Can Plantar Fasciitis Cause Pain in Calf? The Link Explained

Can Plantar Fasciitis Cause Pain in Calf?

Plantar fasciitis is one of the most common causes of heel pain. It involves inflammation of the plantar fascia, the thick band of connective tissue running along the bottom of the foot from the heel to the toes. In addition to sharp heel pain, some people with plantar fasciitis also experience aching or tightness that radiates up the calf.

The connection between plantar fasciitis and calf pain is complicated. In many cases, the calf pain is referred pain stemming from the inflamed plantar fascia. However, plantar fasciitis can also contribute to calf tightness and trigger points which cause secondary pain. Unsupported flat feet or improper foot mechanics are often an underlying cause of both plantar fasciitis and calf pain.

Referred Pain

The plantar fascia helps support the foot's arch and acts like a shock absorber. It withstands tension and stress with every step. In plantar fasciitis, microtears and inflammation develop in the fascia, especially where it originates at the interior heel bone.

This manifests as intense localized pain when taking the first few steps in the morning or after long periods of inactivity. Plantar fascia pain often radiates in a diffuse pattern up the calf. Referred pain means the calf muscles themselves are not the true origin of pain, even though they ache.

A 2015 study found that nearly 30% of patients being treated for plantar fasciitis also reported pain in their calf or arch. Their heel pain reduced significantly after shockwave therapy, and the calf and arch pain improved as well even though those areas were not directly treated.^[1]

This indicates the foot was the primary source, with pain patterns extending up the leg. Other studies using MRI imaging reveal that mechanical stress and inflammation in the plantar fascia activate areas in the spinal cord related to sensation in the calf region.^[2]

Essentially, the inflamed irritated fascia sends signals to the spinal nerves that can be perceived as diffuse calf pain. Treating the underlying plantar fasciitis often relieves associated calf pain caused by referral.

Calf Tightness and Trigger Points

In other cases, true calf tightness and trigger points develop secondary to plantar fasciitis. Trigger points are hyperirritable knots in muscle tissue that can produce pain. They frequently occur in the calf muscles including the gastrocnemius and soleus.

Plantar fasciitis often alters gait mechanics. Sufferers start walking with their foot externally rotated to avoid stretching the plantar fascia and triggering heel pain. This also reduces ankle flexion.

These compensations overload the calf muscles. Having a tight Achilles tendon or calf muscles to begin with also increases strain on the plantar fascia.^[3] It becomes a vicious cycle - calf tightness stresses the plantar fascia, leading to more inflammation and pain. This indirectly causes more calf tightness.

Calf muscles may spasm or develop trigger points. Active trigger points in the calf refer pain into the heel area, mimicking or contributing to plantar heel pain.^[4]

Pes Planus Foot Posture

Many experts believe pes planus (flat) foot posture is an underlying biomechanical cause that predisposes patients to both plantar fasciitis and calf issues.

Those with fallen arches and overpronation (ankles roll inwards) put excessive tensile load on the medial plantar fascia. Pronation also requires greater effort from the calf muscles as they work to stabilize the ankle.

This chronic overloading of the plantar fascia and calves from poor foot position leads to pain and tightness. One study found that people with plantar fasciitis demonstrate weakness in their calf muscles, particularly the gastrocnemius.^[5]

Therefore, collapsed arches indirectly contribute to calf weakness and subsequent calf pain in those with plantar fasciitis symptoms. Addressing fallen arches through arch supports, taping, or foot strengthening exercises may alleviate both issues.

Other Potential Causes

Less commonly, pain that starts in the calf itself but radiates into the heel could be stemming from a calf tear or strain. Muscle imbalances between the calf and shin or damage to the calf nerves or blood vessels could also play a role.

Achilles tendonitis or a partial tear of the Achilles tendon can irritate the calf and cause heel pain. Bone spurs, arthritis, fractures, or a rarer condition like Baxters neuritis could be contributing. Severe circulatory problems like peripheral artery disease may also be involved.

In most cases, isolated calf pain without any heel symptoms does not indicate plantar fasciitis. But if the calf pain started after the heel pain or arch pain from classic plantar fasciitis, the two issues are probably connected.

Key Takeaways

In summary, the link between plantar fasciitis and calf pain has a few possible explanations:

• Referred pain from the irritated plantar fascia that radiates up the calf
• Calf tightness and trigger points that develop secondary to plantar fasciitis
• Underlying pes planus foot posture contributing to overuse of both the plantar fascia and calf
• Less common: Primary calf issues like strains, Achilles disorders, or nerve problems

Treating the underlying plantar fasciitis and addressing any foot biomechanics contributing to arch collapse will often resolve associated calf tightness or pain. Calf stretching, massage, and strengthening may also be beneficial.

Calf Pain Treatment

If you have been diagnosed with plantar fasciitis and have calf pain or tightness along with heel symptoms, the following tips may help alleviate discomfort:

Rest and Ice

Take pressure off your feet and calves by limiting activity that aggravates pain. Apply ice packs to help reduce inflammation.

Stretching

Gently stretch your calf muscles and Achilles tendon, especially first thing in the morning and before exercise. Avoid overstretching or pushing into pain.

Heel Lifts and Orthotics

Use heel lifts or foot orthotics to support fallen arches and reduce strain on the plantar fascia.

Calf Massage

Apply firm pressure and massage techniques to release calf tightness and trigger points.

Foot Strengthening

Perform foot intrinsic muscle exercises to support the arches from underneath.

NSAIDs

Over-the-counter anti-inflammatories like ibuprofen can temporarily relieve pain.

Night Splint

Wearing a night splint keeps the foot gently flexed overnight to reduce morning pain.

Physical Therapy

Seek guided calf stretching, massage, ultrasound therapy, and other modalities from a physical therapist.

Orthotic Devices

Custom orthotic inserts or devices like Strassburg socks help take tension off the plantar fascia.

Corticosteroid Injections

Cortisone injections may be considered if other conservative treatments fail to provide relief.

Surgery

In rare cases, procedures like plantar fascia release surgery may be a last resort.

When to See a Doctor

Make an appointment with your doctor if self-care strategies do not resolve your heel and calf pain. Seek prompt medical advice if you experience:

• Sudden sharp heel pain, especially with bruising or inability to bear weight
• Numbness, tingling, or loss of strength in your foot or calf
• Swelling, redness, or warmth in the affected areas

These signs could indicate an acute plant

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.