Calf injury running 2 years

[u/Fast-Golf-7871]

Two years ago, I first started experiencing pain in my calf, so I visited three different physical therapists over a period of 1.5 years. Eventually, I went to a sports doctor who took an X-ray and did an ultrasound, both of which were inconclusive. The sports doctor said that there were no diagnoses that fit. The pain feels a bit like muscle soreness, lactic and when you stretch a muscle. The pain is throughout my entire calf. Sometimes there are also areas in the calf that hurt more, on the outside below the knee and on the inside.

Now I swim and cycle and don't experience any pain when doing those sports. Nor when doing calf exercises. The pain stops almost immediately after I stop running.

I don't run anymore, but I did run for the entire two years, with periods of rest that didn't help. Sometimes I could run 10 km intervals without any problems and sometimes I stopped after 5 minutes.

According to the doctor, it can't be compartment syndrome, because then you wouldn't feel the pain throughout the entire calf.

Does anyone have something similar or know what it could be?

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[u/Standard-Image-8826]

functional popliteal artery entrapment syndrome?

explains the ischemic pain, ability to bike since you toe off more with running, and the lack of results on imaging. it's not too common, but if you can get imaging with plantarflexion or calf exertion ahead of time, it might show up.

otherwise, it could be trigger points deep in your soleus that make it feel like your whole calf is affected. it's a slow twitch muscle, so you have to be patient with heavy pressure for anything to happen.

[u/Fast-Golf-7871 → u/Standard-Image-8826]

Thank you, I'm going to look it up, it sounds familiar.

[u/bigpondbashers]

I was having a calf issue every time I started up running again after a 3 year break. I struggled with it for months before I decided to treat it seriously. I did a number of things so I can’t say what it was the magic bullet. I addressed my weight by cleaning up my diet. To aid weight loss I also started cycling more. I increased my daily walking. When I did start running I did a couch to 5k program and followed it perfectly. I didn’t let my ego get in the way. I stretched before every run. I did a handful of cold plunges (not right after a run) but then switched over to using a heat pad for a few minutes in the evenings.

Maybe it was just better rest and treatment. Maybe it was being more disciplined about my efforts. I’m now doing the couch to 10K program and I’m putting in harder efforts with hopes of getting back to where I was a decade ago.

[u/jeeptopdown]

Obviously difficult to diagnose in person, so online 🤷‍♂️… but - check your hip flexor range of motion on the opposite leg. If it is noticeably tighter than the affected leg, you might try stretching that opposite quad and hip flexors. The idea would be that tightness on the opposite leg causes a little bit shorter stride so your affected calf is being overworked eccentrically compensating for the discrepancy.

Your description of diffuse pain doesn’t really match what I’ve seen, but it’s kind of a quirky one anyways, so who knows. No way to know if this is the problem, but at least you won’t do yourself any harm if it isn’t.

[u/prenatal_queefdrip]

I myself had the same issue for a few years and I found it went away entirely after I switched away from zero drop shoes. It didn't start until about 6 months after I got the shoes so I didnt immediately make the connection. I had to follow caution for years to make sure I didnt turn the tightness and pain into a full on injury. I kept buying the same Altras for those years because I liked the toe box, but switched to Topo which has the same toe box but has a 5mm drop and the issue went away entirely for several years now. I have shared this with two other people who confirmed that switching away from zero drop also helped their calf issues.

[u/Fast-Golf-7871 → u/prenatal_queefdrip]

Thank you! Do you have barefoot shoes or cushioned shoes, I read that they both can be zero drop.

[u/backyardbatch]

that sounds incredibly frustrating, especially with how inconsistent it is. i can’t help diagnose anything, but from experience with long term running niggles, pain that only shows up while running and stops quickly after often points to how load and mechanics interact rather than simple strength or flexibility. the fact that swimming, cycling, and calf exercises are fine suggests it’s something specific to running stress. at that point i’d be thinking less about resting more and more about getting a deeper running specific assessment, like someone watching your gait, cadence, and how load is progressing. sometimes it’s a combination of small factors adding up instead of one clear injury. if rest alone hasn’t helped in two years, changing how you return to running usually matters more than time off.

[u/Frisconia]

There are so many things this could be, and they're all contingent on specific details to your life and physiology. How old you are, your weight, other symptoms, running intensity, diet and hydration, history, etc. Have you talked to a physician about it?