FAQ: The soleus muscle strain (calf)

Injury: The soleus is a muscle located in the calf complex, it lies beneath the gastrocnemius muscle. It plays a crucial role in activities such as walking, running, and standing. A soleus strain refers to the overstretching or tearing of the muscle fibres of the soleus. Like all strains we can grade them from 1 to 3 severities. A typical grade 2 strain may take 3-6 weeks to heal. 

Where will I feel pain after a soleus strain? Pain from a soleus strain is typically felt deep in the calf, often in the middle or outside portion of the calf or near the Achilles tendon. It may also radiate to the ankle or foot. 

What movements will I struggle to perform if I have strained my soleus? Activities that involve pointing the toes, pushing off with the foot, or lifting the heel off the ground (such as walking, running, or standing on tiptoes) can be painful or limited with a soleus strain. An important factor that differentiates between a gastrocnemius and soleus strain is activating the muscles with a bent knee verse a straight knee; typically, a soleus strain would be seen with a bent knee.  

Will I feel pain in any other regions of my body? The pain is usually localised to the calf complex and may not refer to other regions unless there is a severe injury or compensatory patterns associated with the strain   

How does a soleus strain happen? Soleus strains typically occur due to activities that involve sudden or excessive stretching of the calf muscle, such as overexertion, improper warm-up, or sudden acceleration during sports. This muscle is often seen in new runners who lack the strength and capacity of the soleus muscle 

What things should I try initially once I’ve strained my soleus? Keeping the body moving within a pain-free range is important. To avoid excessive scar tissue forming and delay healing, the more you move and the faster you return to normal movements, the better. Ice to the region can help with pain but this is somewhat ill-advised as it delays healing of the muscle. 

See this blog where we discuss the recent research around RICE (Rest, Ice, Compression, Elevation) – click here 

Seeking assistance from a health professional (Osteopath, physiotherapist) to properly assess, treat, guide and manage your rehab is of upmost importance. With most muscle strains we want to typically get you moving quickly – depending on severity! Rest does not equal best management.  

What things should I try to avoid in the initial stages of a soleus strain? Avoid activities that worsen the pain, such as running or jumping. As mentioned before, your health professional will assess and make a judgement on what you can and can’t do after a soleus strain. Rule of thumb: You’ll be moving sooner rather than later 

What type of exercises or movements do I need to learn/control/be stronger at to rehab the soleus? Rehabilitation exercises should focus on gradually strengthening the calf muscles and improving flexibility. These may include calf raises, heel drops, and gentle stretching exercises. The soleus is a powerful muscle when your knee is bent so your rehab may have a strong focus on bent knee calf raise type movements. It’s also important to address what’s happening above and below the injury. Hip, knee and foot control will be vital to address any biomechanical influences that may have caused the strain in the first place.  

What other considerations contribute to a soleus strain? Holistic factors to consider include your overall leg strength, biomechanics, footwear, and any underlying conditions that may affect healing. For instance, weak glutes or poor running form and overload can contribute to a soleus strain. 

What treatments can help relieve some pain or fast track my rehabilitation? To fast track your recovery from a soleus strain your health professional will look to treat surrounding areas through massage, dry needling, mobilisation or manipulation to allow for increase range of motion, decrease intensity of pain and improve motion through compensatory structures. Typically, addressing foot, knee and hip mechanics through treatment will allow for you to fast track your recovery. 

What are the expected timeframes of rehabilitating a soleus strain? The recovery time for a soleus strain can vary depending on the severity of the injury. Mild strains may heal in a few weeks (1-4 weeks), while more severe strains may take several months (4-12 weeks). Following a structured rehabilitation program and seeking professional guidance can help determine a more accurate timeframe for your specific injury.