If you’ve never really paid much attention to that fleshy part behind your legs, maybe you should! Especially if you constantly experience tightness in your calves, painful feet and heel pain without quite knowing why. “Tight calves are extremely common – in fact, they’re one of the main underlying causes for myriad foot problems such as metatarsalgia and overpronation,” explains orthopaedic surgeon Dr Yung Shing Wai. “They also cause problems much higher up such as in the knees, hips and even back.”
What causes tight calves and how are they related to painful feet?
One might think injuries or physical activities are the leading causes of tight calves. In fact, most people who suffer from tight calves have it on both legs – and it’s often hereditary. They’re also thought to be “atavistic”, says Dr Yung – by those who believe that while the fastest animals run on their toes, humans walk with heels on the ground, thus needing a more flexible calf to walk comfortably.
When calves are tight, compensation results in the feet. The most common one is a deformity known as overpronation. “This is the rolling in of the medial arch and often leads to a flattening of the arches. The constant rolling of the ankle causes intense medial ankle tendon pain. This is the main ‘antagonist’ to tight calves,” warns Dr Yung, “when they are trying their best to hold the arch up against the big calf muscles. This can result in tendonitis and even rupture of the tendon.”
When they lead to overpronation, metatarsalgia and more
That’s not all! Further problems include arch or heel pain from plantar fasciitis, an inflammation of tissue in the sole. Overpronation is also associated with big toe deformities, the most common one being bunions – the bump that forms on the outside of the big toe. While people with higher arches can also get bunions, Dr Yung reveals that the worst bunions are seen in patients with collapsed arches and overpronation of the feet.
“Tight calves also throw weight to the ball of the foot, a condition known as metatarsalgia. Metatarsalgia can result in corns and calluses, toe deformities such as hammer toes and neuromas, and stress injuries such as stress fractures of the feet.”
Thankfully, there is no shortage of remedies available. Dr Yung walks us through some effective ones, below.
#1 Stretch, stretch and stretch!
“Regularly stretching against the wall or with a calf stretch board helps with pain. It is also very important to stretch before and after exercise.”
#2 Prescription insoles for painful feet
“Getting rid of the calf tension solves a great part of the problem, but it does not correct overpronation and flattened arches. Overpronation can be corrected with the use of insoles. Corrective orthotics are prescription insoles made by a podiatrist and are probably the most useful non-surgical treatment.”
#3 Keyhole surgeries to reverse heel pain
“Additionally, today we have minimally invasive procedures such as using an implant in the ankle area. This works as a stent to block overpronation, much like an ‘internal insole’. Another surgical procedure is the loosening of the tight calf, done with keyhole techniques either through a tiny open incision in the back of the knee or with a scope in the middle of the calf. This is minimally invasive with a fast recovery; patients can even start walking the next day.”
Dr Yung is the founder of SW Yung Orthopaedic, Foot and Shoulder Surgery,
#05-07 Mount Elizabeth Medical Centre, 3 Mount Elizabeth.
6235 5225 | 8101 2002 | swyung.com
This article first appeared in the November 2023 edition of Expat Living. You can purchase the latest issue or subscribe, so you never miss a copy!
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