Categorized | Injury

Ask the Experts: Dealing with Sore Calves and Achilles Tendon Discomfort

Posted on 14 October 2011

 Dear Mark,

I follow your site and blog and your writings have been a powerful influence in getting me to start running again at age 48. After many years and many injuries I finally heeded to the doctors’ advice that “running causes injuries” and “running is not for everyone.” Doctors and experts told me that I was an “overpronator” and suffered from “patella misalignment,” and that the combination of these two so-called conditions made me unfit for running.

Only recently, after accidentally stumbling into an article about minimalist shoes I started researching into this topic. I’ve been running again for two months trying to follow the advice of Danny Dreyer and Barefoot Ken Bob (I own both books) plus information on sites like yours (By the way, your videos showing your stride are priceless). I run exclusively either barefoot or in FiveFingers.

In two months I’ve changed my landing from heel to forefoot, beaten plantar fascitis and completely avoided knee pain. Amazing. I’m so excited that I think I may have been running too much, so now I’m keeping a log and measuring my routes .

All through my adaptation period I’ve dealt with sore calves, but it’s the “good” soreness, the one that comes from your muscles working, not from injury. Yet recently I started feeling some discomfort in my Achilles tendon and I immediately slowed down my training as I remember a friend developing a painful long-term tendinitis. A local doctor said that I need to move away from zero-drop shoes and consider higher heels and inserts… so I think I’ll go looking for another doctor.

Anyway, I don’t think this is medical, I think this is a form issue. Could you please, if possible, share with me some tips to reduce the impact of my new running technique on my tendons? I apologize if this is not the right way to ask a question for the “Ask Experts” section, but I couldn’t find other way to do it. Whether you find the time to answer my question or not, thanks for your attention and for taking the time to educate runners on healthy running.

Best,

P.M., Dallas, TX

***

Dr. Mark responds:

Ccongrats on your journey into learning and discovery. Yes the very progressive approach is important; you are loading things in the correct way now but many of your structures need retraining and gradual applied stress to achieve adaptation without overuse.

Many get what Ken Bob describes as the “Barefoot Exuberance” syndrome sine you are feeling free again. What you do outside of running is critically important. get in a very thin flat shoe for work and chuck the desk chair.  Have a stand up desk and as you work do some one leg balance and even use a slant board to do some gentle stretching of calf/Achilles. Over weeks and months this gets your whole kinetic chain and core strong.

On gait. follow the Chi/Ken Bob advice: really light and soft short strides. There is nothing called too slow.  I train really easy and slow. This lets me wake up wanting to run the next day.Let me know your progress. And yes….the doctors are your worst enemy.

***

Dr. Steve Gangemi aka Sock Doc responds:

Good to hear you’re back into running despite what others wanted you to believe. Well done! Many people who have run (and walked) improperly for so long due to poor gait mechanics and improper footwear have developed a shortening of their Achilles tendon. So now that you’re running in very minimalist shoes and barefoot those tendons are going to slowly, and naturally, elongate themselves out. You definitely do not want to go back to high heels or inserts, as you have already figured out.

There are two main ways I’d recommend you reduce the impact. First, don’t over-do your new barefoot gait by running too much, too fast. If your Achilles are starting to hurt, you need to back off a bit either in distance or use the VFFs more than barefoot. Second, look for trigger points in the calf muscles and vigorously work them out, as I show in my Achilles Tendonitis video.  That will reduce the strain on your Achilles significantly. Do not look for trigger points in your Achilles, but the actual calf muscles. It will be tender in the Achilles but you will just aggravate the problem. This is the link between your sore calves and your Achilles discomfort. The muscles are overworked, and now your Achilles is having to work way too hard. So correct it now before it gets worse.

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25 Responses to “Ask the Experts: Dealing with Sore Calves and Achilles Tendon Discomfort”

  1. P.M. says:

    Dear Mark,

    Thanks for your response.

    I’m truly amazed at all I have discovered in such a short period of time, I only wish somebody would have told me all this twenty five years ago!

    But twenty five years ago there was no internet and we just followed our coaches’ advice, “no pain no gain” and “go harder.” I always had knee problems and I was always a heel striker, yet nobody ever assumed the two were related. And while coaches would praise forefoot-landing runners for their perfect mechanics, it seemed as if being a forefoot or heel striker wasn’t a choice but a genetic condition, you were either “born” one or the other. Some people were lucky to have “good mechanics,” others -like me- were not so lucky. The solution was always a different shoe, inserts and RICE. And trying harder.

    In 2000, while trying to finish a 5K in 20 minutes I suffered a tear in my left knee cartilage and for a full month I could barely walk. Running was definitely out of the question. By the time I healed, I was done with running. Over the next ten years, because of lack of exercise and “solidarity weight” during my wife’s pregnancy I put up 30 pounds of extra weight.

    I’ve now discovered that you can train yourself into changing your gait in a very short period of time and as I result I certainly suffer from some form of running exuberance. I know I need to slow down, but after 20 years dealing with knee pain and plantar fascitis, being able to run without having to worry about causing permanent damage to my body is an exhilarating experience! In fact, the nights I can’t run I feel like a caged animal.

    In a little over two months I’ve already lost 12 pounds and I’m two pounds from abandoning my “overweight” BMI (for what is worth). I’m down one jean size and everybody notices I’m leaner and have more stamina. My heart function, cholesterol and blood pressure are, according to my doctor, better than most of the 20 year-olds he sees at his office.

    Imagine if I had been running non-stop, injury-free for the past ten years!

    As for your technique recommendations, since reading Ken Bob’s book I’ve tried to increase my cadence to 180 while keeping my heart rate below the aerobic threshold and… it’s not easy but it appears to be working. Actually as long as I’m below my aerobic threshold it seems like I could run for hours. The only con is that both barefoot and minimalist running with their high cadence / short stride combination have made me terribly slow, but after seeing you run I’m sure speed will come as I improve my aerobic base.

    My running style needs improvement, as I’ve had no coaching in alternative running styles, this is why your videos are so helpful.

    In the meantime I will also follow your advice, will try to spend more time standing up and I will also try to make calf / tendon stretches a part of my daily routine.

    Thanks for your advice and encouragement, it means a lot coming from a successful runner like you.

  2. Alec says:

    Hi Mark,

    Just got back into running again after a 3 week break due to running the Great South Run in Portsmouth UK. As it was dark I wore my Vivobarefoot Achilles with toe toe socks and ran 6 miles without any problems, but after after two days my calve muscles are aching due to the lactic acid. So my question is when running barefooted or in barefoot running shoes are my calves suppose to ache (a good ache).

    Look forward to hearing from you soon.

    Kind regards

    Barefoot Blond – HAPPY BAREFOOT RUNNING :O)

    • MarkC says:

      Barefoot Blonde,

      Your calves should not ache after you have transitioned. The ache is rarely due to lactic acid too. I’d be curious as to what your calf mobility is. Can you do a deep squat and get balanced on the forefoot with heel on ground…this is a good assessment of calf mobility.

      As long as it is a good ache though you should be able to safely work through it.

      Keep up the progress and have fun!

      Mark

      Mark

  3. P.KANDASAMY says:

    I HAVE A KNEE PAIN-MENISCUS-ORTHOTICS -OR CARTLEGE PROBLEM-WHICH TYPE SHOE IS BEST FOR ME-? [---THIS CONDITION DEVELOPED BECAUSE I WORKED AS LONG TIME STANDING WORKER-IN NIGHT SHIFT FOR 3 YRS.]==PLS HELP ME

  4. Signa says:

    I had a motorcycle accident 25 years ago (at age 17) that completely destroyed my ACL and PCL. After 4 reconstructive surgeries over a period of 10 years, I was pretty certain that running would never ever be in my future. In fact, just two or three jogging strides would inflame my knee and create swelling and limited mobility that lasted for weeks. But seven months ago, at age 41, I took up running for the first time in my life. After researching the barefoot running movement I realized that it might be the answer I was looking for, and within 6 months I was running three days a week (a 3 mile, 5 mile, and 8 mile run each week). I have been thrilled to discover that I can do these distances without any pain in my knee what-so-ever, and with only minimal achiness in my ankles and feet. But then — BAM. During my last run the outside of my left foot began to hurt just under and around the posterior ankle bone, and by the time I got home I was limping and it was swollen. I found your site looking for answers to what just happened and it sounds like I got caught up in the euphoria and have fallen prey to over-training — too much too soon, too intense. So, I’ve gotten out my HRM and after taking a week off will start again making sure I’m running aerobically (which I know I wasn’t doing consistently except on my longer run) and will make sure that I work up more slowly and build a better foundation. I’m anxious to get started again because I LOVE running, but I won’t push it. I want to be able to run well into my 80s and 90s and I know that putting the right type of training in now will let me do that.

    • MarkC says:

      Signa,

      Amazing story on your return to running. Good news on the achilles pain is that is will heal and you will progress gradually.

      Keep is mellow and slow and do no more than a minute on your first day out. Add a minute of running a day to your walking and other cross training…this will keep the stress progressive.

      Mark

      Mark

  5. Annalisa Percy says:

    Great stuff Soc Doc and Dr Mark !
    Here is my question, I have received a very recent diagnosis of unilateral osteoarthritis + complicated labral tearing in my hip following a traumatic hamstring tear ( from “too much too soon ” track workouts – complicated by a workplace back injury with disc involvement at L3 to L5 )
    The hamstring is healed thanks to 3 x PRP and I am running again in my 5 Fingers ( too cold here for barefoot -:)
    The barefoot style of running does not cause me any pain while running but I do have pain and stiffness after and cannot sit for very long without residual pain at the ischial tuberosity
    In both your wise opinions , is there anything I can do to keep running ( the ortho Doc says to minimize impact and to come back in about 5 years for a hip replacement when I can’t take the pain …)
    I am an otherwise fit athlete with a Masters track and marathon background, and will go crazy if I cannot run -:)
    Thanks for all you guys do !
    The website is looking awesome and I keep sending my students to it for reference !
    Annalisa

    • O. Cabby says:

      Go to YouTube, lookup Egoscue and ecise and consider ordering the 2 DVD set and do the exercises. Worked wonders for me after several decades of suffering. I apologize if this recommendation breaks an advertising rule. I’m not connected with them in any way.

  6. Sheryl says:

    I, too, have just been getting back into running after a few years layoff due to lower back issues. I had been taking it very easy, just sporadically running and walking (I have turned to biking as my main exercise, but really miss running). I started with the 5 Fingers and would walk about 5-10 minutes, run for 5 (either on grass or dirt), walk and run another 5 a couple of times a week. The first time I did this on pavement, I felt a twinge or pain in my Achilles so I walked the rest of the way back home. It felt better the next day, but a couple of days later I was playing tennis. That didn’t work. ANYway, after a few months of PT, it seemed to be fine and I was “allowed” to ease back into running.
    I have been running a couple of days a week on the treadmill: walk to warm up, run a minute, walk a minute, etc. for a total of about a mile of running. This lead to a little more running intervals. After a few weeks of this, suddenly after a run (probably a total of 14 minutes of running intervals – not sprinting at all), my Achilles tendons were sore. I rested them (stretched – just continuing the stretching I had been doing for PT – and strengthened, still, but no running) and tried running again after about 9-10 days. I can barely walk! Tiny steps, and going downstairs is a challenge.
    I watched the Achilles/calf treatment video, but I can’t find any pain in my calf – it’s only my Achilles…and not right down at the heel, but just along the tendon.
    Can you help me, so I don’t make it worse?! I thought I was easing into this barefoot running and trying to be so careful. This is a huge disappointment.

  7. Richard says:

    Dr. Mark: I ran for years, from college to my late forties, until a couple of years ago when I began to have lower back problems and my legs just felt like lead. I’ve read Born to Run and my wife and I visited Two Rivers Treads last November and I bought a pair of Altra Adam shoes.

    Since then, I’ve been slowly transitioning to proper form. Initially I couldn’t go more than a quarter mile without both my calves stiffening considerably–almost seizing up. I would stop, and within a day or two the “stiff” feeling would resolve and I’d run again. At the rate of about two runs per week, it’s taken a few months but I am slowly extending my distance (up to about a mile now) and my calves are holding up pretty well, though I still feel some stiffness the next day.

    I guess I’m just wondering if this is a normal trajectory for transitioning to proper running form? Everything else feels great–no lower back pain and my legs feel like they have energy. I am really excited about the prospect of being able to run again on a more regular basis. Your latest video was very interesting.

    Thanks for your attention.

    Richard

    • MarkC says:

      Richard,
      Thanks for the note and you are teaching others. the transition can take years but when things are reset you have it forever. Listen to your body as you are…trust it and progress. the body adapts, just do not exceed the current capacity. Mark

  8. Lisa says:

    Thanks for all the great information! I am currently off running temporarily due to a calf muscle issue and corresponding foot pain. I know that I overtrained, so I will be taking all of your fabulous advice to help me recover quickly. I’m eager to get back on the road and practice the running form that I saw in the other video.

  9. Miriam says:

    Dr. Mark,

    Just discovered your website and am reading as fast as I can all the amazing information. I have been running in minimalist shoes for about 1 year now. Started with Newtons and presently been running with Merrils and VFF’s for about 3 months – been trying to take it slow like I’ve read from other websites. Am dealing with Achilles Tendonitis, I think from going to fast or too much running. I have a 1/2 marathon next week so hope my lower leg doesn’t let me down. Going to try doing the trigger point massage as much as I can till race day. Thanks for all your knowledge.

  10. Aubrey A says:

    I have been running in VFF’s for about 6 months now, and am thoroughly enjoying it! Currently waiting for my HR monitor to arrive in the mail to begin aerobic training. I have been trying to find out if post run stretching/yoga (such as before going to bed) is something you would recommend? I can’t seem to find any info on this so I thought I would ask here. Thank you for all your great advice!!
    Aubrey

    • MarkC says:

      yes! if you are tight in calves and hip extension stretch later in the day. i’m in hip stretch (lunge) now while typing this. Mark

      • Aubrey A says:

        Thanks! I wasn’t sure after reading the article on Phil Maffetone’s website that was about stretching… Have you read it? I would love to hear what your opinion is on it. Mainly my calves are tight, but my hamstrings also. Doing some stretches really helps them feel relaxed!
        Thank you!
        Aubrey

  11. Chris says:

    Hi,

    I’m currently suffering from the “too much, too soon” syndrome (transitioning into minimalist shoes) and have developed some pain in my achilles. Question is: When can I start running again? Should I wait until my achilles feels 100%? Will my achilles flare right back up?

    Thanks!
    - Chris

    • MarkC says:

      Chris, do some eccentrics with the Achilles and start with very gradual walk/runs.
      Mark

      • Chris says:

        Thanks for info! Great website by the way! Have taken about a week off, no running. Achilles still not 100%. So it looks like another week of no running. Lots of biking. Thanks again!

  12. Eric Cooper says:

    Sorry to be contrarian but Tibialis Posterior, the body’s pronation regulation muscle, refers pain to the Achillies Tendon. Janet Travell MD, author of the gold standard on muscles, Myofascial Pain and Dysfuntion, call the Tibialis posterior the:’Runner’s Nemesis”

    Most Achillies pain is referred pain from the Soleus or Tibialis Posterior. Pain is a liar. The problem is often not where the pain is.
    -Eric Cooper

  13. Tori says:

    Oh, I am always so jealous of anyone who has overcome plantar fascitis. I’ve been struggling with it for years!! Now I have increased my workout intensity and have aggrivated my calves. The shoes that feel good on my feet aggrivate my calves and vice versa. I am so discouraged. I, too, have always been told that foot pain is inevitable because I am flat footed. I so badly want to train and have no idea where to start to eliminate the pain. Any input is appreciated.

  14. Kelly says:

    Hi,

    I recently ended college running and have been doing my runs faster and shorter… I think not giving myself much recovery/easy days. I have been battling what i think is achilles tendonitis. I have never had an achilles injury all through college, many other injuries though. A podiatrist gave me a heel lift to use. I am taking time off and it just isn’t getting much better. The weird thing is that my leg feels fine when I am walking around without a shoe on and pain is there instantly once a shoe is put on my foot.
    Have you ever heard of this?

    Thanks,
    Kelly


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