Your soleus muscle is one of two muscles in your calf, located beneath and below the other larger calf muscle, the gastrocnemius. The gastrocnemius muscle is more prone to strain, due to its high proportion of fast twitch muscles, which contract quickly and generate a lot of power. However, even with its abundance of slow twitch fibers, the soleus muscle can suffer a strain. Once you determine the severity of your strain, you can treat it at home or visit your doctor.
Mild strains can be treated at home with ice and rest; more serious strains require medical attention.
Types of Strains
Acute muscle strains result from an injury such as a fall or overdoing it on the soccer field. No matter how the injury occurred, it results from the muscle fibers becoming overstretched to the point of tearing. There may be small tears, or the muscle may completely separate, either tearing in half or detaching from the tendon that connects it to bone.
Acute muscle strains are graded in terms of their severity and symptoms:
- A grade I sprain is a mild injury. There may have been a sharp pain at the time of the injury, but activity can likely be continued with little difficulty. Later, there might be residual pain, tenderness, slight swelling, spasms and tightness, but there is no loss of strength or range of motion.
- A grade II sprain is a moderate injury. There is usually more pain when it occurs and the activity typically must be discontinued. There may be immediate swelling at the time of injury, or it may develop later, along with some bruising, muscle spasms, and noticeable loss of strength and range of motion.
- A grade III sprain is a serious injury in which the muscle has been separated in two or detached from the tendon. The pain is immediately severe and disabling. This is followed by continued severe pain, swelling, bruising, and a complete loss of muscle function. A mass or dent may also develop at the point of muscle separation.
This grading system helps you and your doctor determine the scope of your soleus muscle injury and the best way to treat it.
Treating a Soleus Injury
If your soleus muscle pain is not severe and there is no loss of function, you can treat your injury at home. The first goal is to rest and protect the muscle. Even if you have no loss of muscle function, you should cease the activity that caused it. It's important to let the muscle rest, as continuing to put stress on it can lead to a more serious injury.
Icing the pulled soleus muscle as soon as possible after the injury will prevent and control swelling and pain. Apply an ice pack to the area for 10 to 20 minutes each hour as often as possible.
Compressing the muscle by wrapping the calf in an elastic bandage can also help prevent swelling. If there is weakness associated with the injury, the bandage will also provide some support while the muscle heals.
Lastly, control swelling by elevating the lower leg at or above the level of the heart to draw fluid away from the injury site. This home treatment method is most effective when initiated immediately after the injury and continued for at least 48 hours.
When to See a Doctor
Grade I soleus strains typically don't require a doctor's visit if you use the home treatment method. Some grade II strains may also be treated at home, but you should call your doctor to make sure. Grade III strains require medical attention as soon as possible after the injury occurs.
Your doctor will want to know what happened to cause the injury. He will ask if you heard or felt a popping sound or sensation at the time of injury, which indicates a complete tear. He will examine your injury, assessing swelling, bruising and the muscle's appearance. He may also ask you to do some physical exercises to test muscle strength and range of motion.
If he still can't determine the scope of the injury and the proper course of treatment, he may order further testing, including X-rays and magnetic resonance imaging (MRI).
If your doctor determines that the sprain is a complete tear, he will likely refer you to an orthopedic specialist. Treatment for a complete tear sometimes requires surgery.
Rehabilitation and Recovery
Recovery depends on the extent of the soleus injury. According to Harvard Health Publishing, mild strains can heal within a couple weeks. Grade II strains can take a few months, while complete tears can take several months.
According to a 2015 article in the Orthopaedic Journal of Sports Medicine, recovery time for a strained soleus can be difficult to predict and is influenced by several variables. One of these is which part of the muscle was injured. Central soleus muscle injuries typically take longer to heal than injuries to the lateral or medial part of the muscle and reinjury is common. Because of this, you should not resume your pre-injury level of activity until your soleus muscle has completely healed.
Stretching and Strengthening
Part of the healing process includes doing rehabilitative exercises to strengthen the soleus muscle and restore range of motion. The first step is gentle stretching, which will help lengthen the intramuscular scar and ready the muscle for strengthening.
The soleus muscle is difficult to target with stretching, and the usual calf stretches aren't effective. To stretch the soleus, take the same position as you would for a standing wall calf stretch: Face the wall with your palms on the wall about shoulder height. Step one foot back a few feet and bend into the front knee. Instead of keeping the back leg straight, bend into it, keeping the heel on the floor, until you feel a slight stretch in the lower calf.
How to Strengthen Your Soleus
Once you've stretched your soleus, you can introduce and slowly progress some strengthening exercises. The first stage is calf raises on the floor. Stand with your feet shoulder-width apart and slowly press up onto the balls of the feet and lower back down. Start with eight repetitions and work your way up to 20.
Next, do calf raises with both feet on a step. Slowly rise up onto the balls of the feet, then allow your heels to come down just below the level of the step. Come back to your starting position and repeat eight to 12 times, increasing up to 20. When that feels easy, you can try single leg calf raises on the floor, then on the step.
For athletes returning to a sport, such as running, Sports Injury Bulletin recommends small hopping exercises as the next rehabilitation stage. Begin on both feet then move to single-leg hops. Keep the landing gentle. Do as many as you can, rest, then complete another set.
- ScienceDirect: Gastrocnemius Muscle
- Harvard Health Publishing: Muscle Strain
- Orthopaedic Journal of Sports Medicine: Return to Play After Soleus Muscle Injuries
- Sports Injury Bulletin: Rehabilitation of Soleus Muscle Injuries in Distance Runners
- Kirby Podiatry: Gastrocnemius and Soleus Muscle Stretching Exercises