To avoid calf pains, runners must warm up and rest
Onset of pain
More serious cases
Treatment and prevention
Long distance running, or marathon, takes the challenge of physical endurance and will power to the extreme. Many companies and sports organisations in Hong Kong regularly run marathon events – for example, the annual Standard Chartered Marathon – raising citizens’ awareness and interest in this sport.
If you feel soreness or numbness in the calves after running in a marathon, do not ignore it, as it could lead to serious consequences.
The calf is made up of muscle “compartments” surrounding the two calf bones, the tibia (commonly known as the “shin bone”) and the fibula. Each of the four muscle compartments is surrounded by interosseous membrane and fascia (see diagram). During long-distance running, the calf muscles are called into repeated and continuous strenuous contractions. If pre-exercise warming up is not adequately performed, or if the leg muscles have not been tuned up with training, the muscle fibres attached to the interosseous membrane or to bone will be injured, either in the form of micro-tears or tears, leading to swelling and pain.
The site of pain is usually the inner side of the Soleus muscle that attaches to the tibia and the interosseous membrane. The runner normally does not feel much pain during the activity. Instead, pain and swelling frequently get worse the next morning. Fortunately, this kind of pain usually goes away after three to four days.
In more serious cases, the muscles in the calf are swollen beyond the tolerable pressure level of the surrounding fascia, causing not only pain but a decrease in strength, affecting the blood circulation to the muscle fibres and the nerves and vessels within the compartments. The inner calf, the sole and the heel would experience numbness or even sharp pain. These are symptoms of “chronic compartment syndrome”, caused by the higher-than-normal pressure experienced in the muscle compartments. The longer the person has been running, the worse the pain gets. But pain can be alleviated as soon as there is adequate rest.
When running, the tibia and fibula not only respond to the pulling action of the muscles, but also absorb the shock coming from the feet’s contact with the ground. If a person has not been training regularly, the calves will experience a sudden increase in workload. If the activity continues for a substantial amount of time, the consequence can be serious. For example, this could lead to stress fracture. The fractured area of the bone would experience sharp pain whether in motion, rest or sleep.
If a runner experiences persistent calf pain in running, he or she should immediately stop and get some rest. Other steps to take include putting the affected limb in elevation; applying ice to reduce swelling and pain. If the pain persists, or if it increases, a visit to the doctor is imminent. When the pain is taken care of, running can be resumed gradually based on the recovery process.
Although there are certain risks involved in marathon running, it is still full of fun and benefits as long as you have proper warm-up and training before a race, and only do what you can.