If with every step you take there's a dull ache or a stab of pain in your calf, something's not right. But determining just what's wrong might not be so easy. A number of things can cause calf pain when walking, from a simple strain to a blood clot. If you can't easily determine the cause of your pain, give your doctor a call.
If your calves hurt when walking, it could be a muscle strain, tendinitis, peripheral artery disease or a blood clot.
Calf Muscle Strain
A muscle strain occurs when muscle fibers become overstretched or torn. This happens either because the muscle was stretched beyond its natural range of flexibility or because an overly forceful contraction caused trauma.
A calf muscle strain commonly occurs while running or jumping, and it's a common problem for runners, soccer and basketball players, dancers and gymnasts, according to the American Physical Therapy Association.
This condition can affect any of nine different muscles in the lower leg; the gastrocnemius and soleus are the main muscles of the calf, but other muscles that are responsible for movements of the knee, toe and foot may be affected too.
Signs and Symptoms
Wherever the strain occurred, the symptoms will depend on the severity of the injury. Being able to walk is a good sign that the strain is not severe. Referred to as a grade III strain, the most serious strain results in a complete tear and a loss of muscle function. Grade I and II muscle strains are less severe, and usually, you can still do some some walking when you have them.
Along with leg pain, there might be some tenderness when you press on the muscle as well as swelling and muscle weakness. If there was a traumatic event that caused your calf pain while walking, a pulled muscle is a likely candidate.
Calf Muscle Tendinitis
Tendons connect muscle to bone. Just like muscles, they can become strained and weakened. When the tendon that connects the larger of the two calf muscles — the gastrocnemius — to the top of the leg bone degenerates or becomes inflamed, it causes pain in the upper calf behind the knee.
Tendinitis is an overuse injury. It comes on more gradually than a strain and can be longer-lasting. Calf muscle tendinitis is common in runners, and according to SportsInjuryClinic.net, increasing mileage too quickly or doing a lot of high-intensity sprinting can invite this type of injury.
Symptoms include a gradual onset of pain behind the knee. The pain may be made worse by doing calf raises or hopping on one foot; in certain cases, you might feel leg pain while walking or stretching your calf muscle.
Treatment involves resting the muscle and, as with a strain, applying ice, compressing the calf and elevating it to relieve pain and inflammation. Following that, targeted strengthening and stretching exercises can restore the tendon's integrity before you resume normal activity.
Achilles Tendon Leg Pain
Like calf muscle tendinitis, Achilles tendinitis is an overuse injury. Your Achilles tendon connects the bottom of the calf muscle to the heel bone, thus the pain is concentrated in this area. This condition is common in runners, especially when they have suddenly increased their mileage or intensity, according to Mayo Clinic. It's also common in middle-age "weekend warriors," or those who play sports only on the weekends.
The pain associated with Achilles tendinitis is often worse in the morning but improves with light activity. You might notice that it hurts in the beginning of your walk, but gets better as you go farther. However, going too far can cause the pain to flare up later on.
Treatment for Achilles tendinitis is the same for calf muscle tendinitis. Mayo Clinic says this type of injury can usually be resolved with self-care measures, but if the pain is persistent or severe, you should contact your doctor.
Delayed-Onset Muscle Soreness
Did you recently start a new workout routine or change up your old one? Or did you go for a long hike yesterday? Any time you challenge the muscles via strenuous activity, it causes damage to the muscle fibers. During the body's repair process, muscle pain is common, especially when it's a new activity that the muscles aren't used to.
Called delayed-onset muscle soreness, or DOMS, the pain typically shows up about 12 to 24 hours after the activity. This can cause muscle aches, sore legs or arms and pain for a few days after the workout. In the calves, you might feel more pain when walking because the muscles are contracting.
Coincidentally, walking may actually help relieve DOMS. Although there's no treatment, getting the blood flowing to the affected muscles often lessens the pain and stiffness. You can also apply heat or cold, do some gentle stretching or massage the muscles. Next time you do the activity that caused the pain, you probably won't have as much soreness because your muscles will have adapted as they recovered.
Peripheral Artery Disease
Peripheral artery disease (PAD) is a narrowing of the arteries (atherosclerosis) that occurs when fat and plaque build up in the arteries — frequently, those that supply blood to the leg muscles, according to Harvard Health Publishing. The primary symptoms of PAD are leg pain and cramping, most commonly in the calf. The pain gets worse with walking and dissipates when at rest.
Other symptoms of PAD include heavy, tired legs, fatigue, lowered pulse below the narrowed artery, scrapes and bruises on the legs that don't heal and skin that is cool and pale.
PAD is a serious condition that requires medical attention because it may lead to heart attack and stroke. Exercise and medication can improve PAD, and supervised exercise programs can help extend the amount of time sufferers can walk before the onset of pain. These sessions typically involve walking until the pain kicks in, stopping to allow it diminish and then walking again.
Deep Vein Thrombosis
Blood clots occur when your blood thickens and clumps in a vein. When this happens in a vein located deep within the body, it's called deep vein thrombosis (DVT). The lower legs are a common site of DVT, and the earliest signs are tightness and swelling. A deep ache that is worse when standing or walking may develop too. In later stages, the skin around the blood clot may feel warm to the touch and be discolored.
DVT requires medical attention. If left untreated, it can lead to varicose veins, ulcers and pain. While most blood clots dissolve on their own, a clot can break apart and travel to the lungs where it can cause a potentially fatal pulmonary embolism. Treatment for DVT typically involves weight loss, support stockings and medication.
- Harvard Health Publishing: Muscle Strain
- American Physical Therapy Association: Physical Therapist's Guide to Calf Strain
- SportsInjuryClinic.net: Gastrocnemius Tendinopathy
- Mayo Clinic: Achilles Tendinitis
- PainScience.com: Post-Exercise, Delayed-Onset Muscle Soreness
- Harvard Health Publishing: When Walking Makes Your Legs Hurt
- WebMD: Lower Leg Pain: Causes and Treatments