Soleus Muscle Strain: Causes, Symptoms, Treatment

What is Soleus Muscle and What is its Function?

Soleus muscle is also known as calf muscle. The muscle lies on back of the leg. Most muscle mass forms calf muscle. Origin of Soleus muscle is attached to tibia and fibula bone that forms knee joint. The soleus muscle continues as an aponeurosis and tendon to ankle joint.1 The aponeurosis and tendon forms Achilles Tendon that is attached to calcaneus bone at ankle joint. Thus muscle is attached to knee and ankle joint. Muscle contraction helps to maintain balance while standing and also contraction is necessary while walking. Muscle contraction is primarily used for pushing the foot off of the ground when walking. Thus, soleus muscle stabilizes the ankle joint.2 The soleus muscle is innervated by the tibial nerves. This muscle gets its blood supply from the sural, peroneal and the posterior tibial arteries.

What is Soleus Muscle and What is its Function?

Sprain and strain terms are used to expressed injuries of ligament and tendon. The injury of ligament is known as ligamental sprain and injury of tendon is known as tendon or muscle strain.4 Muscle injuries causes muscle spasm, laceration, strain and tear. Injury of ligament and aponeurosis of soleus muscle is diagnosed as muscle sprain. Any strain or injury to the Soleus Muscle will result in significant impairment with regard to performing normal activities of daily living and other recreational activities. The recovery time is prolonged for injury or tear of aponeurosis of soleus muscle than soleus muscle mass.3 An individual with Soleus Muscle Strain will have problems with ambulation, negotiating stairs along with doing recreational activities like dancing, jogging, running, or even do a brisk walk. The patient may also feel a sense of imbalance if the Soleus Muscle is strained or injured as this muscle also assists in balance.

Risk Factors for Soleus Muscle Strain

There are also certain medical conditions which may cause Soleus Muscle Strain. These medical conditions are:

  1. Peripheral vascular disease
  2. Thrombophlebitis
  3. Deep vein thrombosis
  4. Varicose veins
  5. Nocturnal cramping
  6. Posterior compartment syndrome
  7. Frequent knee dislocations
  8. Heel spurs
  9. Baker’s Cyst
  10. Achilles tendon rupture
  11. Plantar fasciitis
  12. Sciatica.

What is the Treatment for Soleus Muscle Strain?

What Can Cause Soleus Muscle Strain?

There are certain activities which may result in a Soleus Muscle Strain. These activities are:

  • Walking on slope or inclines like hills or bridge.
  • Frequently climbing stairs.
  • People who are involved with frequent cycling can also strain the Soleus Muscle.
  • Athletes involved in long jump also put tremendous pressure on this muscle resulting in a Soleus Muscle Strain.
  • Females who have a habit of wearing high heels also put excessive pressure on the Soleus Muscle resulting in a Strained Soleus.
  • People who use recliners and use heel to push the recliners are prone to a Soleus Muscle Strain.

Symptoms & Signs of Soleus Muscle Strain or Injury

  1. Pain
  2. Calf muscle spasm
  3. Tender and painful lower back
  4. Unable to walk
  5. Unable to climb
  6. Swelling over calf muscle or back of Achilles Tendon.
  7. Bruises and discoloration of skin over muscle and tendon

Clinical Examination Findings of Soleus Muscle Strain or Injury

  1. Pain- Severe pain in the heel to an extent that the patient may not even be able to bear weight on the affected foot can be a symptom of soleus muscle strain. Pain in the calf radiating to the back of the knee can be a symptom of soleus muscle strain. In most cases individual also feel severe knee pain. Low back pain at times is secondary to change of posture and interferes with sitting and standing.
  2. Calf Muscle Spasm- The examination of leg indicates painful contracted calf muscle that suggest presence of muscle spasm. Muscle spasm is observed in both soleus as well as gastrocnemius muscle
  3. Tender and Painful Lower Back- The pain is observed in lower back. Back muscle spasm is one of the cause of pain. Occasionally the change of posture to adjust ambulation causes muscle strain and tendon sprain. Pain becomes continuous and restricts activities.
  4. Unable to Walk- Achilles Tendon is extremely painful in most cases when an individual makes an attempt to put weight on the injured leg in an attempt to walk. Severe pain in the ankle is also associated with signs of difficulties to put weight on the affected ankle.
  5. Unable to Climb- Intensity of Soleus Muscle Strain pain increases when one tries to climb. The contraction of soleus muscle is necessary to lift the foot off the ground while climbing.
  6. Swelling Over Calf Muscle or Back of Achilles Tendon observed in most cases.
  7. Bruises and Discoloration of Skin Over Soleus Muscle and Tendon- The soleus muscle and achilles tendon strain causes bleeding in muscle and tendon. Occasionally injury also causes tear of blood vessels in subcutaneous tissue. Such injury causes bleeding and hematoma formation within subcutaneous tissue as well as muscles. The blood slowly spreads under the skin and causes purple discoloration also known as bruises.

What Is The Treatment For Soleus Muscle Strain?

Treatment for Soleus Muscle Strain or Injury is normally conservative. Some of the treatment measures for Strained Soleus are:

  1. Conservative Treatment

    The conservative treatment recommended immediately following soleus muscle strain or injury is RICE therapy.4 RICE stands for rest, ice, compression and elevation.

    1. Adequate Rest or Immobilization to Treat Soleus Muscle Strain: Patient suffering from soleus muscle strain needs to rest and not bear weight on the injured foot for a week or so to allow healing of the muscle to occur. It will also allow inflammation and swelling associated with soleus muscle strain to come down.
    2. Heat and Ice Therapy to Treat Soleus Muscle Strain – The next step towards treatment for an injured or strained soleus muscle is application of heat and ice. The patient may apply ice packs to the injured area for 15-20 minutes two to three times a day. The patient can also use warm compresses to the injured foot to calm down the swelling and inflammation. One should make sure that both ice and warm treatments should not be given simultaneously.
    3. Wraps or compression to Treat Soleus Muscle Strain: The patient can use elastic ace bandage to wraps or compressed the affected area of the ankle and calf. The compression helps to stop bleeding and reduce size of hematoma. Wrapping helps to compress and reduce the pain caused by the inflamed muscle that otherwise would be very painful. Pain relief following wrapping helps to reduced intake of less NSAIDs and avoid opioids.
    4. Braces to Treat Soleus Muscle Strain: In few cases ankle joint is covered with braces to immobilize or less mobilize ankle joint.
    5. Elevation to Treat Soleus Muscle Strain: Leg is elevated immediately after the injury. Leg elevation helps to reduce pain as well as bleeding.
  2. Medications to Treat Soleus Muscle Strain:

    1. NSAID to Treat Soleus Muscle Strain: The single most important symptom that causes suffering is pain. Pain is treated with non-steroidal anti-inflammatory medications (NSAIDs). NSAIDs also helps to reduce inflammation.
    2. Tylenol For Soleus Muscle Strain: Tylenol does not cause gastric mucosal injuries like NSAIDs that results in stomach and duodenal ulcer. Individual with history of peptic ulcer are then treated with tylenol.
    3. Opioids to Treat Strained Soleus Muscle: Opioids are prescribed for severe pain that is not responding to NSAIDs and other adjuvant treatments. Opioids are prescribed for 2 to 3 weeks only, to prevent dependence and addiction.
    4. Antibiotics to Treat Soleus Muscle Strain: Antibiotics are rarely prescribed. If wound is infected and causes cellulitis, then individual suffering with such condition is aggressively treated with antibiotics.
  3. Physical Therapy to Treat Soleus Muscle Strain:

    Physical therapy is recommended once the pain symptom subsides. Physical therapy helps to prevent muscle weakness, improve muscle coordination and strength. Physical therapy also is recommended for knee and ankle joint stiffness. Most stiffness is caused by joint immobility secondary to pain.

  4. Surgery to Treat Soleus Muscle Strain:

    Surgical procedure is performed to remove hematoma and repair torn muscle or tendon.6 Occasionally muscle strain is associated with muscle or tendon tear. Surgery is recommended for repair of muscle or tendon tear.

References

  1. Documentation and Three-Dimensional Modelling of Human Soleus Muscle Architecture”

    Agur, Anne M.; Ng-Thow-Hing, Victor; Ball, Kevin A.; Fiume, Eugene; McKee, Nanacy Hunt (2003). ” Clinical Anatomy.  16 (4):285293.doi:10.1002/ca.10112.   PMID 127949

  2. Empirical Evaluation of Gastrocnemius and Soleus Function During Walking

    Rachel L. Lenhart,a Carrie A. Francis,a Amy L. Lenz,b and Darryl G. Thelena,c,d,*,

    J Biomech. Author manuscript; available in PMC 2015 Sep 22., Published in final edited form as:

    J Biomech. 2014 Sep 22; 47(12): 2969–2974.,

  3. Return to Play After Soleus Muscle Injuries

    Carles Pedret, MD, PhD,*†‡§ Gil Rodas, MD, PhD,‖¶ Ramon Balius, MD, PhD,‡# Lluis Capdevila, MD, PhD,**Mireia Bossy, MD,‡§ Robin W.M. Vernooij, MD,†† and Xavier Alomar, MD, PhD§Orthop J Sports Med. 2015 Jul; 3(7): 2325967115595802.

  4. What are sprains and strains?

    https://www.niams.nih.gov/health-topics/sprains-and-strains

  5. The plantaris muscle: anatomy, injury, imaging, and treatment

    Andreo A. Spina, DC*,, J Can Chiropr Assoc. 2007 Jul-Sep; 51(3): 158–165.

  6. Surgical treatment for muscle injuries

    Leonardo Addêo RamosRogério Teixeira de CarvalhoRene Jorge Abdalla, and Sheila Jean McNeill Ingham, Curr Rev Musculoskelet Med. 2015 Jun; 8(2): 188–192.

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