Soleus Muscle Pain: Causes, Soleus Strain and How to Recover

01Anatomy

What the soleus does

The calf has two main muscles: the gastrocnemius, which crosses the knee and gives the calf its shape, and the soleus, which lies beneath it and attaches below the knee. Both join to form the Achilles tendon. Because the soleus does not cross the knee, it works especially hard when the knee is bent, such as during walking, running, climbing and standing. It also helps pump blood back from the legs to the heart. Endurance runners rely heavily on the soleus.

02Symptoms

Symptoms of soleus pain or strain

• Deep ache or tightness in the lower or middle calf.
• Pain that builds gradually during a run rather than a sudden “pop”.
• Pain with bent-knee calf raises or walking uphill.
• Stiffness in the morning or after rest.
• Tenderness when pressing either side of the lower calf.
• Usually little bruising, unlike some gastrocnemius strains.

03Causes

Causes

• Increasing running distance or pace too quickly.
• Hill running and speed work.
• Changing to minimal or lower-drop shoes.
• Fatigue and inadequate recovery.
• Previous calf strains.
• Weak or poorly conditioned calf muscles.
• Older age, as calf strains become more common.

04Compare

Soleus or gastrocnemius strain?

• Gastrocnemius strain: often sudden, sharp pain in the upper calf during a sprint or jump, sometimes with bruising; see calf strain.
• Soleus strain: more often gradual, deeper and lower in the calf, worse with bent-knee movements.
• Test: calf raises with a straight knee mainly load the gastrocnemius; with a bent knee they load the soleus.
• Recovery: soleus strains may take longer to return to running.

05Other

Other causes of lower calf pain

• Deep vein thrombosis: swelling, warmth and redness in one calf.
• Muscle cramps: sudden tightening, often at night; see charley horse.
• Shin splints: pain along the inner shin bone; see shin pain after running.
• Achilles tendinopathy: pain lower down, near the heel.
• Referred pain from the lower back (S1 nerve root).
• Chronic exertional compartment syndrome: tightness and pain that start at a predictable point during exercise and ease with rest.

06Early

Early management

• Stop running if pain builds during a run.
• Walk normally if comfortable, avoiding limping.
• Use ice for comfort in the first days.
• Gentle calf movements, such as ankle circles, to maintain mobility.
• Avoid deep massage in the first few days.
• The NHS advises rest, ice, compression and elevation for strains in the first days.

07Exercises

Rehabilitation exercises

• Seated calf raises: sitting with knees bent and a weight on the knees, rise onto tiptoes, 3 sets of 15.
• Bent-knee standing calf raises: on both legs, then single leg.
• Bent-knee calf stretch: against a wall with the back knee bent, 30 seconds, 3 times.
• Isometric holds: hold a bent-knee calf raise for 30–45 seconds.
• Walking and cycling as pain allows.
• Hopping and skipping later, before returning to running.

08Return

Returning to running

Return to running when you can walk briskly without pain and perform 20 or more single-leg bent-knee calf raises comfortably. Start with short, easy runs on flat ground, possibly using walk–run intervals, and build gradually. Avoid hills and speed work until running feels normal. Keep strengthening the calves two or three times a week to reduce the risk of recurrence, as previous calf injury is a strong risk factor for future strains.

09Time

How long does recovery take?

Mild soleus strains often settle in two to four weeks, while more significant strains can take six weeks or more. Recovery time depends on severity, age, training history and how gradually activity is resumed. A physiotherapist can guide a structured programme if pain persists or keeps returning.

10Cases

Three common situations

• Marathon runner with deep calf tightness after adding hill sessions: likely soleus overload; reduce hills and start bent-knee strengthening.
• Sudden sharp pain in the upper calf during tennis: more likely a gastrocnemius strain.
• Swollen, warm calf after a long flight: seek urgent assessment for DVT.

11Prevent

Preventing soleus injuries

• Increase running volume gradually, by around 10% a week.
• Include seated and bent-knee calf raises in your weekly routine.
• Warm up with easy jogging and dynamic calf movements before speed work.
• Change shoes gradually, especially to lower-drop or minimal shoes.
• Allow recovery days after long runs or hill sessions.
• Address previous calf injuries fully before returning to high loads.

12Older

Soleus strains in older runners

Calf strains, including soleus strains, become more common with age, and recovery may take longer. Older runners benefit especially from regular calf strengthening, sufficient recovery between hard sessions, and gradual changes in training. Research on calf strain risk factors found older age to be one of the more consistent predictors of injury.

13Summary

Key points to remember

• The soleus is a deep calf muscle working hardest with a bent knee.
• Soleus strains often develop gradually in runners.
• Bent-knee calf strengthening is key to recovery.
• Swelling, warmth and redness need urgent assessment.