member Question

I started my journey this month to lose weight with a goal of 100 pounds and completing three sprint triathlons. My beginning weight was 321 and it is now down to 307. I'm a former amateur boxer and loved skipping. I'm still pretty good at it. I attempted it for the first time today and felt a sharp pain in my calf and stopped right away to prevent injury. I had stretched and had already biked for 40 minutes so I was definitely warmed up. I am wondering if I'm too heavy for this exercise right now?  

Answer by George G.A. Pujalte, MD, FACSM
Member AMSSM

Dear reader,

It sounds like you strained your calf. The sharp pain that you felt is characteristic of this type of injury. Usually the pain comes on suddenly, just as you described.

When the leg muscles’ endurance, flexibility, and conditioning are not quite enough to cope with a particular activity, an athlete may suddenly suffer calf strain. A sudden burst of physical activity may put the calf muscles at risk of a tear. When an athlete does skipping exercises, a great deal of tension is put on the back of the leg, especially as the calf fires to make the ankle joint move to point the foot downwards (plantar flexion). The heavier the athlete’s upper body, the more force the calf is required to generate while skipping to push him upwards with the plantar flexed ankles. The suddenness of this pain in your calf leads me to believe that you may actually need to see a doctor as some strains, in reality, turn out to be bad tears of the calf or other structures at the back of the leg.

Instinctively, you appear to have stopped skipping and are looking for low-impact options. That’s a good move because treatment of calf strains definitely includes rest. Often, a walking boot may even be needed, as well as anti-inflammatory medications.

To get back to sports, a lot of athletes need to do specific physical therapy exercises to get back the full strength of their calf muscles without experiencing significant pain. Your return to sports will depend on how fast you get back to not experiencing pain while running and jumping, and that depends on the severity of the strain.

If there is a significant tear in your calf, there is a high likelihood you may injure it again, especially if you do not consistently do strengthening exercises. There are exercises called “eccentric” calf strengthening exercises that may be helpful not only as treatment but also for prevention. As unbelievable as it may seem, stretching appears not to help prevent such an injury, at least based on current evidence.

Biking is a good low-impact option, although swimming may be better, especially at it sounds as though you feel you need to lose some weight. Use of an elliptical machine may be an option that is somewhere between biking and running as far as putting stress on the injured leg.

Good luck! 

George G.A. Pujalte, MD, FACSM
Assistant Professor, Division of Sports Medicine
Departments of Family and Community Medicine, and Orthopedics and Rehabilitation
Penn State Milton S. Hershey Medical Center, Hershey, PA 17033

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date: January 20, 2014