11 Best Exercises For Calf Pain After Knee Surgery

Do you have calf pain after knee surgery? If you are experiencing calf pain you are not alone! Calf pain after knee surgery is very common.

I know this because I also experienced calf pain after knee surgery. There are many causes of calf pain. Calf pain after a total knee replacement surgery and calf pain after acl surgery are two common surgical procedures that may cause calf pain.

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Before we can treat this calf pain, we must first identify the root cause of the knee pain. After identifying the cause of the knee pain, this post will go into the specific exercises to fix calf pain after knee surgery related to muscular pain and tightness.

Causes of Calf Pain After Knee Surgery

Deep Vein Thrombosis

After any surgical procedure you are at a higher risk for a deep vein thrombosis or DVT. A deep vein thrombosis is when blood clots form in a deep vein.

The blood vessels coming from these deep veins are responsible for bringing blood from the body to the heart and lungs. When there is a blood clot in these deep veins, this can cause severe pain, most commonly in the lower leg.

Blood clots can also less commonly form in the thigh, arm, or pelvis. We will be focusing more on the deep vein thrombosis occurring in the lower leg or calf. Deep venous thrombosis can occur in the popliteal artery or popliteal vein of the knee.

Deep vein thrombosis is a serious condition. In severe causes the blood clot can break off and travel through the blood all the way to the lungs. This causes a severe and serious blockage known as a pulmonary embolism. In rare cases this blood clot can prevent the blood flow to the lungs, which can result in death.

A deep vein thrombosis can be the cause of post-surgical calf pain, but it is not the only cause.

Calf Pain After Knee Surgery That Is NOT Due to DVT

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If you are still reading to this point of the article you most likely do not suspect a DVT. That is great news! After my knee surgery I was frustrated because I was unable to find any information of calf pain after knee surgery that did not have to do with a DVT.

DVT’s are very important and if you ever suspect a DVT you should get immediate emergency care. However, there are other reasons for calf pain after knee surgery. The causes of calf pain after knee surgery are:

• Calf Pain After Knee Surgery Due to Lack of Knee Extension
  • This is probably the most common reason for calf pain after acl surgery or calf pain after total knee replacement surgery. Calf pain can occur when you begin walking before your knee joint has achieved full knee range of motion. This lack of range of motion is specifically knee extension, or ability to fully straighten the knee.
  • When you have this lack of range of motion you are forced to walk on a bent knee. Each time you take a step you are causing your calf to tighten up more, which can cause pain.
• Tight Calf Muscle After Knee Surgery
  • The calf muscles that are become excessively tight after knee surgery are the gastrocnemius and soleus muscles. These muscles attach to the achilles tendon. As mentioned before, walking with a compensation like a bent knee can also result in pain in the surrounding tissues of the calf or even in the back of the knee.
• Calf Pain Due to Calf Injury
  • Calf Strain: Calf pain due to a calf strain or calf tear is less likely after knee surgery. This is because a calf strain is usually due to a forceful or high impact motion such as running or cycling. A calf strain can also occur from an injury caused by a sudden or abrupt movement or jump.
  • If you just had knee surgery you are not jumping or making any quick movements. This means that your calf pain is most likely due to lack of knee extension.
  • If your calf pain is in fact due to a calf strain then the severity of your symptoms will depend on the grade of calf strain. Calf strains are typically graded I-III. A calf muscle pain due to a calf tear or calf strain will typically be associated with sudden calf pain.
  • This may feel like a pulled calf muscle. A calf muscle strain can be very painful but this type of pain is usually associated with a traumatic incident that caused the strain.

How Long Does Calf Pain Last After Knee Surgery?

Calf pain after knee surgery typically lasts until 3 months after surgery. Of course this can vary by person, however typically the calf pain is worse a few weeks after surgery when you start walking more. It is possible to speed up the recovery of calf pain through specific exercises.

Exercises For Calf Pain After Knee Surgery

These exercises for calf pain after knee surgery will improve your function and get you back to all of the activities that you love. These following exercises for calf pain focus on calf stretching and strengthening. Knee surgery can affect your balance. These 11 Creative Dynamic Balance Exercises To Improve Stability In Seniors will help to improve your balance.

1. Ankle Pumps

• This exercise can be performed in any position but it is most effective when performed lying down on your back with the legs elevated. Ideally a pillow or soft supportive surface should be placed underneath the ankles.
• Now bring your toes and ankle towards you and then push down like you are pushing down on a gas pedal.
• These ankle pumps do 3 very important things after surgery. They improve your ankle range of motion and flexibility. If your ankles are tight they help to relieve some of that tightness. The calf muscles are working and are the number one pump to get fluid out of the body. This will help to decrease swelling in the legs. Lastly and most importantly it gets you moving, thus reducing your risk of developing a DVT.

2. Calf Stretch

• This exercise can be performed 3 separate ways depending on your weight bearing precautions, surgery that you had and which muscles in the calf are tight. This exercise is also perfect for flat feet. These are the 11 Best Exercises For Flat Feet To Fix Knee And Back Pain.

3. Towel Calf Stretch

• This stretch is best for people who are not very mobile or who are not able to weight bear on their surgical leg yet. Start lying or sitting down and place a towel underneath your foot with your knee straight.
• Now pull the towel which will pull your toes and ankle towards you. Hold this position for 30 seconds. You should feel a good stretch in the back of your calf or lower leg.
• Be sure to perform this stretch only to your tolerance. It should feel like a good stretch but not painful.

4. Standing Calf Stretch With Knee Straight

• This exercise can only be performed if you do not have any weight-bearing restrictions with your surgery. Sometimes an ACL surgery is performed with a meniscus repair and you are nonweight bearing for 6 weeks.
• If this is the case just perform the first version towel version of this exercise. For this standing exercise, you will face a wall. For the purposes of this example let’s pretend that your left knee is the affected knee.
• Stand facing the wall with your right knee bent and in front and your left knee straight and behind. Keep your back heel on the ground and try to push it further into the ground. Hold this position for 30 seconds. Again do not push the heel down so much that it is painful. Just push to the point of a good stretch in the back of the calf. This exercise is stretching the gastrocnemius calf muscle.

5. Calf Stretch With Knee Bent

• Now stand against the wall in the same position as before but bend your back knee. Still lean forward into the stretch and push your back heel through the floor but keep your knee bent. This stretch stretches your soleus muscle of the calf.
• Depending on which muscle was tighter will depend on how much of a stretch you feel.

6. Quad Sets

• If your calf pain is due to lack of knee extension/ ability for your knee to straighten, this exercise will be very beneficial! Start by placing a small rolled up towel underneath your ankle. This helps to facilitate knee extension.
• Now tighten or squeeze your quad muscle, also known as the upper thigh muscles. While activating the quad try to push the back of your knee into the mat or bed underneath you. If you have a lack of knee extension the back of the knee will be hovering over the mat.
• Try to push the knee all the way down so that it makes contact with the mat below you. Hold this activation for 5 seconds and then relax. Perform 10 times. If you are interested in more knee exercises you can find them in 9 Forgotten Knee Exercises For Pain Relief.

7. Seated Calf Raises

• This exercise is a great exercise to get the ankles moving and to strengthen the calves. The easiest version of this exercise is in the seated position. Sit at the edge of a chair and slowly push up onto your toes. Now slowly lower heels back to the floor.

8. Standing Calf Raises

• Stand while holding onto a wall or supportive surface. Now push up onto your toes while your heels lift off the ground. Now slowly lower your heels back to the floor. The key here is to control the descent of the movement. Do not just slam your heels back to the ground.
• Please keep in mind that you can only perform this exercise if you do not have any weight-bearing precautions. Typically you should be able to perform this exercise safely after a knee replacement or ACL reconstruction surgery. Check with your surgeon to be sure.

9. Hamstring Stretch

• Lie on your back with your affected knee straight. Place a hamstring strap, sheet or towel around the bottom of your foot and lift your leg up in the air. Keep your knee straight and while lifting your leg as high as you can.
• Stop and hold to the point where you feel a good stretch in the back of your thigh.

10. Lie Down With Towel Under Ankle

• This isn’t a specific exercise, but it is a great way to increase your knee extension range of motion. Lie down with a towel or pillow underneath your ankle as much as you can. This allows gravity to help the knee to straighten out more. The straighter the knee is, the better you will be walking and prevent over-stressing your calf muscles.

11. Work On Walking

• Slow down and work on your walking form. By this I mean try to walk without a bent knee and without just swinging your leg forward. Often times when we are in a rush we walk the fastest way possible and neglect our form.
• This causes all kinds of compensations. Focus on placing your affected foot in front of you with your heel first. Put weight on your heel and then slowly shift weight forward onto middle of foot as you walk forward. As you begin walking and moving more after surgery you may develop back pain due to walking with compensations. Here you can find 7 Miraculous Exercises For Lower Back And Hamstring Pain.

Risk Factors of Deep Vein Thrombosis

Now that we have identified what a deep vein thrombosis is, let’s look at the risk factors of a deep vein thrombosis. There are a couple of possible causes of a deep vein thrombosis.

• Nerve damage
  • Nerve damage such as found in a vein injury most commonly found in fractures, muscle injury or a major surgery, specifically to the lower body.
  • An orthopedic surgery such as a total knee replacement surgery or acl reconstruction surgery are two examples of surgeries that are associated with developing a deep vein thrombosis.
• Decreased blood flow
  • This is usually caused by being bedridden or limited movement in a joint such as after a surgery
• Hormones specifically with birth control, and pregnancy
• Medical conditions such as heart and lunge disease and cancer
• Previous DVT or PE or family had history of DVT or PE
• Age
• Obesity
• Clotting Disorders
• Peripheral Artery Disease
  • Peripheral arterial disease results in the narrowing of the arteries that allow blood to flow to the legs and arms.
  • Peripheral artery disease can also cause calf discomfort on its own without the presence of a deep vein thrombosis.
  • If you have peripheral artery disease or peripheral vascular disease and are experiencing calf pain, it is important to seek medical care to determine what type of calf pain you are experiencing.

Preventing Deep Vein Thrombosis

The quick and easy answer to how to prevent a deep vein thrombosis is to move more! Although you may want to lie on bed not moving the week after surgery, this is the worst way to prevent a deep vein thrombosis.

The first week after your surgery you are at the highest risk of developing a deep vein thrombosis. This is due to the recent major surgery and decreased activity level. Your orthopedic surgeon understands this.

For this reason your orthopedic surgeon or healthcare provider will take preventative measures in order to decrease your risk. The American Academy of Orthopaedic Surgeons outlines the importance of preventative measures before a surgery.

Your orthopedic surgeon will most likely encourage you to move more. Although it may be more difficult with get up and walk, they will encourage you to at the very least perform ankle pumps to get the blood flow moving. This is important for patients after any knee surgery, including total knee replacement, anterior cruciate ligaments and meniscus tears.

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Your care team may also suggest wearing compression stockings. These compression stockings can help to decrease swelling in the calves and ankles. Lastly they will most likely put you on anticoagulants or blood thinners to reduce the risk of developing a deep vein thrombosis.

What Are The Signs of a Blood Clot After Knee Surgery?

Approximately 50% of people with have a DVT will not have any symptoms. For those that do develop symptoms they may have

• Swelling
• Pain
• Tenderness
• Redness of the skin

Many times these symptoms are localized to the calf. It is important to pay attention to these symptoms. After a knee surgery it is normal to have swelling and pain in the knee. However if you suspect a DVT or have any of these symptoms you should seek emergency care immediately.

Symptoms of Pulmonary Embolism

It is important to note that you can develop a pulmonary embolism with absolutely no symptoms of a DVT. The common symptoms for a pulmonary embolism are:

• Shortness of breath
• Chest pain
• Coughing up blood
• Irregular heart rate
• Low blood pressure.
• If you have any of these symptoms you should seek emergency care immediately.

Diagnosing a DVT

The most common way to diagnosis a DVT is through either a blood test or an ultrasound. The specific blood test will look for D-dimer which is a protein produced in patients with blood clots. This test will most commonly come back positive if the patient has a severe DVT.

The gold standard test for diagnosing a DVT is the ultrasound. This is due to the ease of the test, noninvasive and it’s good reliability of results. You can read more about

Pain Management

It is important to manage your pain after your knee surgery. This can be done through pain medications. Be sure to take your pain medication as prescribed by doctor’s instructions. In addition to pain medication you can also manage your knee pain with an ice pack. This can help to alleviate pain while also decreasing swelling.

Summary of Calf Pain After Knee Surgery

It is always a good idea to follow your surgeon’s instructions. The best way to fix your calf pain after knee surgery or after acl reconstruction surgery is to follow these physical therapy exercises. These exercises will help to assist you in your full recovery and get you back to your everyday activities.

It is always best to see a physical therapist so they can evaluate you and target physical therapy exercises to your specific diagnosis. If you did have an acl reconstruction surgery you can find 15 Fantastic ACL Physical Therapy Exercises to Rehab ACL Injury.

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