Calf pain when the foot bends upward and Homan's sign

This manoeuvre is often called Homan's sign. It stretches several calf structures, so discomfort may arise from a muscle strain, tendon irritation, or other causes. Clinicians assess the whole symptom pattern and use appropriate testing when a clot is a concern.

Dorsiflexion brings the top of the foot toward the shin and lengthens the calf muscles and Achilles tendon. Local soreness after running, jumping, a sudden push-off, or unfamiliar exercise can therefore become more noticeable during this movement.

A deep vein thrombosis can present with one-sided swelling, pain or tenderness, warmth, and red or darker skin. Some clots cause few clear signs. The presence or absence of pain during dorsiflexion does not settle the diagnosis.

Stop repeatedly forcing the ankle upward to check the symptom. Record which leg hurts, where the pain sits, when it started, and whether there is swelling, warmth, discolouration, breathlessness, recent immobility, surgery, pregnancy, or previous clotting.

If there are no urgent features and a minor strain seems plausible, avoid the movement that sharply reproduces pain and arrange review if walking is difficult or symptoms do not improve. Do not use deep massage on an unexplained swollen calf while awaiting assessment.

Seek urgent assessment for unexplained one-sided calf pain accompanied by swelling, warmth, tenderness, or skin colour change, particularly after surgery, prolonged reduced movement, during pregnancy, or after giving birth. Diagnosis may require a clinical assessment and leg ultrasound rather than a bedside stretch test.

Sudden difficulty breathing, chest pain, coughing blood, fainting, or collapse requires emergency help. Do not drive yourself if you are severely breathless or faint.

Ask which findings raise or lower concern for a clot, whether ultrasound is needed, and whether the pain fits the calf muscle or Achilles tendon. Mention any injury, recent travel, reduced mobility, operation, pregnancy, birth, hormone medicine, previous clot, or family clotting history.