Calf and Achellies pain

Calf & Achilles Pain

The Achilles tendon attaches the powerful lower leg muscle known as the Gastrocnemius, or calf, to the back of your heel. The calf muscle, via this attachment, can lift your entire body weight off the ground quickly and easily. The Achilles tendon itself has tensile (pulling strain) strength greater than steel – when a muscle like this becomes irritated, you know you’ve got a problem!

Your symptoms are likely to be pain of a sharp or aching nature in the calf or tendon, worse after activity, although the symptoms may lessen during the activity, they often become worse again directly afterward or the next day. Mornings are often the worst time with the ‘hobble' to the bathroom first thing, becoming a standard routine. Things will tend to ease a bit as you get moving, but pretty much every morning the symptoms are the same.

Calf/ Achilles pain may begin in a number of ways with the following being the most common:- Poorly fitting shoes/ trainers, with the heel ridge pushing into the Achilles tendon when walking or resting. Over pronation of the foot, (Arches dropping), unaccustomed intense activity rather than gently building up to it. Unaccustomed hill running, constantly wearing high heels (causes the calf and tendon to shorten leading to stress when not wearing high heels).

Heavy quilts can cause shortening of the calf and tendon by regularly pushing the feet into the ‘tiptoe’ position (plantar flexing). Problems with your back, or other leg muscles can also lead to postures that cause inappropriate use of the calf, causing strain.

There are probably few other muscles in the body as powerful as the Gastrocnemius but at the end of the day it’s still a muscle; it goes wrong in the same way that all muscles do see Muscle Dysfunction and responds to therapy in the same way.

There is no doubt in my mind that stretching this muscle as a form of self help/rehabilitation is next to useless. The same with strengthening. I don’t believe stretching and strengthening are useless full stop, just their role in rehabilitation. This is confirmed through my own experience (2 years of calf pain) and time and again through patient histories.

If you have a chronic or acute Achilles tendon inflammation then this applies even more so.

With calf pain on its own (no tendon involvement) remedial massage is likely to be quite uncomfortable but very beneficial, in conjunction with the self help activities listed later.

If you have chronic Achilles pain, it tends to respond poorly to any therapy, although occasionally ultrasound is helpful. if you’ve had a swollen and painful Achilles tendon for over 6 weeks, or months, or even years (in some cases) it is worth trying a course of physical therapy because it can often help. But if symptoms don’t noticeably improve, then I believe that the only solution is to spend 6 weeks in a plaster cast.

With both Achilles and calf problems, my approach will be to check your lumbar pelvic structure for imbalances. these could lead you to shift your weight inappropriately, causing more stress on the lower leg muscles. I’ll also check your hips, knees, ankles and feet for any problems that could contribute to causative factors. Generally, I will try to treat both the cause and the symptoms in the first session, although it depends on the severity of either.

Importantly there are several muscles that are deeper in towards the back of the shin bone, such as the soleus and the deep toe flexors such as the flexor halucis longus, these can sometimes be a sneaky cause of what appears to be calf or tendon pain. I will check these areas as well.

I will also give you information to help you minimise the stress on your calfs and tendons , often this will involve wearing heel lifts (these are rubber wedges in the shape of your heel that you wear in both shoes) these will take some of the stress off of your heels by stopping them fully stretching.

If you already wear high heels a lot, then a slightly different approach is required.

I may give you self massage instruction, and i may ask you to try running backwards. As an exercise the ‘eccentric’ contraction effects of this activity can be extremely helpful, although i prescribe this on a case by case basis.

Overall Calf and/or achellies tendon pain can be very difficult to resolve though sometimes it responds extremely well to the right approach. As you can see there are many factors to consider, and getting a thorough assessment is well worthwhile.