Soleus Strain

Additional Information

Home Treatments

• Acute management:
• RICE (rest, ice, compression and elevation)
• Crutches if the patient walks with a severe limp.
• Early activation (contractions) as early as able
• Pain-free stretching to maintain muscle length.

Professional Medical Treatments

• Anti-inflammatories (if able to take – consult GP) seen to be superior to paracetamol. For elite athletes, this is via injection if deemed appropriate.
• Soft tissue management (massage / dry needling) after initial inflammatory phase
• Ensuring optimal lower limb mechanics

Physical Therapy Exercises:

• Progressive strengthening of the soleus should be initiated as early as able (will depend on grade of injury). It is important to note that activation of the soleus muscle requires the knee to be bent / flexed.
• Strengthening exercises are performed with the knee bent, often starting either in sitting or completing double leg bent knee calf raises. These can then be progressed in weight (if completing seated exercises) or to single leg in standing and progressing with weights from there. Another progression is standing bent knee calf raises with the heel dropping down off the edge of a step.
• Soleus length is also important, therefore stretches should be incorporated. A soleus stretch involves bending the knee to the wall without letting the heel lift until you feel a stretch in the calf

Prevention

• The medial third of the soleus is prone to becoming very inflexible in athletes with excessive subtalar pronation of the foot, which means this tissue becomes more susceptible to strain. Optimising foot mechanics is therefore extremely important in prevention. This may be through strengthening or orthotics depending on the athlete.
• Optimising strength of the soleus muscle as well as maintaining flexiblity of the calf