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How To Tell The Difference Between A Calf Cramp And A DVT?

By April 26, 2017February 7th, 2024Physiotherapy, Running, Sports Physiotherapy

Have you been making the most of the Barangaroo Reserve running route? Or testing yourself on the Barangaroo stairs? A common complaint among runners is cramping in the calves. But how do you tell the difference between a straight forward calf cramp and a more serious injury like a DVT?

A DVT (deep vein thrombosis) is a blot clot that forms as a result of blood thickening and clumping together in a vein deep in the body. A muscle cramp is defined as an uncontrollable and painful spasm of the muscle.

Signs & Symptoms of a DVT

– pain and tenderness in the leg

– pain on extending the foot

– swelling of the lower leg, ankle and foot

– skin that is red and warm to touch

– a “tiredness” in your calf
A calf cramp can commonly present in both legs, where as a blood clot will usually appear in one spot. A DVT will often present with pain, redness, heat and a palpable lump, whereas a strain or muscle cramp will be painful but doesn’t always have redness or heat radiating from the area. A cramp can usually be “walked off”, whereas a DVT has a constant pain intensity.

Risk Factors for a DVT

– prolonged bed rest

– long haul car, train or airplane journeys

– obesity

– smoking

– varicose veins

– major surgery or serious injury

– pregnancy, hormonal contraception and/or hormone replacement therapy

– stroke

– spinal cord injury

If you’ve experienced a running injury or any lower leg pain that you’re uncertain of, be sure to have it looked at with one of our Bend + Mend Physiotherapists today. We have clinics at both Darling Park and Martin Place in Sydney’s CBD. If you’re concerned you might be suffering symptoms similar to that of a DVT be sure to book an appointment with your GP immediately.

Bend + Mend

Bend + Mend has been providing Sydney’s CBD with Physiotherapy and Pilates services since 2003. We have 4 great locations in Martin Place, Barangaroo, Darling Park and Circular Quay, all with private rooms and specialised one-on-one care. We also have Sydney CBD’s best-loved Physios who have helped over 10,000 people recover from pain and injury.


  • joanne clarke says:

    Hi their, I get pain and throbbing in the back of my leg, hard to sleep at night, and can’t rest my other leg on it in bed to sleep, starts hurting, not sure what is going on. Yours joanne clarke

  • Hi Joanne,
    Thanks for your response! Some of your symptoms could be related to DVT but they could also indicate other musculoskeletal injuries depending on your presentation and clinical history. The most important thing is that you have your leg properly assessed to rule out anything sinister, and some treatment to help reduce your pain. I’ll email you to see if we can organise someone to see you for a more thorough assessment of your leg in one of our clinics. If you’re not in Sydney, then we can review you by Telehealth and help work out the best management for you.
    Kind regards,

  • Donna says:

    I get a leg cramp not overly frequent but enough to be concerned usually I’ve leg cramps in the middle of the night that pain then doesn’t go away for days although the actual cramping sort of goes away if I’m in a certain position too long it cramps again . I go gym and seems to be after lunges and I can’t stop the pain usually a week after the first cramps help please

  • Ben Cunningham says:

    Hi Donna,
    Sorry to hear about your calf cramps! Cramping in the calves can occur for many different reasons and the fact it seems to be after lunges may suggest some muscle weakness or motor control problems. Having an in depth discussion about your activities, loading patterns and assessing your strength will give us further insight into this. Our reception team will reach out to help you organise a physiotherapy appointment. Thanks, Ben

  • Monique Matthews says:

    So I put on some military boots that I have not worn in a while. I don’t know whether I tied them too tight around the ankle but a few hours later I started having slight cramps but enough to notice in the back of my calf with each step that I took while we were shopping. It started to hurt to put any pressure on it although I did go and take the boots off and wear slippers the next day. A few days later I’m experiencing cramps in the back of my calf or a pain that is dull but recognizable that it is there.

    • Hi Monique, sorry to hear that you’ve had these issues with your calf. This is a slightly trickier one to work out as the tight boots definitely sound like they were the main cause of your problem but it’s unclear whether this is more the pressure of the boot on the calf muscle group or whether it is something a little more in line with DVTs. Although DVT sounds less likely in your case, if it’s still a problem now then I’d get it checked out by your physiotherapist or doctor so that they can take a closer look and give you the best advice with a specific examination of the area. Good luck with it all!

  • Jeannie says:

    Hello I have pain in the back of my thigh. It’s excruciating. I can’t even walk for more than 2 minutes or sit on my thigh.

    • Hi Jeannie, I sorry to hear you are in so much pain. If your symptoms have been brought on by a recent activity (like running) I would suggest stopping that for the moment. DVT pain is usually located in the lower leg but can also occur in the thigh sometimes. It sounds like this is something that would significantly benefit from an in-person assessment by either a Physiotherapist or another medical practitioner. They will be able to give you some more specific and in-depth advice regarding your injury. If you are based in Sydney I would be happy to help.

  • Jumai says:

    I get this pain in my arm caused by a particular visible vein every once in a while, it makes my arm so heavy to lift and I still don’t know what triggers the pain.

  • Grace Adams says:

    Hey! I’ve been on hormonal contraceptives, but stopped about a month ago, and I regularly travel about 3 hours by car every couple weeks, more frequently in the past couple weeks (three 3/4 hour drives within the last two weeks— the most recent being yesterday). I’ve been having a steady calf pain for all of today and am slightly concerned it might be more than a cramp, I can’t work it out or stretch it— it doesn’t help. I am debating going to an urgent care but don’t know if it’s just a cramp. Thoughts? Thanks, Grace.

    • Grace Adams says:

      To clarify the three hours, it’s three hours one way, three hours the other, usually a few days apart. My last drive was three hours at night, a day of break, and three hours yesterday.

      • Hello Grace,
        If there is no other reason for your calf pain, that is, you have not done any new type of exercise or more activity than usual that might have caused a muscle strain, then it is best for you to go and get this pain checked by your Doctor. Calf pain that appears for no apparent reason, and is not going away, should be looked into further. A muscle cramp can cause calf pain afterwards for a day or two but this type of pain usually subsides.
        Kind regards,

  • Mindy Mcelfresh says:

    I have been suffering with some cramping in my legs and hands and feet, but I have soreness in the back of my calf that is pretty sore and hurts to walk. Should I be concerned? Thanks

    • Hi Mindy,
      Sorry to hear about your cramping and calf pain! The cramping can be due to different reasons, from dehydration to muscle overuse. How often do you suffer these cramps? Regarding the calf, was there a specific event that made it start hurting? Pain at the back of the calf can be due to soft tissue injuries, including muscle and tendon, but also more serious causes like DVT. If you pain has continued to worsen and not ease off, I would suggest seeking an in-person opinion of a medical professional.
      Thanks, Ben

  • Firdous says:

    Last Sunday I was playing cricket whole running I got cramp on my left calf which was very pain full but after a day the pain was not their but still there is that hardness and bit of swelling.what is that?

    • Hi Firdous,
      It sounds like you may be suffering from a calf muscle strain. When pushed beyond their capacity, muscle injuries can occur. The good news is the tissue often heals quickly, but this still make take between 2-4 weeks to heal completely. The hardness in your muscle could be due to the swelling around the muscle. A good rehabilitation program for a calf strain should include some light stretching and strengthening to help you return to cricket without pain. If you would like any further information, please do not hesitate to reach out to the clinic.
      Kind regards,

  • Rosie says:

    Hi I recently just noticed very mild I wouldn’t call pain but maybe a tightness or just slightly sore in the back of my calf. Is this worrisome ? I get nervous

    • Hi Rosie,
      This depends on if this tightness is the result of new exercise or appeared for no particular reason. If it is still present after a few days, or becomes worse, red or hot to touch, you should get it checked out by a Physio or GP just to be sure.

  • EDePena says:

    Hello, I had a muscle spasm on my left calf in the AM while stretching in bed . It was very painful! Around 7pm I notice my leg around the calf area was swollen. I did go to the ER and had some blood work done and a venous Doppler. Everything came back negative for DVT and was told I was dehydrated. I was discharged. But it’s been a week and my leg is still swollen even though the pain is lesser each day. No redness nor feverish on contact. Should I be concern?

  • Heather says:

    I’m not sure if anyone checks this still but I have this calf tightness feeling, NO PAIN AT ALL, on my left calf whenever I stand. It’s not there when I walk, not there when I sit or lay down. If I put my weight on my right leg it goes away.

    I did the homans sign test and I was squeezing the heck out of my calf and not even a percentile of pain. It just feels kinda tight. Not even like vice grip level, just sorta like I’m flexing a bit.

    I’m a super hypochondriac so I’m up late thinking it’s a DVT but when I called my docs office they said if it’s not painful, red, or getting worse then it’s most likely a muscular incident from running or from an during-sleep RLS situation.

    Does it sound like a DVT? It’s been like a week and sometimes I feel like it’s getting marginally better and it’s never gotten worse or spread either. Again NO PAIN, just a cute little tight moment.

    Any advice would help.

    Hypochondriac Heather

    • Hi Heather,
      Thanks for the comment and sorry to hear about your calf tightness! Great job in contacting you doctor’s office and getting yourself cleared of a DVT. It can be common after a muscular injury or if a muscle is weak for it to feel tight. The factors leading up to this will depend on your currently levels of strength and activity. A period of strengthening and modifying your activities could help in decreasing your leg tightness symptoms. This is however a very simple hypothesis and would need to be confirmed with a full assessment by a physiotherapist to confirm your diagnosis and tailor a treatment plan specifically for you.
      Hope that helped!
      Kind regards,

  • Amdrea says:

    Good morning!
    I’m a careegiver helping my mother up and down from her wheelchair throughout the day. I also take short walks in the morning. Since yesterday evening, I’ve had what feels like a cramp tightening in my left leg’s upper calf and then letting go quickly, so quickly that it’s hard to tell exactly where it’s at. At this time, I can’t leave to get it checked out as I can’t leave my mother alone and it’s the weekend. I have no recollection of doing anything that would have injured my leg except for some gardening in which I was bending over or any of the above tasks. I’ve tried walking it out, soaking in a hot tub and resting it. Sometimes there’s a long time between the sharp pain and other times it comes faster. Does this sound like something serious that I should have looked at right away? If so, I’ll need to go to some extraordinary lengths to get someone to be with Mom. My sister is out of town. I realize it’s difficult to tell what’s going on from an email, but hope you can give me some guidance. Thank you for your help.

    • Hi Amdrea,
      I’m really sorry to hear about your calf pain. Sometimes even a small increase in activity (eg. gardening) can lead to a small calf strain injury. DVT pains usually are painful in a specific spot and are paired with redness and heat. If you haven’t noticed any of these and don’t have previous medical history that would increase the likelihood of a DVT, I would say the chances are very low. However regardless I would recommend talking to a health professional about your onset of calf pain even if it is just a calf strain. We do offer telehealth services where you can talk with one of our physiotherapists and they can assess your injury in some more detail, and better asses if it requires medical attention.

      Please let me know if we can be of any further assistance.


      Ben Cunningham

  • Gary says:

    Hello so I have been having leg cramps behind my knee this past year here and there and the other night I got one and I just let it do it’s thing and bear through the cramp pain and the next day I felt like I pulled a lower back muscle and now the pain is mostly in my lateral calf and hurts when I walk or stand for a while on it I don’t know what it is I am 39 years old and haven’t been to active lately I used to be very athletic in my younger days but these past three years I’ve put on some weight and I think that could be the issue too

    • Hi Gary,
      There is a chance your leg cramps could have a connection with your lower back if you feel low back pain around the same time. It might be a good idea to have this checked more thoroughly with a Physio to rule out lumbar involvement (which can refer pain to the leg) and also any DVT. DVT pains usually are painful in a specific spot and are paired with redness and heat usually. Cramping be due to different reasons, from dehydration to muscle overuse. Cramps can also be painful the day after they occur. If you have had symptoms ongoing for a while it might be best to get checked out to work out the source (Calf muscle, DVT or lower back).
      Kind regards,

  • Kayla says:

    Hello, I’ve been having calf and lower leg pain for almost two weeks. I am a dancer and the pain happened after a few prolonged dancing sessions. The pain is in my left calf only, aches, sore when I stand on it especially when standing on my toes. also feels sore and feels kind of strange when im at rest. Easily gets pins and needles too…. Its not swollen, red, or warm. I thought it was muscle soreness but its taken so long to heal that I stopped dancing or doing physical activity the past week. There is also a new clicking sound in my knee when I extend my leg. What kind of injury could this be? The pain is behind my ankle but seems to appear in diff areas of my lower leg. When I put pressure on certain areas of the calf it feels sore.

    • Hello Kayla,
      Sorry to hear that you are having calf pain. From what you describe there are a few possible sources of pain including the calf muscle itself (often sore with standing on toes), referral from an area higher up such as the lumbar spine (as you have some indications of nerve symptoms due to pins and needles) and Achilles area pain. It may be just a simple calf strain that can take a few weeks to recover. However it would be a good idea to have an assessment of all areas so you can get back to dancing soon and also to give you some guidance on prevention of recurrence. The fact that you do not have redness or swelling means it is less likely to be a DVT which is good news.
      Good luck!
      Kind regards,

  • Corinne says:

    Hi There,

    Not sure if this is checked anymore but I have had very achy muscle type pain in BOTH calves for a few days now. No redness, or swelling, not hot to the touch. It feels like I’ve done tons of calf raises but I haven’t. I can feel the pain when walking, on my tip toes going up stairs. Does this sound like a muscle concern or DVT?

    • Hi Corinne,
      I’m sorry to hear about your calf pain. DVT pains are usually painful in a specific spot and are paired with redness and heat. If you haven’t noticed any of these and don’t have previous medical history that would increase the likelihood of a DVT, it is less likely that a DVT is what is causing your calf pain.
      Calf pain that appears for no reason and is not not going away should be looked into further. If your pain is still present after a few days, or becomes worse, red or hot to touch, you should get it checked out by a Physio or GP just to be sure.

  • Douglas Retama says:

    So i was sleeping one time, and I woke up with a pain in my left leg. It felt minor but it slowly started to ramp up just a bit. Ive had it for almost a week and now the pain decides to go around the entire leg. If im standing or walking the pain is still there, just not as bad. When im in bed however the pain starts peaking and its frustrating to try and sleep with it, knowing that it’s just going to bother you for the rest of the damn night. Also as im writing this the bottom of my calf and foot feel randomly cold. im scared but id be glad to get an answer

    • Hello Douglas,
      Thanks for your comment.
      If your pain is in the entire leg (above and below the knee) it would not usually be a muscle cramp but could in fact be referring from the lumbar spine. This is one of the more common reasons for leg pain when you are resting that feels a little better with walking and standing. This type of pain related to referred nerve pain also often feels worse at night resting in bed. I would recommend you have this pain assessed by a Physiotherapist. We would do some tests to work out if you have any joint, nerve or muscle issues as the source of pain and work out the best treatment programme to manage the pain and also prevent long term issues. Early assessment and treatment is usually best.
      Kind regards,

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