One of the most common complaints I hear from my patients, especially the very active ones, concerns calf pain. I’ve even experienced it myself on occasion after a strenuous workout. Calf pain can range all the way from mild to excruciating and be kind of frightening, especially when it strikes in the middle of the night and wakes you from sleep!
What Causes Calf Pain?
One of the most frequent causes of calf pain, those sudden, intense sharp pains/cramps that wake you in the middle of the night, is mineral deficiency from dehydration. This occurs when you’ve been exercising/sweating a lot and not sufficiently replacing electrolytes (calcium, magnesium, potassium), all those minerals that make your muscles (including your heart!) work correctly. They’re not able to relax, as they should so they kink up and start causing pain/cramping.
Then there are other types of calf pain, which can occur during the day, when you’re up and going through your day. These include:
- Pulled or torn muscles – from overuse injury, heavy exercise. These can occur from sports that require a lot of running and jumping like tennis, basketball, racquetball, etc. The pain is usually very sharp and putting weight on that leg will be difficult and tender. Your calf may feel warm to the touch. Though initially very painful, these kinds of injuries usually heal within a few weeks with the proper rest and treatment.
- Circulation problems – arterial or venous insufficiency that causes a temporary pain in the calf from exercise and is relieved after about 5-10 minutes of rest. This type of calf pain is usually referred to as intermitent claudication, as the pain comes and goes with exercise and rest. There is also the type of calf pain that occurs at rest and can be relieved by movement, but sometimes not. Both types occur most often in older patients, but every now and then I see these in a younger patient as well.
What Can You Do About Calf Pain?
As I said earlier, most calf pain is brought on by muscle strain/pull/tear from overuse and strenuous exercise and/or dehydration. Prevention is the best way to avoid calf pain from happening. Here’s what I recommend:
- Dehydration calf pain/cramps: Muscle maintenance minerals: Calcium, magnesium, potassium are what all your muscles need to fire and relax completely. You should be getting about 1500 mg calcium, 400 mg magnesium and ideally about 2-3,000 mg potassium daily. Take a good combined calcium/magnesium/zinc supplement daily, if you do not drink or eat dairy products. Also include rich potassium sources in your diet like vegetable juice (680 mg per 8 oz), milk (640 mg per 8 oz), baked potatoes (1085 mg per medium potato), beet greens (1300 mg 1 cup), lima beans (955 mg per cup).
- Water: Also most important to drink enough water, especially if you are exercising heavily: 91 oz for women, 105 oz for men. Quick Fix: Drink an 8 oz glass of vegetable juice or 8 oz of milk mixed with 8 oz of orange juice at the onset of pain/cramp. Or you might try 8 oz of tonic water (which contains small amounts of quinine); or 4 oz of pickle juice; or 4 tb of apple cider vinegar in warm water. These are natural remedies, which can relieve cramps within a minute or two. Try sleeping with warm socks on to keep your calf and feet muscles warmer and help them relax. If this type of calf pain/cramp continues, despite your best efforts, please see your doctor.
- Pulled Muscle/Tear: Stretch/Warm Up – To prevent this kind of injury and calf pain, warm up sufficiently before strenuous exercise.
o Stretch your calf muscles out by bending at the waist to touch the palms of your hands on the floor. Shift from heel to heel to stretch out both backs and sides of calf muscles.
o Stand about 3 feet away from a wall with the palms of your hands against the wall, stretch one leg out behind you while you lean into the wall on the other foot and bounce slowly until you feel the back of your calf stretch. Repeat on the other side.
- Epsom salts bath: Fill your bathtub with warm water and add about 1/8 cup of Epsom salts. Soak in it for about 20 minutes after you’ve done strenuous exercise, which can help the muscles relax and avoid pain from inflammation. If you experience a sudden pain in your calf while exercising stop immediately. If you cannot put weight on the leg without severe pain, you may need to see an orthopedic or sports medicine doctor to determine muscle tear or pull.
- Circulation Type Calf Pain: This type of calf pain is something that needs to be evaluated by a vascular doctor who specializes in blood flow through veins and arteries. This type is a little more complicated than dehydration cramps or overuse injury as there is a physical inability of the blood vessels of the legs to get enough blood to the calves and feet. Tests like lower extremity Doppler imaging needs to be done to assess for blockages. Or, you may even have congenitally smaller leg veins/arteries that is limiting sufficient blood flow to your calves. Complications like slow-healing ulcers, and even gangrene of toes/feet, can occur with this condition so it is important to have it evaluated/treated by a specialist.
Calf pain can be very uncomfortable and keep you from being as active as you would like to be. However, with a little prevention using the recommendations above most types of calf pain can be prevented and/or remedied fairly easily. In addition, getting evaluated and treated by an orthopedics/sports medicine or vascular specialist can help treat/resolve your calf pain so you can comfortably participate in the activities you love and enjoy life!