Soleus: Pain & Trigger Points

The soleus is a muscle of your calf. If it is tense or carries trigger points, it can cause various ailments and pains.

With a self-massage you can relieve tensions and trigger points and thus free yourself from pain triggered by this muscle.

On this page you will find exercises and instructions for such a self-massage.

Furthermore, I will explain which specific problems the muscle can cause, where it is located, which functions it performs, why it develops problems, and how you locate it.

1. Pain Patterns, Symptoms & Differential Diagnoses

Tensions and trigger points in the soleus can lead to pain in the calf, heel, sacroiliac joint and jaw.

Note that tension usually leads to local pain and sensitivity of pressure.

Trigger points, on the other hand, can refer pain to distant regions of the body. The pain zones of individual trigger points of the soleus are shown below.

1.1 Pain pattern sacroiliac joint & jaw – Trp X1

This trigger point arises very rarely and can trigger pain at the sacroiliac joint and in the temporomandibular joint (not shown).

It’s located at the lower lateral portion of the soleus, just before it “merges” into the Achilles tendon.

1.2 Pain pattern calf & back of knee – Trp X2

This trigger point is located at the uppermost part of the muscle. It often triggers pain in the middle of the calf, which may extend into the hollow of the knee.

This is why it contributes to the following pains:

1.3 Pain pattern heel & Achilles tendon – Trp X3

The trigger point X3 sits in the lowest part of the muscle, in the lateral area directly next to and above the Achilles tendon.

If it is active, it can trigger pain in the area of the Achilles tendon and of the heel. It thus contributes to the following ailments:

1.4 Symptoms and further ailments

1.4.1 Pain during exercise

The pain described above (especially calf and heel pain) usually arises during exercise, namely during walking and standing. Overall walking uphill or downhill and climbing stairs often causes great problems.

The pain can be so severe that it is unbearable to stand and put any weight on your heels.

1.4.2 Limited mobility in the ankle joint

Trigger points in the soleus often lead to limited mobility in the ankle. This means that affected persons are no longer able to bend it (move toes towards shin).

Nevertheless, to sink down on one‘s knees requires exactly this mobility, otherwise compensation movements would occur.

  • You get down on your knees and lift your heels off the ground.
  • You bend over with a round back.

Both can lead to more complaints.

Flexion at the knees with your heels up:

Many people push their knee joints far forward, which puts a heavy load on them. Especially if you don’t have a lot of musculature and are not able to control the movement properly.

Bending over with a round back:

When you bend over with a round back, your back muscles are heavily strained. At the same time, they cannot work properly, because they are in an extended position due to the round back.

This often overloads this muscle group, especially if you are not well trained.

1.4.3 Edema/Accumulation of fluid in calf and ankle joint

The soleus contributes to the venous return (more about this see chapter 3. ). Trigger points in the superior part of the muscle can impair this function and subsequently lead to edema in the area of the ankle joint and calf.

2. Attachment Points

The soleus extends down from both bones of the lower leg (tibia & fibula) its entire length, merges into the Achilles tendon and attaches onto the posterior surface of the heel.

Origin:

  • Tibia & Fibula

Insertion:

  • On the calcaneus via the Achilles tendon

Innervation:

  • The muscle is innervated by the nervus tibialis.

3. Function

This muscle has the following functions:

  • Plantar flexion of the ankle joint
  • Supination of the ankle joint
  • Vein pump support

3.1 Everyday examples of plantarflexion:

You perform a plantar flexion when you stand on your toes.

When walking and running, the soleus supports the toes when pushing off the ground. In addition, it controls and stabilizes the ankle joint during the stance phase by contracting eccentrically (tensioning while extending/stretching the muscle).

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2

3.2 Everyday examples of supination:

During supination, you move the inner edge of the foot upwards.

This function is very important when walking during the standing phase or when standing on one leg. Forces arise from the side which can push the ankle joint into a „valgum-position”. Supination prevents this and stabilizes the ankle joint.

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Supination & Inversion

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This picture shows a slight “valgum-poistion” at the ankle joint (pronation & eversion).

The soleus helps to avoid this position ...

3

... and thus "neutralize" the ankle joint – as shown in this picture.

3.3 Everyday examples for the venous pump

Most people have never heard of this function.

Blood from the veins of the legs must be transported to the heart against gravity, which is why active pumping is necessary. This pumping work is largely done by muscles.

The blood of the veins from the calves is pumped by the soleus towards the heart. If there are trigger points in the muscle, this function can be impaired.

The blood then sinks, and liquids can accumulate in the area of the calf and ankle joint. This can lead to pain due to the increased pressure.

If the vein pump is not used for longer periods of time, fainting might occur, for example in young soldiers who must stand still and are not used to tense their calves again and again while standing in order to maintain blood flow.

4. Soleus – Trigger Point Activation

Trigger points in the soleus are often, but not exclusively, activated by:

  • Active overloads
  • External factors
  • Satellite trigger points

4.1 Active overloads

In the case of active overloads, the function of the muscle is “overused”.

Especially if you are not used to put stress on it, or if your muscles do not have enough time to adapt to the demands and if you don’t perform any balancing activities (stretching & massaging), trigger points develop.

  • Long hikes
  • Jogging – especially trail running
  • Walking on slippery ground and toes slipping on the ground while performing a step
  • Volleyball, basketball, soccer etc. – strong muscle activity with every jump or sprint

4.2 External influences

If the muscle is exposed to cold for longer periods of time, especially after or before exercise, trigger points can get activated.

  • Thin trousers in winter
  • Short sports pants at low temperatures

External forces can also lead to an activation of trigger points.

  • Ball against calf
  • Someone’s stepping on your lower leg.
  • Crushing of the calf

4.3 Satellite trigger points

Satellite trigger points can arise in a muscle (here in the soleus) due to trigger points in other muscles.

In this case, it is possible that trigger points in the gluteus minimus lead to trigger points in the soleus.

5. Palpation

Since the upper part of the muscle is covered by the gastrocnemius, you can only feel it in the lower third of the calf. And even there only along an area of about a few inches, before it merges with the Achilles tendon.

  • Place one or two fingers on the lower middle part of your calf.
  • Do not apply any pressure.
  • Stretch your toes downwards repeatedly.
  • Try to feel the muscle contracting below your finger every time you move your toes down.
  • Experiment with the position of your fingers during the movements and try to feel the course of the muscle.

6. Self-massage of the Soleus

There are many massage options for this muscle. You can massage it with your knee, thumb, foam roller, massage ball or the Body Back Buddy.

As a massage technique, you can use all the techniques presented on this website, i.e. the …

  • Ischemic compression
  • Precise massage strokes
  • Pressure-motion technique

Which massage device you choose, depends on the required intensity and under what circumstances you want to massage yourself.

On this page, I show you the massage with a foam roller. This is, for a beginning, sufficient for most of you.

6.1 Self-massage with a foam roller

  • Sit on the floor and support yourself with your hands.
  • Place a foam roller under your lower leg.
  • Push yourself with your hands off the floor.
  • Slowly roll over the entire area of your lower leg and search for painful tensions.
  • Roll over the lateral, middle and medial areas of the calf by turning your leg inwards and outwards.
  • Massage each painful spot a few times, rolling from just before to just behind it.
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Pressure from the "outside".

2

Pressure from the "inside".

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Intensification of the massage.

References

  • Calais-German, Blandine. Anatomy of Movement. Seattle: Eastland Press, 1993. Print
  • Davies, Clair, and Davies, Amber. The Trigger Point Workbook: Your Self-Treatment Guide For Pain Relief. Oakland: New Harbinger Publications, Inc., Print
  • Simons, David G., Lois S. Simons, and Janet G. Travell. Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. The Lower Extremities. Baltimore, MD: Williams & Wilkins, 1993. Print.
  • Schünke, Michael., Schulte, Erik, and Schumacher, Udo. Prometheus: Lernatlas der Anatomie. Stuttgart/New York: Georg Thieme Verlag, 2007. Print