The soleus is a muscle in the calf that runs from directly behind the knee to just above the muscles around the ankle. The soleus is essential for everyday activities, such as running, walking, standing, dancing, and balancing.

Muscle injuries are the most common injuries in sports. Correctly diagnosing and treating muscle strain is vital for a full and speedy recovery. Identifying the injured muscle and getting suitable treatment can help prevent reinjury.

In this article, learn about soleus strains and other common calf injuries, as well as how to prevent and treat them.

soleus strain causing calf pain in person outdoors in running clothes with leg on bench holding calf.Share on Pinterest
The soleus is a muscle in the calf that plays a part in walking and running.

Soleus injuries are relatively common in runners. This type of injury is known as an overuse injury, which is why endurance and long-distance runners are at higher risk.

Injuries commonly occur as a result of fatigue or overtraining. They can also happen when the knee is flexed for a long time while running, such as during uphill running.

Other calf injuries, including gastrocnemius strains, are more common in athletes who sprint, including tennis players.

It can be challenging to identify a soleus injury just from a physical examination. As a result, doctors will typically use an MRI or ultrasound to confirm this diagnosis.

Ultrasounds are less good at detecting this type of injury, but doctors may still use them in some instances.

A doctor will also ask a person about their symptoms. Anyone with a soleus strain will feel pain when:

  • using the calf muscles
  • pressing on the Achilles tendon
  • doing dorsiflexion, which is lifting the foot by pointing the toes upward
  • stretching the foot or walking on tiptoe

As part of the diagnosis, the doctor will classify the soleus injury as a grade 1, 2, or 3 strain.

Grade 1

A person with a grade 1 strain may experience:

  • sharpness or pain initially during an activity
  • mild discomfort or no pain when continuing with the activity
  • tightness
  • post-activity aches or tight muscles

Grade 2

A person with a grade 2 soleus strain may have the following symptoms:

  • sharpness or pain during an activity
  • inability to continue the activity
  • pain when walking after the activity
  • swelling
  • bruising or discoloration

Grade 3

Symptoms of a grade 3 soleus strain include:

  • severe pain
  • inability to do physical activity
  • significant bruising or discoloration
  • swelling

The calf muscle comprises three different muscles called the gastrocnemius, soleus, and plantaris. These muscles come together above the ankle to form the Achilles tendon.

Injuries that can affect these muscles include:

Gastrocnemius strain

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Quick movements, such as sprinting or jumping, may cause gastrocnemius strains.

The gastrocnemius is the muscle in the calf that it is most common to strain. Also located behind the knee, the gastrocnemius is larger than the soleus.

While soleus injuries typically result from overuse, a gastrocnemius strain is more likely to be a sudden injury.

Commonly called tennis leg, this strain is often the result of a quick movement, such as sprinting or jumping.

Plantaris strains

Injuries to the plantaris are rare, as this muscle is well-protected by other muscles and does very little. In fact, the body does not require this muscle to function, and it may be absent in 7–20 percent of the population. Doctors use an MRI to diagnose a plantaris strain.

Doctors frequently recommend the RICE method as the initial treatment for muscle strains and injuries. The RICE method refers to:

  1. Rest: Avoid moving the strained muscle as much as possible. Get adequate sleep to help the body repair itself.
  2. Ice: Apply ice to the affected area to reduce inflammation and pain. Wrap the ice in a light towel to protect the skin from ice burns.
  3. Compression: Wrap the affected area with a medical bandage to prevent swelling. Do not wrap the leg too tightly, as this could cut off blood flow. Loosen the bandage if the area feels tingly, cold, or looks blue.
  4. Elevation: Keep the leg elevated above the heart when possible to reduce bruising and pain.

Despite being a standard treatment method for muscle injuries, there is limited research on the effectiveness of RICE. However, studies have shown that safely applying ice can reduce pain and swelling.

It is easier to avoid injuries than to treat them. Tips to avoid a soleus strain and other muscle injuries include:

  • Paying attention to discomfort. When exercising, it is vital to listen to the body and stop when there is pain or uncomfortable tightness in the muscle.
  • Warming up. Warming up the muscles with light cardio, such as walking, jogging, or gentle cycling, before vigorous exercise can reduce the chance of injury.
  • Stretching. Doing gentle stretches before and after exercising can also help prevent injury.
  • Using a foam roller to loosen tight muscles. There is evidence to suggest that using a foam roller can increase a person's range of motion and reduce pain. A 2018 study supported these benefits and found that foam rolling could temporarily increase muscle length and flexibility in addition.

Some stretches and exercises may help a person prevent or recover from a soleus strain. However, if the movements cause pain or discomfort, do not continue to do them.

Stretches to help soleus strains include:

Research indicates that up to 10 percent of people who have symptoms of a soleus strain or a gastrocnemius strain could have deep vein thrombosis (DVT).

DVT is a blood clot in the leg that can cause severe complications if it moves to the lungs. It requires immediate medical attention.

A person should contact a doctor immediately if they experience the following symptoms in the calf as these could indicate DVT:

  • severe acute pain
  • significant tenderness
  • swelling
  • discoloration, bruising, or a visible defect
  • redness

Getting a proper diagnosis and personalized treatment plan will help speed up recovery time and prevent reinjury. A doctor may also recommend physiotherapy for rehabilitation if the strain is severe.