Calf pain can have different causes (aches, stretching, tearing) and can occur after sport, at rest, at night, while walking… When to worry? A sign of phlebitis? What treatment?
Who has never had calf pain? After a workout? At rest ? This pain is common and can result from many causes: cramp, soreness, elongation, tear… It is usually benign. Be careful however, if the pain radiates towards the thigh, one can suspect phlebitis. What causes calf pain? How to relieve it?
What does calf pain after exercise mean?
► Curvature. “If there is calf pain following a sporting activity, it may be a stiffness or a contraction. The causes are lack of warm-up, stretching, hydration, or too intense activity., explains Dr. Amina Fouzai, sports doctor. Ithe pain appears within 24 hours, and they are differentiated by the intensity of the pain and the time to recover. “Calf pain often affects runners during a sprint”she says.
► Then there are the elongations muscle: these are the fibers of the muscle that tear during the activity. This leads to sudden pain during exercise, and more or less severe limping depending on the severity. “An elongation requires a sports stoppage of 21 days. A tear (or breakdown) is the category above. The shutdown will be longer: 45 days”, she details.
► In the most serious cases, there is muscle rupture. It is a brutal pain during the effort: impossible to set foot on the ground. “When the muscle completely de-inserts from the calf and tears off. It’s called a tennis leg, because it often happens to these athletes.” There is then between 8 and 12 weeks of stoppage. The difference between the breakdown and the rupture is made on ultrasound. When there is this kind of accident, the first measures must be taken immediately: “Ice immediately, elevate the leg, then compress with a bandage to avoid the hematoma. Then, you must consult”recommends the doctor. “The specialist will have a muscle ultrasound done, then prescribe a painkiller and anti-inflammatory treatment, and finally rehabilitation at the physiotherapist.”
What does calf pain that radiates to the thigh mean?
A pain in the calf, which can go up on the thigh, can also be the sign of a pathology, generally the deep vein thrombosisOr phlebitis. “It is a pebble of blood in a vein in the lower limb, which will block venous return”, explains the doctor. The classic causes are long trips, where you stay in a sitting or lying position for a long time. Phlebitis usually affects only one leg and causes spontaneous calf pain, increased on palpation. The pain can sometimes be caused by raising the forefoot. There may also be swelling of the calf, a feeling of heat, redness, and sometimes even a fever.
What does lower calf and heel pain mean?
Pain in the lower calf and ankle or heel, certainly indicates Achilles heel rupture. Indeed, it is attached between the muscle and the bone, behind the ankle. The break generally occurs when landing a jump. “There is then significant pain behind the calf, the patient will limp, the clinical signs show that he has ruptured the tendon”explains Amina Fouzai.
What tests can make the diagnosis?
The doctor performs a physical observation of the calf to determine the origin of the pain. The context is suggestive of the pathology in question (recent trauma, advanced age, history of phlebitis, prolonged immobilization or recent surgery are risk factors for phlebitis). In general, the most common cause is muscle cramp, involuntary contraction occurring during physical exertion. As seen above, it can also be muscle injuries such as a muscle strain or tear or a ligament cause such as an elongation. Other reasons can still be at the origin, such as problems of poor blood circulation (venous insufficiency), varicose veins… In the most serious cases, the formation of a blood clot in the veins of the limb inferior, also called venous thrombosis or phlebitis is involved. A negative biological assay of D-Dimers confirms, or not, the hypothesis of phlebitis. In case of persistence of doubt, a Doppler ultrasound of the lower limbs makes it possible to highlight the lesion. If this is the case, the search for the main complication of phlebitis, pulmonary embolism, should also be carried out.
There are as many treatments as there are causes of calf pain. In the case of muscle pain, treatment is based on taking analgesics and sometimes physiotherapy sessions. In the case of phlebitis, wearing compression stockings and taking anticoagulant treatment for a period set according to the context are essential.
In case of phlebitis, walking promotes good blood circulation in the lower limbs, as well as an elevation of the legs, which may sometimes be necessary. Compression stockings are also used. If there is a risk of developing phlebitis, anticoagulant therapy may be prescribed for some time. “In case of pain due to physical activity, warming up, stretching, as well as good hydration are essential”, insists the sports doctor.
Thanks to Dr. Amina Fouzai, sports doctor.