Calf and Forefoot Pain from Running Injuries

Calf and foot pain are very common manifestations of running injuries. Here are two examples of these problems. Tim, a new physical therapy patient, came to me with complaints of sudden calf pain. The problem began within the last 3 months since he had converted to a new “barefoot running style” and started wearing minimalist shoes. Tim was concerned that his calf pain had continued to worsen, and, after only 150 miles of use, there was excessive wear throughout the forefoot of his minimalist shoes. Prior to adapting this new running style and changing his shoes, Tim ran consistently for the last 30 years without any significant injuries and was able to get 300 miles of use from his trainers. I then explained that minimalist shoes have less material then trainers, and Tim’s new forefoot style of running put excessive strain on the calf. Thus, the stress on the calf from the forefoot strike in combination with the minimalist shoe led to an obvious premature forefoot wear pattern which, in turn, resulted in injury. I addressed Tim’s running mechanics and weaknesses and had him over his calf injury quickly.

Hank, a returning physical therapy patient, went more than 3 years without injury until he began wearing minimalist shoes and changed to a “barefoot running style.” Hank was concerned that after a full year and a half of successfully converting to the barefoot running style he began getting worsening foot pain. He then stopped using minimalist shoes due to premature wear, but his foot pain continued to increase and became crippling despite the fact that he returned to running in a new pair of traditional training shoes. Hank brought me his new trainers and I explained that the excessive wear in his shoe proved that he had adapted to this barefoot style of running and all of the force was isolated to his forefoot. I further explained that as Hank continued to run with this new style it caused break down over time, and he became unable to tolerate the continuous force solely on his forefoot. After a prolonged recovery, I taught Hank how to return to a “flatfooted running style” which distributed the force throughout his entire foot, as he had previously done for several years without injury.

Injuries after converting to a “barefoot running style” are a growing and now common problem that I see in my practice. In the first year of converting to the barefoot style of running, the injury rates sore due to increased strain on the legs from simply changing running styles. After a year, the injury rate for barefoot running remains slightly higher than other running styles because randomly changing to a forefoot landing pattern puts unnecessary, excessive load on the forefoot that causes breakdown overtime. Moreover, the barefoot style running certainly does not prevent injuries because all running injuries are multifactoral in nature. The best way to run is to use a properly designed, manufactured, fitted, and functioning running shoe utilizing a running technique that does not continuously overstress one particular area of the body.

The Running Recovery Program will help you to self manage calf and forefoot running injuries.


Bruce R. Wilk, P.T., O.C.S. is author of the “The Post Injury Running Recovery Program” and Director of Orthopedic Rehabilitation Specialists.

Dr. Annmarie Garis is a Certified Post Injury Instructor and Physical Therapist at Orthopedic Rehabilitation Specialists.

This entry was posted in Calf tear, Do I need running shoes, Feet injuries from running, Old running shoes injuries, Running injury calf, Running injury calf Achilles, Running injury calf strain, running injury foot, Running injury foot arch, Running injury foot instep, Running injury foot outside, Running injury foot pain, Running injury foot pain side, Running injury foot tendon, Running injury foot top, running injury muscle, Running injury top of foot, Running injury top of foot ankle, Running injury top of foot sore, Running injury top of foot tendon, Running shoe injury, Uncategorized and tagged , , . Bookmark the permalink.

78 Responses to Calf and Forefoot Pain from Running Injuries

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    • Bruce Wilk says:

      Does see runners that do all their running in “barefoot style” developing severe fore foot pain and dysfunction 3-5 years after successfully making the “transition”. My best advice is to master many strides!

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  22. sobe says:

    I have been a forefoot striker all my life and have never found a good shoe (my heels don’t touch). My biggest problem is that my forefoot gets extremely sore during my run to the point where I feel like I can feel the grid of the shoe in each step. I run 4-6 miles at a time and only 2 to 3 times a week. The only time it doesn’t hurt is if I’m going uphill. I have tried to change my stride to be more of a mid foot or flat foot striker but I just can’t do it. Any suggestions for me?

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  63. Bruce,

    Thanks for sharing! I’ve ready tons of studies that argue one way or the other on running style but it’s nice to get some anecdotal evidence sometimes. My question is, why are these patients adjusting their running styles after running injury free with their original form?

    I am a forefoot striker but that is what always felt natural to me. Making the transition into this running style should be done slowly and deliberately. Starting right away with a minimalist shoe is not the way to do it. I feature many great transition shoes on my website.

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