Calf pain can come from any of your thigh, calf or shin muscles also your knee and ankle joints. To establish where exactly the calf injury is, can be very helpful at identifying what structure is causing the pain. Calf pain can be caused by any of the muscles, tendons or joints, so let’s look at the different types of structures in the calf:

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Do you experience a pain when you’re walking down stairs, or climbing up them? Standing on your toes? Pushing the pedal while driving? Or even just pulling your toes to your head?

Each person’s case is unique and we want to address your specific needs. If you would like us to investigate or provide some insight, we invite you to contact us by clicking the link below.

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Muscle pain

Calf muscle strain is probably the most common cause of calf pain. The calf muscle group consists of two muscles – the Gastrocnemius muscle which is the big muscle at the back of the lower leg and the Soleus muscle which is a smaller muscle lower down in the leg and lies underneath the Gastrocnemius.


Your larger Gastrocnemius starts from the thigh bone (femur) above the knee joint and inserts into the heel bone via the Achilles tendon. When the muscle contracts it assists the Hamstrings in bending the knee but its main function is to point toes and ankle downwards towards the floor.  This is the same movement as standing up onto your tip-toes, or like a calf raise. The Gastrocnemius is the most powerful muscle of the calf that produces propulsion during movement such as sprinting and jumping.  A medial Gastrocnemius muscle injury is often referred to as “Tennis Leg”.


Your Soleus muscle originates below the knee joint from the Tibia and Fibula (shin bones) and also inserts (like Gastrocnemius) into to the back of the heel via the Achilles tendon. When the Soleus muscle contracts it also points your toes and ankle downwards, but unlike Gastrocnemius it has no effect on bending the knee.

If the Soleus muscle is damaged as opposed to the Gastrocnemius, the pain is usually lower down the leg but is not painful when attempting to bend the knee (unlike Gastrocnemius).   The Soleus muscle is the main calf muscle that gives us the ability to run for long periods (endurance activities).

Either of these two muscles can be injured but the usually the injury occurs at the junction where the muscle meets the Achilles tendon called the “musculotendinous junction”.

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Nerve pain

Nerve supply to the calf mainly comes from the Sciatic nerve at the back. Irritation, compression or impingement of these nerves can cause nerve pain in your calf. Sciatica is also a condition that can cause a nerve type of calf pain at the back of the leg, all the way to your toes. Often people describe it as a burning, constant pain.

Joint Pain

Joints can refer pain downwards from the knee, or upwards from the ankle. Joint pain is usually more difficult to pinpoint therefore a skilled set of hands would need to determine where the pain is coming from

Tendon Pain

Tendons are cables that anchors the bone to muscle tot the bone. Every muscle has a tendon on either side of the muscle, the one at at the top called the proximal tendon and one at the bottom, called the distal tendon. Any one or multiple tendons can become irritated causing a inflamed tendon and in the calf we have the Achilles tendon that anchors both heads of the  Gastrocnemius and Soleus muscles to the Calcaneus (heel bone). An Achilles tendinitis can progress to a tendinopathy, this is a state when your body stops repairing the injured tendon fibers and the risk of a complete tendon is very high.

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Calf pain, Calf injuries, Calf muscle pain, Calf injuries treatment, Calf muscle Physiotherapist
Calf pain, Calf injuries, Calf muscle pain, Calf injuries treatment, Calf muscle Physiotherapist

Calf Injuries

Calf injuries usually occur as a result of a sudden pushing off movement like jumping. It can also come from excessive over-stretching of the calf muscle while it needs to contract, like running up a hill. Unfortunately calf pain is extremely common, therefore we have helped many patient relieve their pain.

If you are suffering from calf pain, rather get it checked. Please do not delay in consulting your physiotherapist if you have injured your calf. Rather do something about it and get it looked at, than wait with your fingers crossed and hope it goes away.

An accurate diagnosis is vital to manage your pain and treat it appropriately, because what works for one problem rarely works for another. Many conditions can take many months or even years to heal when the diagnosis is incorrect or treatment is neglected.

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Calf Pain can be

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Causes of Calf injury

Calf pain is one of the most common leg complaints that we see in practice. Your calves contains some very powerful muscles in your body, not to mention you use them every day. We rely on your calf muscles in every step we take. The structures in the calf are vulnerable to injury especially overuse injuries i.e. repetitive movements like walking, climbing stairs and running.

Calf pain may be caused by:

  • Overload – Muscle or tendon strains and sprains
  • Overuse – Tendon inflammation, repetitive muscle strains
  • Poor management of a previous injury
  • Referral from other joints – Knee or ankle joint
  • Trauma – Contusions, or Tibia fractures
  • Autoimmune – Rheumatoid arthritis
  • Referral from nerves – Irritation, compression of the sciatic nerve branches
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What NOT to do

  • Anti-inflammatory medications are not recommended, especially in the first 48 hours as they are thought to delay healing

  • Stretch your calf through the pain

  • Walk, run, jog through the pain

  • Do not ignore calf pain that gets worse (it could be an sign of a Deeper problem)

  • Leave it untreated, if you are uncertain of the diagnosis, rather call us and be safe

What you should do

  • Follow a POLICE or PRICE protocol.

  • Make an appointment to confirm the diagnosis and determine the severity of your problem.

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Making the injury worse

  • Walking up a ramp or incline

  • Climbing stairs

  • Running uphill

  • Stair running drills

  • Sprint running drills

  • Single leg jumps

  • Giving a bigger stride in a jog or run

  • Walking on your toes or heels

  • Raising onto your toes, when dancing

  • Wearing high heels

Calf Pain Treatment

  • Acupuncture & Dry Needling
  • Heat packs (Thermal therapy)
  • Kinesiology Tape
  • Rigid Strapping or taping
  • Neurodynamics (Nerve tissue mobilizations)
  • Dynamic Strapping
  • Strengthening exercises
  • Guided loading protocol
  • Stretches (Static, dynamic and ballistic)
  • Moon boot
  • Brace
  • Compression Bandage or Sleeve
  • Supportive strapping and taping
  • Biomechanical Analysis
  • Gait Analysis
  • TENS
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PRICE protocol

1st Phase: Protection & initial Healing



We have found that patients tend to continue walking on the injured calf with a limp. The muscle still contracts every time that your weight is put onto the leg. It’s better to get crutches and keep the load off your calf. The main concern is to prevent your calf from further injury.


No weight on the injured leg. Use crutches to take the load off your calf.

As soon as there’s no pain, don’t test it. Give it time to fuse completely.



Ice cubes warped in a towel, tied around the calf reduces pain & inflammation and speeds up the healing process. For at least the first 3 days or until the swelling goes down, apply an ice pack for 20 minutes every two hours. Always keep a towel between the ice and your skin (to prevent a clod burn), and press the ice pack firmly against all the curves of your calf.



Use strapping (Leukotake S) or elastic compression bandage to keep your  muscles supported and prevent blood pooling in your calf. This can be done either with taping or tube grip bandage and helps to control swelling.



Lying on your back with your foot on a chair (your calf must be higher than your heart to allow gravity to assist in draining the pooled blood in your leg.) Raise your calf for 15 minute intervals during the day.

Each injury is different depending on the specific structure that’s a problem, so treatment is tailored to where you are in the recovery process. This is a Physiotherapists skill to determine what needs to be done to get you back to ‘normal’ again.

If we consider a Calf muscle tear, each injury has a set of guidelines and goals you must achieve, this includes:

  1. Regain Full Range of Movement
  2. Eccentric Muscle Strength
  3. Concentric Muscle Strength
  4. High Speed, Power, Proprioception
  5. Sport Specific Training
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Why is your calf pain lasting longer than expected?

  • You believed the calf muscle pain would go away over time (on its own) but it didn’t

  • You went to the Doctor who told you to rest your calf muscle and take painkillers. The painkillers helped to relieve the calf muscle pain but didn’t help your injured calf. As soon as the painkillers wore off, the calf muscle pain returned.

  • A family member (or friend) told you that “Everybody experiences calf pain as they grow older,” and that you should just accepted it

  • In the past you went to other Healthcare Professionals (or a Physiotherapist) but the calf pain treatment did not seem to help or solve your problem

  • YouTube exercises and home remedies didn’t help relieve the calf muscle injury, or in some cases made the calf pain ten times worse

  • You thought it would be a good idea to rest because your calf muscle pain was so sore. However, afterwards your calf muscle pain felt even worse than before

  • You went for massages, hoping they would relieve the calf muscle injury. The massages felt pleasant and relaxing, but didn’t do anything to fix your calf pain in the long term

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What to do?

Experiencing these situations or applying similar advice and not getting results is a good thing. Why? Because these experiences help you know what doesn’t work for you. It means that you are closer to finding out what does work for you!

We invite you to book an appointment with a Physiotherapist (at our Pretoria practice). During an appointment we assess your calf injury symptoms, diagnose the cause, educate you about what is happening in your body and then start treatment. See our FAQ for more in depth information about what to expect from a physiotherapy session.

Alternatively, click the link below to book a FREE phone call. The phone call is complimentary and there is no obligation to book any appointments with us after the call is over. This is an opportunity to get an expert’s advice about your situation. Our goal is to help you make an informed decision about what to do next concerning your calf injury.

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Choose a Cilliers & Swart Physiotherapist to aid you in getting rid of your calf pain

What can we do for you?

  • We quickly put an end to pain and stiffness – often within a couple of sessions

  • We help you find out what is going on in your body and help you understand the root cause of your calf pain

  • Pain can rob you of sleep or rest. We make it easier for you to return to your normal sleeping patterns and positions so that your energy and potential for recovery increases

  • Cilliers & Swart Physiotherapists closely manage and treat your problem. We also provide you with related exercises to speed up your recovery

  • Using painkillers in the long-term can be harmful to your health. We help you lower or completely stop your need for painkillers to manage pain

  • Our physiotherapists safeguard you against dangerous and costly surgeries and painful injections

  • We reduce visits to specialists or doctors who only order you to take more pills

  • Calf pain can limit the activities you enjoy with your family and friends. Our experts help you get back to spending quality time on the activities you (and your loved ones) like

  • We can get you to sit comfortably and walk longer than 15 minutes, in both cases without feeling that your calf is weak, in pain or about to collapse

In short, we help you get back to living life free from calf pain. For information about costs and availability, click the button below:

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4 steps to get rid of calf pain quickly.

  • Decide to get help.
    Many people put off going for treatment, that by the time they receive treatment the injury has worsened over time or caused other problems. Don’t think that calf pain will ‘just go away with time’. It might sound brave to ‘put up with pain’ over an extended period of time, but the lack of treatment could end up costing you more in terms of time (for recovery) and resources (money) the longer you wait.

  • Do the RIGHT exercises.
    One of the best things to help ease your calf pain is an appropriate series of progressed exercises (as advised by your Physiotherapist or Health Professional). The right kind of activities can reduce your pain and increase your range of movement. Above all, exercises ensure that problems don’t come back. However, the wrong kind of exercises have the potential to increase the pain in your calf even more.

  • Avoid sitting still for long periods.
    Ever tried to get up from the sofa after resting for a while, but you struggle? That’s because one of the worst things you can do is to ‘rest’ in a sitting position for too long. As a safety measure we recommend specific strengthening exercises for better posture. We can help you get active by combining these exercises with our Physiotherapists’ hands-on treatment.

  • Get hands-on Physiotherapy treatment.
    Physiotherapy is proven to improve the lives of people suffering from calf pain. Your calf pain could be affecting your physical performance in a professional or private capacity. It could even threaten your independence or get in the way of spending quality time with family and friends. Physiotherapy can enable you to live the life you desire as quickly as possible.

If you would like to know how the Physiotherapy team at Cilliers & Swart can help you, we invite you to book a FREE, no-obligation, risk-freeCall me backphone call.

Note: This Free Call is a service we offer to people who are nervous or unsure. You might not know if Physiotherapy is the right treatment for you. If you are unsure, please fill out our online form. We will contact you to find out what is wrong and how we can help. There is no financial obligation or risk on your part. You have nothing to lose except your pain.

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