Why Do My Calves Hurt?

Got that calf pain? Not sure of the cause?

Here’re a few potential contributors.

1. Delayed Onset Muscular Soreness (DOMS). DOMS is thought to be caused by an excess of hydrogen ions in the muscle, brought on by exercise of a newer intensity or a really high intensity, causing lactic acid release into the bloodstream. DOMS symptoms usually settle down within a day or two.

2. Tibial nerve related. The tibial nerve innervates most of the muscles in the calf. It is a division of the sciatic nerve. So if the sciatic nerve, the lumbar nerve roots, or the tibial nerve are impeded in any way, this may compromise the functioning of the calf muscles, causing cramps or discomfort.    

3. Nutrient deficiency (magnesium). Magnesium deficiency, also know as hypomagnesemia, is an often overlooked health problem. This may cause twitching, tremors, muscle cramps or muscle weakness.

4. Dehydration. As the blood thickens with dehydration, the muscles find it harder to contract and relax. This may lead to cramping or similar feelings. The loss of enough salt in the sweat may also lead to cramps.         

5. Muscle tear. Muscle tearing has different degrees. A low grade tear may be experienced with the high volume training seen in footballers. A higher grade tear will usually be felt immediately as a sharp pain or “pull.”   

6. Under conditioning. Often times, the calf muscle group can feel tight, with people presenting to a physiotherapist saying, “I need to stretch my calves more.” However, upon examination, there is usually no lack of flexibility. Often, the individual needs to improve the conditioning and / or strength of this muscle group to alleviate their discomfort.  

7. Inadequate blood supply (claudication). Claudication is a medical condition in which cramping pain in the leg is brought on by exercise. This is typically caused by obstruction of the arteries. It may be a symptom of peripheral artery disease (narrowed or blocked arteries in the limbs). This is more commonly seen in older populations plus those with co-morbidities such as heart disease and diabetes.   

8. Achilles tendinopathy. This is pathology of the Achilles tendon, and comes in different forms and degrees. The pain is not always ‘logical’ in that it does not always come on during exercise, but may be felt 8 to 48 hours following.   

(Medical Disclaimer: This is general education only and not specific health advice for any one individual).

At Destiny Health, we offer apppointments on the hour to investigate musculoskeletal aches and pains, and prescribe a tailored solution for the individual.


Gragossian et al (2022) Hypomagnesemia https://www.ncbi.nlm.nih.gov/books/NBK500003/

Pham et al (2014) Hypomagnesemia: a clinical perspective. DOI: 10.2147/IJNRD.S42054

Mayo Clinic (2022) Claudication https://www.mayoclinic.org/diseases-conditions/claudication/symptoms-causes/syc-20370952