Soleus Muscle Strain and Trigger Point Pain: Symptoms, Causes, Treatments
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 The Soleus Control?
- Bends the ankle down toward the floor (plantarflexion)
Soleus Muscle 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.
What Are The Signs and Symptoms of Soleus Trigger Points?
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
What Causes Trigger Points To Develop In The Soleus Muscle?
- 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.
Soleus Pain Pattern: Pain in the back of the knee, calf, ankle, heel, and low back can be a sign of soleus muscle. A trigger point in this muscle can also contribute to TMJ type pain as well as pain on the side of the head.
How To Avoid Development of Trigger Points In The Soleus Muscle
- 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. I recommend that you 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.
TWD Suggestions For Soleus Trigger Points
The Trigger Point Therapy Workbook is the best resource to learn how to treat and manage your muscle pain. Learn the methods and have the knowledge to relieve muscle pain throughout the body.
Sombra Warm Therapy Pain Relieving Gel is highly recommended for trigger point and chronic pain relief. It relaxes the muscles without the burning heat of other creams. (not sold in stores)
The Tiger Tail Roller is an excellent tool to roll out leg and foot muscles. The roller does not require upper body strength like a normal foam roller and can be easily used by anyone.
The Simple Spectra Hot/Cold Wrap provides compression with warm/cold treatments. Compression with warmth can help treat and reduce the pain of trigger points. The wrap is adjustable and can be used on many areas of the body.
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.
Interesting facts about the soleus muscle:
- 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)
Soleus Muscle Strain Pain
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.
Some of the signs of a soleus strain are:
- 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
Runners, joggers, and power walkers often experience soleus muscle strains, pain, and soreness.
What Causes A Soleus Strain?
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
Soleus Muscle Strain Treatment
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.
When to see a doctor:
- Unbearable pain level
- Excessive swelling and bruising
- Inability to move leg without extreme pain
- Unable to put weight on the leg
- Pain, swelling, redness, and heat have not decreased in 24 hours
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.
TWD Suggestions For Soleus Strains
Biofreeze Pain Relieving Gel cools the area much like ice discouraging inflammation. Provides excellent pain relief between cold treatments. Recommended by medical professionals and trainers.
The Simple Spectra Clay Hot/Cold Wrap can be placed and on the calf muscles, providing hot or cold treatment as well as compression which is important for recovery. The wrap is versatile can also be used on other areas of the body.
The Neo G Calf/Shin Brace provides support and warmth to the lower leg muscles. Three Velcro straps allow you to adjust compression to your comfort. An excellent choice for soleus muscle support.
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.
More Pain Relief and Support Suggestions from TWD:
The products listed below are products that I use and highly recommend to my clients and customers. If you regularly work out, run, bike, or hike, or have problems with calf and lower leg pain, these products are well-made and stand up to frequent use.
If you are an athlete or exercise aficionado the Freeze Sleeve provides excellent cold compression treatments for lower leg muscles, knees, and ankles. Keep on hand for post sports and exercise treatments.
Penetrex was formulated specifically to reduce inflammation. If you have strained a muscle and have swelling this is the cream to use. Also works well on joint inflammation caused by arthritis. Read and follow directions for best results.
Pro Stretch for Calf Pain is used in many physical therapists offices and rehabs for those who have tight lower leg muscles pain. It provides a deeper stretch to the calf and foot muscles than traditional lower leg and foot stretches.
Rymora Calf Graduated Compression Sleeves is recommended to those who deal with sore calves and have a tendency for muscle strains. The graduated compression provides support and helps keep circulation at optimal levels.
Twelve years of experience working with clients with chronic pain, post injury pain, and post surgery pain. Muscle dysfunction is often overlooked but can hold the key to many pain conditions.