Soleus Muscle: Trigger Point Pain
The soleus muscle contributes to pain in the knee, calf, ankle, heel and the low back. In rare instances, a trigger point can cause pain in the jaw and side of the head.
There are differences in trigger point pain and pain caused by a soleus muscle strain. The most telling difference is that trigger point pain develops and increases over time. When you strain the muscle you know the injury occurred immediately by a pulling, popping, or tearing sensation. The pain of a muscle strain is felt and remains in the calf. Trigger point pain will cause pain in the calf but it may also send pain down into the ankle and heel as well up into the lower back.
It is important to determine which is the cause of soleus pain so you can apply the appropriate treatment.
Where Is The Soleus Muscle?
It attaches to the large bone in the shin (tibia) and to the head of the small bone (fibula) also in the lower leg. It travels down the back of the leg to join with the Achilles’ tendon. The Achilles’ tendon continues down to connect to the heel bone (calcaneus).
What Movements Does It Control?
- Bends the ankle down toward the floor (plantarflexion)
Soleus Muscle Trigger Points Symptoms:
Trigger points in the soleus muscle usually cause deep aching pain in the back of the knee, calf, ankle, and/or heel. However sharp stabbing pain can occur with certain movements. Bending the ankle up toward the body, walking down stairs or an incline, and putting weight on the heel of your foot will often cause pain that will make you hesitate or stop the movement immediately.
Signs and symptoms include:
- Pain in the heel often to the point of not being able to put weight on the heel
- Pain in the ankle
- Pain in the calf when bending the ankle upward
- Pain in the calf when walking down stairs or inclines
- Pain in the calf when running
- Pain in the calf sometimes extending into the back of the knee
- Deep aching in the back of the knee
- Deep pain in the low back on the same side of the affected side
- Hypersensitivity to touch in the lower back on the same side of the affected side
- Poor circulation in the lower legs and feet
- Swelling in the ankle and foot
- Pain in the jaw and on the side of the head
Neo G Medical Grade VCS Calf Support/Shin Splint provides support and warmth to the lower leg muscles. This brace is recommended for Achilles tendon strain or sprain, and also strains, sprains and overuse injuries of the lower leg muscles. An excellent choice for compression and support of the lower leg muscles. If you suspect or have ever been diagnosed with blood clots consult your doctor before using this brace.
What Causes Soleus Trigger Points To Develop?
- Jogging and running
- Walking/running uphill
- Climbing stairs
- Wearing high heels
- Wearing shoes with stiff, inflexible soles
- Standing still for long periods time
- Using footstools and recliners that put pressure on the back of the calves
- Immobility of the lower leg due to a cast or brace
Note: Trigger points often develop as a result of a strain or other injury to the back, hip, leg, ankle, and foot.
Sore shins or calves? Feel as if shin splints are coming on? The ProStretch Calf Stretcher & Foot Rocker can help! The stretcher/rocker stretches and helps to relax most of the muscles in the lower leg and foot. Used by physical therapists to treat sore shins and calves as well as foot pain and planter fasciitis.
How To Avoid Development of Trigger Points In The Soleus
- Warming up before sports, exercise and other strenuous activities is important. To warm up the soleus muscle be sure to do ankle circles, flex the ankle up and down and point the toes several times.
- When sitting with your legs or feet supported by an ottoman, footstool, or recliner, take a break and drop your legs and put both feet on the ground. Get up, walk, and flex the ankles, do circles with the ankles, and point the toes to relax the muscle and keep your circulation moving.
- If you wear high heels give your legs and feet a break by alternating to low heels or walking around barefoot several times during the day.
- If you must stand in one spot for long periods of time, shift your weight foot to foot at the pace of your normal walking pace. This helps with circulation in the legs.
- If your lower leg, ankle, or foot is immobilized by a cast or heavy brace ask your doctor if it would be safe to tense and relax the lower leg muscles throughout the day to help decrease stiffness in the calf muscles. For some injuries, this will NOT be possible.
Soleus Trigger Point Treatment
The easiest way to learn to treat specific trigger points in the soleus muscle is to find a professional with training in trigger point pain and pain referral. Many massage therapists, physical therapist, and chiropractors have this specialized training. Be sure to ask before booking an appointment.
If you have patience and are willing to put in the time and practice, you can learn to self treat trigger points. The Trigger Point Therapy Workbook is an excellent guide to learn this therapy. Take time and learn trigger point therapy because the treatment needs to be done several times a day for 1-2 minutes per treatment for optimal results. Also when you learn the techniques to self-treat, you will have a tool to treat and relieve muscle pain throughout the body.
The book recommends several tools to use during treatment. The most versatile of the suggested tools is the Thera Cane Massager. The cane can be used on other muscles, including those that are hard to reach, like the muscles of the back and bottom of the feet.
The Knobble is another tool that works well on the soleus muscle. The Knobbler is used to apply precise pressure to a trigger point and is used on other muscles that you can easily reach.
The last tool recommended is a massage ball. You place the ball on a stack of thick books on the floor. Then, you lie on the floor with your lower leg on the ball, supporting your body with your arms and roll the ball up and down the leg. This method works very well, but you must have the arm strength to support your body weight as well as the ability to get down on the floor.
How Long Before I Feel A Reduction In Pain?
Depending on the trigger points you may feel some relieve quickly, but most feel noticeable relief in a several days. The key to trigger point therapy is consistency in doing your treatments. You must do the treatments regularly and continue until the trigger point is gone.
Sombra Warm Therapy Gel is recommended for relaxing muscles and relieving pain. It warms without the burning heat of other gels. An excellent choice for pain caused by trigger points, muscle/joint over-use and stiffness, and arthritis. If you have reoccurring leg or foot cramps you should keep Somba on hand, it provides almost instant relief. (Not sold in stores)
Biofreeze Pain Relieving Gel is an excellent pain-relieving gel recommend for those who have sudden onset muscle pain or recent injuries. It is better to use than warm therapy gels and creams for muscle pain caused by inflammation as it cools the area much like ice. If your pain is from a recent injury use Biofreeze. It is excellent to use on sprains, strained and sore ankles.
- The soleus is sometimes called the second heart because it helps pump blood up from the feet and lower leg.
- A trigger point in the soleus muscle can cause jaw pain and pain on the side of the face and head. If you are suffering from pain in the under eye, cheek and jaw area and cannot find relieve, you should consider examining the soleus muscle.
Soleus muscle pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:
- Peripheral vascular disease (PVD)
- Deep vein thrombosis (DVT)
- Superficial vascular thrombosis (SVT)
- Varicose veins
- Nocturnal cramping
- Tennis leg
- Post-exercise soreness
- Posterior compartment syndrome
- Buckling knee syndrome
- Dislocation/Subluxation of knee
- Heel spur
- Posteromedial Shin splint
- Bruised periosteum of the tibia
- Baker’s cyst
- Ruptured Achilles tendon
- Achilles tendinitis
- Plantar fasciitis
- Plantars wart
- Bone spur
- Hip rotator dysfunction
- Temporomandibular joint Dysfunction (TMD)
Other muscles that should be considered and examined:
Soleus Muscle Strain
The pain from a soleus muscle strain can range between an aching pulling sensation to severe stop in your tracks pain.
Muscle strains are graded by the number of muscle or tendon fibers that are torn.
A mild strain (Grade 1) – a few fibers are torn. You feel a pulling or tearing sensation with some pain. Though there may be discomfort, it does not affect daily activities.
A moderate strain (Grade 2) – numerous fibers are torn. You will feel a tearing sensation or pop in the muscle when the injury occurs. Pain and muscle weakness will cause you to stop activity immediately and make you limp. Daily activities are affected to varying degrees.
A severe strain (Grade 3) – most or all of the fibers in the muscle are torn. A complete tear is a rupture also called an avulsion and requires medical care. If you suffer a Grade 3 strain the pain is excruciating and will often cause you to go to the ground. The pain and muscle weakness may keep you from putting any weight on the leg. Daily activities are affected because of extreme pain and muscle weakness.
Symptoms of Soleus Strain:
- Pulling, tearing, or popping sensation felt at the time of injury
- An intense ache or sharp shooting pain is felt instantly in calf
- Walking and putting weight on the leg is painful. If the strain is severe putting weight on the leg may be impossible
- Swelling and bruising occurs around the injured area
What Causes Soleus Strains?
Over-use and muscle fatigue are the primary causes of a soleus muscle strain.
- Runners often have problems with calf strains. Conditioning, muscle fatigue and lack of a good warm-up are contributors.
- When climbing stairs, walls, and hills you keep your knees bent and the ankle bent up toward the body which keeps the soleus muscle tight and stressed.
- Skaters and skiers risk a soleus strain if the ankles are not properly supported.
- Wearing shoes with stiff immobile soles makes the soleus work harder when you walk, jog, and run.
Sports and activities that contribute to soleus strains:
- Runners especially long distance runners and joggers
- Power Walkers
- Hiking up hills and steep inclines
- Ice and roller skating
- Aerobic Dancers
If you are an athlete or exercise aficionado the Thera Ice Hot/Cold Wrap provides excellent cold compression treatments for lower leg muscles, knees, and ankles. Keep on hand for post sports and exercise treatments.
Soleus Strain Treatments
Mild and most moderate strains can be treated at home using the P.R.I.C.E. protocol. If you suspect a Grade 3 strain you need to see a doctor to determine the severity of the muscle fiber tears.
The P.R.I.C.E. protocol should be started as soon as possible to reduce pain and inflammation.
- Protect the injury – Use an elastic bandage or Velcro wrap to stabilize the injured area. Limit movement, and weight bearing.
- Rest – You should rest the leg as well as get extra sleep. It is during rest and when you sleep that the healing process is optimized.
- Ice – Use cold wraps or ice packs for 20 minutes per treatment every 1-2 hours until swelling, bruising and redness subside. Cold treatments longer than 20 minutes are discouraged because soft tissue damage may occur.
- Compression – Applying moderate pressure with an elastic bandage or Velcro wrap will reduce swelling and provide support.
- Elevate – Use pillows and folded blankets to keep the leg elevated to reduce fluid accumulation around the injury. It is important to spend time laying down with your leg slightly elevated above your heart to reduce swelling and aid circulation.
Once the swelling, heat, and bruising begin to subside it is time to alternate cold and warm treatments. Start with cold treatment for 20 minutes then 1-2 hours later apply a warm treatment. Alternate treatments throughout the day.
Lower Leg Compression Sleeves are used by many athletes. Compression sleeves provide compression, support and warmth without adding bulk to the lower leg muscles. Sleeves are recommended by athletic trainers for shin splint, strained calf muscles and overuse injuries of the lower leg muscles. Sleeves are also great as a preventative measure against shin splints and tired sore calf muscles after sports activities. Compression sleeves are also shown to reduce recovery time after strenuous activities and injury.
Note: If you suspect or have ever been diagnosed with blood clots consult your doctor before using compression sleeves or braces.
How long does it take a soleus strain to heal?
Grade 1 strains heal quickly, most within 2 weeks. Daily activities, sports, and exercise are not significantly impacted.
Grade 2 strains often take 4-8 weeks to heal. Daily activities can be resumed within your comfort level. Be careful not to resume strenuous sports or exercise too soon. If you experience pain, stop and give the strain additional time to heal.
Grade 3 strains can take months up to a year to fully heal. If the muscle or tendon has ruptured surgery will likely be required. If you have a severe stain, your return to activities should be monitored by a medical professional.
Tips To Avoid Soleus Strains
- A few minutes of warm up before sports, exercise and strenuous activities go a long way to avoiding injury.
- Do not stretch past muscle capacity.
- If you feel muscle fatigue set in stop and rest. Most soleus strains are caused by over-use and muscle fatigue.
- If you are a runner or exercise enthusiast, take recovery days (days off) to allow the muscle to rest.
- Wear appropriate footwear for activities.
Doctors and physical therapists often recommend TENS to relax muscles and ease pain. The Belifu TENS Unit Muscle Stimulator is highly recommended and a great choice for treating upper and lower leg pain.