John Fiore, PT
Sapphire Physical Therapy

The days are longer, the temperatures are warmer, the trails are inviting, and the upcoming road and trail running races are ever closer.  It happens to us all:   First you feel a slight tightness in your calf, Achilles, or hamstring, and eventually you may find yourself hobbling around tight and sore.  How did I get injured?  Should I rest?   Am I stretching enough?   Is my training schedule in jeopardy?  Do I have a stress fracture?  Is this what tendonitis feels like?   Do I need new shoes?   What can I do to keep these nagging lower leg injuries to a minimum?   How can I fit in core exercises and physical therapy into my training plans?

The answers to these injury related questions is simple if the cause of the injury is correctly diagnosed.  Pain is often not the source of injury, but rather the manifestation of an unrecognized cause.  Asymmetry in lower extremity joint motion, muscular strength, muscle and tendon tissue tension, and rest & recovery routines are the most common causes of running-related leg pain.   While pushing ourselves through training and completion is healthy, ignoring the warning signs of soreness and pain is not.


Hilly trail runs, fast, flat road runs, and large mileage increases all lead to calf soreness.  While post-running calf soreness an accepted consequence, soreness which persists longer than one day is not.  Post-run deep tissue retrograde massage and ice will help relieve the symptoms.  Proper stretching of the calf (gastroc and soleus) will improve tissue extensibility.  Proper nutrition and hydration will speed recovery and reduce soreness as well.

If soreness persists or increases two or three days post-running, seek medical advice to rule out medial tibial stress syndrome (included in the basket term “shin splints”), excessive resting muscle tone/tension, overpronation due to weakness in the intrinsic foot musculature, or stress fracture.  A comprehensive physical therapy consultation with a physical therapist familiar with diagnosis and treatment of running injuries is a wise place to start.


Achilles tendon soreness should not be taken lightly as the Achilles tendonitis can be tricky to heal.  Preventing Achilles tendonitis is much easier than treating tendonitis symptoms.  Standard calf stretching often does not address Achilles tightness.  Deep tissue mobilization, foot stabilization & mobilization, running analysis (over ground, not on a treadmill), and proper Kinesio tape techniques provide effective treatment and expedite a return to a full training schedule.

Running-related hamstring soreness may have a variety of causes.  While hamstring tightness is often blamed for hamstring pain, stretching alone often results in chronic hamstring issues.  Hip joint compression, pelvic obliquity, lumbar spine stiffness, and hip/gluteal muscle weakness are the most common causes of hamstring soreness.  Once more, a comprehensive evaluation which investigates the cause through hands-on clinical testing will bring about an effective, long-term solution and return to running.

Contact Sapphire Physical Therapy with your running-related or other injury questions.  Visit our website for more information on our comprehensive services and run pain-free!!!