Issue link: https://www.massageandbodyworkdigital.com/i/77400
SOLEUS MUSCLE STRAIN Every April, Boston-area massage therapists see more than the usual amount of people with strained soleus muscles. This injury can be quite painful and last longer than most muscular injuries, and it often occurs in marathoners—especially those who run hilly courses, like Boston's. The soleus (Image 1) is the largest and strongest muscle in the calf. It gains its power from its complex configuration, attaching to its corresponding tendons at a 45-degree slant (called a multi-pennate structure) in multiple rows. The muscle starts at the top of the calf and attaches to the Achilles tendon at the bottom. It lies underneath the gastrocnemius muscle, which was discussed in a previous article ["Gastrocnemius Muscle Strains," Massage & Bodywork, November/December 2010, page 90]. These two structures are intimately connected, with some of their fibers overlapping. Some people consider them to be a single muscle, but their functions are different, and different tests are needed to check for injury of either structure. Pain from a soleus strain is felt deep in the calf, usually in the superior part, toward the knee. Discomfort can be felt in one spot or over a broad area, because this injury can leave many fibers strained and inflamed. HOW AND WHY THIS INJURY OCCURS It takes a lot of stress to injure this muscle. As mentioned, running uphill is one way people strain the soleus. That's because running uphill forces a person to bend his or her knees more than usual, and that puts a lot more stress on the soleus muscle. This same kind of stress is experienced with a lot of high jumping. Most people don't roll through the foot when they land from a jump, and landing on the balls of the feet with the knees bent puts stress on the soleus. If this is done repeatedly, the soleus can become compromised and ultimately injured. Improper alignment throughout the body can also affect the soleus muscle. For instance, when the feet are pronated and the arches are dropped, more of the body's weight is shifted toward the medial half of each foot. This places an imbalanced amount of weight on the medial half of the soleus and very little weight on the lateral half. As a result, one portion of the muscle is overused while the other is underused, causing an imbalance of muscle strength across the muscle fibers. Consequently, when force is applied to the lower leg, both halves of the muscle are vulnerable to injury—the medial half because it receives excessive strain, and the lateral half because it's in a weakened state. At the other end of the body, the alignment of the head and neck can also contribute to a soleus injury. If the head is forward and out of alignment, Soleus Sobota: Atlas der Anatomie des Mensche @ Elsevier GmbH, Urban & Fischer Verlag Munich the other end of the body is forced to compensate. A continual stress is placed on the posterior aspect of the entire leg, making it more vulnerable to gradual breakdown and eventual injury. INJURY VERIFICATION When the soleus is injured, a dull aching pain begins during, or directly after, strenuous activity. This injury isn't usually debilitating, but it puts a stop to the strenuous activities a person might enjoy doing, like tennis, biking, or running. As the injury progresses and more adhesive scar tissue develops, the discomfort earn CE hours at your convenience: abmp's online education center, www.abmp.com 97