Changes in daily routines and reduced physical activity can lead to unexpected issues — even if you’re less likely to get injured. One common effect of being less active is tightening of the two calf muscles that form the Achilles tendon. When the gastrocnemius muscle becomes tight, it can lead to “start-up pain,” often experienced as morning calf pain.
When pain occurs with the first few steps after arising in the morning or getting up from a chair and resolves after a minute or two of walking, this is referred to as “start-up pain.”
How The Calf Works
To understand what’s happening below the surface, a quick anatomy lesson is helpful.
The two primary muscles that join together to become the Achilles tendon are:
- Gastrocnemius: The gastrocnemius muscle forms the calf and assists with walking, running, and jumping. Tightness here can cause cramps or pain, especially in the morning. Regular stretching and gentle exercise help prevent discomfort. Persistent pain should be evaluated by a healthcare professional.
- Soleus: The soleus muscle, found beneath the gastrocnemius, stabilizes the lower leg and supports standing and walking. It joins with the gastrocnemius to form the Achilles tendon. Tightness in the soleus can cause morning calf pain and leg cramps, especially in those who are inactive. Regular stretching and strengthening can relieve discomfort and help prevent leg pain.
“When the gastrocnemius is tight,” Dr. Michael Castro explained, “the position of the knee can affect how the ankle moves. Since the gastrocnemius crosses the knee, it is typically slack (loose) when the knee is bent for extended periods of time. Most commonly this happens when sitting or in bed for the night. When the gastrocnemius muscle is slack, it will slowly tighten to take the slack out and apply a slight tension to the Achilles tendon.”
“Start-up” Pain
When one gets up from bed in the morning or from a prolonged period of sitting, the gastrocnemius is typically at its tightest. “This prevents the ankle from accommodating the body going over the foot. As a result, the heel must come off the ground sooner, applying greater stress to the foot and ankle,” Dr. Castro said.
This stress can cause “start-up pain” in a variety of places:
- Ball of the foot
- Top of the foot
- Front of the ankle
- Bottom of the heel
- Back of the heel (where the Achilles tendon connects to the heel bone)
- Achilles tendon itself
We know that gastrocnemius tension is the cause of “start-up pain” because it is the only thing that changes significantly as that muscle warms up and stretches out while walking. “This scenario can be amplified by the significant decrease in activity we are experiencing,” Dr. Castro said, “In the face of this change, we feel that stretching the calf on a regular basis can prevent the development of a number of foot and ankle problems associated with calf tightness.”
Dr. Castro’s Recommended Stretch for Calf Pain
Watch Dr. Castro demonstrate the calf stretch in the video above to ensure correct form and prevent calf cramps and morning leg pain. Regular calf stretches help maintain flexibility and reduce tightness, easing discomfort and supporting healthier lower legs. If pain continues or you’re unsure about the technique, consult a foot and ankle specialist.
Leg Pain and Cramps Staying Consistent?
If you notice that your morning calf or leg pain is becoming more frequent or is lasting longer each day, it may be a sign that a more serious underlying condition is developing. Early attention to worsening symptoms can help prevent further complications, such as chronic muscle tension, persistent cramps, or damage to the Achilles tendon. Keeping a record of your discomfort — such as noting when the pain occurs, how long it lasts, or if you experience muscle weakness — can provide valuable information for your healthcare provider.
When To Seek Help
Prompt evaluation by a foot and ankle specialist can help identify causes like muscle imbalances, nerve compression, or circulation issues, and allow for tailored treatment to relieve pain and prevent long-term problems. Effective management may include a combination of stretching routines, physical therapy, custom orthotics, or in some cases, surgical intervention for lasting relief and improved mobility.
