Most runners and other physically active individuals have experienced calf pain at one point or another. That feeling when your calf begins to seize up, and you immediately think to yourself, “Uh-oh.” You figure you’ve strained your calf muscle, and in many cases, you’re probably correct.
But not all calf pain is straightforward. Sometimes pain in that area can be something much more serious. Even in someone we consider to be of perfect health.
I recently evaluated a seasoned male triathlete whose training had been going well, but he reported to me that every night in the last week or two he had been awoken by fairly intense calf pain. He never felt this discomfort during the day; in fact, he felt he could have run without any issues if he had tried.
So, what could be going on?
I immediately became concerned about the possibility that the source of this triathlete’s calf pain was really a blood clot -- and that he was actually suffering from something called deep vein thrombosis, or DVT.
DVT occurs when a blood clot forms in one or more of the deep veins in your body, usually in your legs. The main danger of DVT: If the blood clot travels to your lungs and is large enough to stop blood flow, you could die.
Now, before you start worrying that every jab of pain in your calf is another blood clot forming in a deep vein, understand that there are some differences between DVT and your typical calf strain. In this triathlete’s particular case, two alarming differences were that he was experiencing only night pain (and no daytime activities aggravated it) and that his calf was slightly swollen with no clear mechanism of injury.
I cannot stress enough the importance of seeking advice from a trusted health care professional when you begin experiencing a new pain, especially one that’s unexpected and unexplained. Health care professionals are trained to identify the red flags that indicate higher likelihood of DVT versus another similar diagnosis. Dr. Google is not.
As a physical therapist able to see patients directly, I identified such red flags in this triathlete and had him schedule an appointment with his family physician for that same afternoon. DVT was confirmed via an additional test, and he then began a regimen of blood thinners to help dissolve the clot.
But the question remains: why did this healthy triathlete develop a blood clot in his leg? We don’t usually think of blood clots forming in individuals who exercise a lot -- rather in those who are overweight or obese, have just come out of a major surgery, or are laid up in a hospital bed. However, several circumstances can place healthy, active individuals at increased risk for DVT as well.
Even if you’re fairly active and in good health, if you’re traveling long distances by plane or car, dehydrated, taking oral contraceptives or are pregnant, you’re more likely to develop DVT. These risk factors are typically what an active individual not laid up in the hospital or at home will commonly face.
Some active individuals who suffer from DVT do not have any of these main risk factors though, so other, lesser-known factors need to be considered as well, including the influence of genetic predispositions and the impact of intense training.
Also, one other factor we need to discuss is the possible negative impact of poorly fitting sports compression garments like socks and sleeves. You’ll see many runners and other physically active individuals wearing compression socks or sleeves while training for or competing in different events. While many individuals appear to be wearing these garments with no issues, the ONLY factor that changed in the daily routine of our triathlete mentioned earlier was he began wearing compression socks on all his runs a couple of weeks before the initial onset of his calf pain.
Although individually-fitted, medical-grade compression stockings are often used to treat or help prevent DVT, there’s a difference between beginning to wear such stockings after being fitted by a professional and simply buying a pair of sports compression socks or sleeves at your local running store or online and then starting to wear them on runs right out of the box. We have to question if the compression socks worn by this triathlete were too tight around the top, thereby restricting circulation. When circulation is restricted, a blood clot is more likely to form.
One then has to wonder if this triathlete’s sudden wearing of compression socks could have been a contributing risk factor in the development of his DVT. Purely coincidental? Perhaps. But the possibility is certainly something to consider further. If you like to wear sports compression socks or sleeves when running or participating in other activities, you don’t necessarily need to stop wearing them, but my recommendation is to try to find a better fit if your current ones are feeling too tight in any one area.
Ultimately, the reality is we don’t know everything there is to know about DVT at this time, particularly in the case of athletes, weekend warriors, and other physically active individuals. What I recommend is to be aware of the many possible risk factors for DVT and do whatever you can to prevent one by consciously changing your habits.
For instance, if you’re traveling, make sure you take occasional breaks from sitting by simply walking around -- whether that’s on a plane or at a rest stop along the highway. Also, be mindful of staying hydrated throughout the day.
And if you happen to begin experiencing unexplained pain in your calf, do yourself a huge favor and speak with a trusted healthcare professional as soon as possible. You don’t want to wait too long to seek help and become another statistic.
Read more Sports Doc for Sports Medicine and Fitness.