Do you like to run? Have you experienced acute muscle soreness after starting a running program? Has your entire calf ever become stiff, making it impossible to flex the foot? If you’ve answered ‘yes’ to these questions you may have strained your soleus muscle. For information on how to treat this injury, read the details below.

What is a soleus muscle strain?

● The soleus runs from just below your knee down to the ankle joint, attaching at the top of the tibia and fibula leg bones (at your knee) and inserting at the achilles tendon (by your heel).
● A soleus muscle strain is a low risk injury because the muscle crosses the ankle and is composed mostly of slow twitch muscle fibers that make the muscle resistant to fatigue.
● Soleus muscle strain is an injury caused by overuse.
● Tends to be underreported due to the misdiagnosis as thrombophlebitis

Causes

● Muscle fatigue
● Overtraining

Signs and Symptoms

● Calf tightness
● Stiffness
● Pain worsens over days and weeks
● Provoked by walking and jogging
● Mild swelling
● Can be mildly debilitating

Diagnosis

● Muscle must be isolated at the injury site, palpate along the length of the muscle
● Pain is located on the lateral side of the calf

Treatment

● The first week:
○ Must limit hemorrhage, pain, and prevent complications
○ Rest
○ Limit the stretching and contraction of the muscle
○ Use crutches to keep weight off the muscle
○ ACE wraps to help prevent swelling
○ NSAIDs (Ibuprofen or Naproxen) to help reduce pain and inflammation
○ Acute rehab and physical therapy

Complications

● Myositis ossificans
● Compartment syndrome
● Surgical consultation should be considered for grade III strains and cases of prolonged pain (>4-6
months).

Figure 1: Soleus Muscle Strain

References

Bryan Dixon J. (2009). Gastrocnemius vs. soleus strain: how to differentiate and deal with calf muscle
injuries. Current reviews in musculoskeletal medicine, 2(2), 74–77. https://doi.org/10.1007/s12178-009-
9045-8

Pedret, C., Rodas, G., Balius, R., Capdevila, L., Bossy, M., Vernooij, R. W., & Alomar, X. (2015). Return
to Play After Soleus Muscle Injuries. Orthopaedic journal of sports medicine, 3(7), 2325967115595802.
https://doi.org/10.1177/2325967115595802

Pepermpron. (2022). [Illustration]. Calf Pain leg back muscle blood vessels nerve acute sport damage
arterial trauma tennis soccer tear Cramp spasm Charley horses medial fiber bruising run walk tendon Clot
deep vein pull torn up sprain. https://www.shutterstock.com/image-vector/calf-pain-leg-back-muscle-
blood-1983713825

Leave a Reply

Your email address will not be published. Required fields are marked *