When your calf or the back of your heel has been sore for months, a busy day on your feet can feel like something to get through rather than enjoy. You may plan routes around it or wonder whether a walk is worth the ache later. Building calf strength steadily, alongside a few changes to your day, can help you do more with less pain.

Why long-term calf pain can linger

Long-term pain in the calf or at the back of the heel often involves the Achilles tendon, the thick cord that joins your calf muscles to your heel. Tendons get stronger when they are loaded gradually. When they are rested, they lose some of their ability to cope, so pain returns as soon as you do more.

Around menopause, falling oestrogen can make tendons slower to adapt, and calf muscles can lose strength more quickly in midlife. Together, these can make an ache harder to shake. The encouraging part is that both tendons and muscles respond well to the right kind of exercise, at any age.

What the evidence says about strength

Strength work is at the heart of managing long-term Achilles and calf pain. Research using slow, controlled heel raise programmes over around three months has found that many people with long-term Achilles pain were able to return to their usual activities. Strong calves take more of the load each time your foot hits the ground.

Building calf strength

Something to try three or four times a week:

• Heel raises on both feet. Hold onto a worktop, rise onto your toes, pause, then lower slowly over about three seconds.
• Single-leg heel raises. As both-leg raises feel easy, rise on both feet and lower on the sore leg alone.
• Bent-knee heel raises. Same movement with your knees slightly bent, to work the deeper calf muscle.

Start with a number you can do comfortably and build up over weeks. When they feel easy, you could add more repetitions, then hold a rucksack for extra weight. If you would like to follow along, VIDA has short videos of heel raises you can use at your own pace.

If the pain is right at the back of your heel, doing heel raises on flat ground rather than off the edge of a step tends to be more comfortable.

Getting the amount right

A mild ache during exercise that settles by the next day is usually fine. Check how your calf feels the following morning. If it is sorer, ease back a little rather than stopping. Changing one thing at a time, every week or two, gives the tendon time to adapt.

Managing a busy day on your feet

Long days of standing and walking add up for a sore calf. Some things that can help:

• Wear supportive, cushioned shoes with a small heel, especially on busy days.
• Break up long spells of standing with short sits, or lean on a stool or high seat.
• Shift your weight and move your feet if you have to stand still for a while.
• Plan rests before the ache builds, rather than waiting until you have to stop.
• Sit down for jobs you can do seated, like preparing vegetables or folding laundry.
• Stand on a cushioned mat where you spend the most time on your feet.

If you know a busy day is coming, keeping your strength session lighter the day before can help.

Staying active

Walking is part of your strength work too. Flatter routes, a steady pace and spreading walks across the day often feel easier than one long outing. Swimming and cycling are good ways to stay active on days your calf prefers less load.

Looking after the bigger picture

Broken sleep around menopause can make pain feel louder, so a cool bedroom and a regular wake-up time can help. Your VIDA pain check-in is a good way to notice your progress over time, including small wins like a longer walk or an easier day on your feet.

What to take away

• Strengthen your calves three or four times a week with slow heel raises.
• Build up gradually, using the next-morning check as a guide.
• Wear supportive shoes with a small heel on busy days.
• Break up long spells of standing with short sits.
• Spread walking across the day rather than doing it all at once.

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