From the Guidelines
Treatment of soleus muscle strain should prioritize a comprehensive approach focusing on pain management, rehabilitation, and gradual return to activity, rather than solely relying on rest, ice, compression, and elevation, as recent evidence suggests that functional support and exercise therapy are more beneficial for recovery 1.
Key Considerations
- The most recent and highest quality study, published in 2018, recommends against the use of RICE as a treatment modality after a lateral ankle sprain, which can be applicable to soleus muscle strain treatment 1.
- NSAIDs may be used to reduce pain and swelling, as suggested by the 2018 study 1.
- Functional support, such as the use of a brace, is preferred over immobilization, and exercise therapy should be started as soon as possible to recover joint functionality 1.
- Gentle stretching and progressive strengthening exercises should be introduced after the acute phase, starting with isometric heel raises and advancing to eccentric heel drops as pain allows.
Rehabilitation and Return to Activity
- Physical therapy is beneficial for moderate to severe strains, focusing on restoring range of motion, strength, and proprioception.
- Gradual return to activity should follow a structured rehabilitation program, typically taking 2-6 weeks depending on strain severity.
- Supervised exercises with a focus on proprioception, strength, coordination, and function are advised for sport resumption 1.
Additional Recommendations
- Identifying and addressing modifiable risk factors, such as predisposing factors, can help prevent future injuries 1.
- Communication between healthcare professionals and patients is crucial to ensure proper treatment and rehabilitation, and a communication checklist can be used to minimize errors 1.
From the Research
Treatment of Soleus Muscle Strain
The treatment of soleus muscle strain is not explicitly mentioned in the provided studies. However, the following information can be gathered:
- The anatomy of the soleus muscle is complex, with two proximal intramuscular aponeuroses (medial and lateral) that are formed as a direct continuation of the surrounding epimysium 2.
- The location of strain injury in the soleus muscle can be identified using MR imaging, with five sites of strain distribution: musculotendinous junction sites (proximal medial strains, proximal lateral strains, and distal central tendon strains) and myofascial sites (anterior strains and posterior strains) 2.
- Clinical and ultrasound examinations can lead to misunderstandings about traumatic injury to the soleus, highlighting the importance of accurate diagnosis 3.
- Differentiating strains of the gastrocnemius or soleus is important for treatment and prognosis, and simple clinical testing can assist in diagnosis, aided by knowledge of the anatomy and common clinical presentation 4.
Key Findings
- The soleus muscle has a unique anatomy, with intramuscular aponeuroses that penetrate deep into the muscle belly 2.
- Strains of the proximal medial musculotendinous junction are the most common type of soleal muscle injury, comprising 56.4% of all cases 2.
- Accurate diagnosis of soleus muscle strain is important for treatment and prognosis, and can be aided by knowledge of the anatomy and common clinical presentation 4.
- MR imaging can be used to identify the location of strain injury in the soleus muscle 2.