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Soleus strain. Now what?
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Short question: left soleus strain. Just “ran” 2 miles at 10:00 pace, and stopped as soon as I felt it tighten. ANY increase in speed causes immediate pain.
Medium question: Tight posterior chain, particularly my hamstrings. Long time commuter, never stretching. Had regular issues with pain in my heels at the Achilles attachment point, and sometimes at the calf muscle where it connects to the Achilles’ tendon. Last week, I did some VO2 intervals on the bike (no stretching, of course). The next day, I did a basic, gentle 5 miler, at very basic 9:20 pace. It started tightening by mile 3, but since I didn’t stop, by mile 4 1/2 I was cooked. This week I didn’t run at all. I did 75 min on the trainer, and swam twice. I also did about 30 min of yoga every day this week. During the swims, I used the buoy the entire time. Today, as per above, I had to stop at 2 miles, even at a conservative pace. I had done a 10 min yoga warm up before going. Focusing on on Downward facing dog to lengthen the hammies?
I had planned to put a 20-30 min run on the schedule each day to gradually get back to my normal 90 min runs, but if I can’t even jog for 20 min yet, how can I proceed and not lose my fitness? Bike/swim focus for a while?
Last question: what kind of doctor/specialist should I look for? My general doctor isn’t very interesting in helping me solve this, long term.

Thanks,

Michael
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Re: Soleus strain. Now what? [mpderksen] [ In reply to ]
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Few hours later, it now hurts just walking around, doing chores. This is the same as last week, when I first blew it, and it was tender for a few days. First step is preventing re-occurrence, right? I assume that means typical gentle stretching, and rest (swim and bike are okay?).
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Re: Soleus strain. Now what? [mpderksen] [ In reply to ]
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Careful here. I had a Soleus tear from US Duathlon Nationals back around 2015 in St. Paul & unfortunately got some bad advice from a "sport's doc" who sent me down the wrong road. I ended up with a compensation injury on the other side at the hammy--a tear at the insertion-arse, it took me out of competition for a year. Thought HOKA's would help, it didn't really. I'm not a doc, but can only tell you to make sure you get a good one. A verbal reputation doesn't mean a good diagnosis or rehab program is a done thing. Even good docs have jacked stuff up regardless of the reputation.

That said, take all the time you need to heal this & literally work the kinks out. It's been about a good 2+ years now & am just getting my feet under me (literally).
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Re: Soleus strain. Now what? [mpderksen] [ In reply to ]
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The only thing that worked for me was resting it...2-3 weeks. A PT friend gave me a couple of stretches to do but resting was the key. When you start back stay off inclines...treadmill would probably be your best bet since you can stop immediately if it feels like it's tightening up. Do not try to gut out a run...you'll just reaggravate it and prolong your recovery...walk it in if this occurs during a run.
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Re: Soleus strain. Now what? [JoelO] [ In reply to ]
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Second the being careful advice. I'm actually heading back to the doctor tomorrow to figure out where to go from here with my chronic soleus issue I've had for the past 6-7 months. I did have a stint of physical therapy, which included massage, ultrasound treatment, calf raises, stair steps, stretches, and that all seemed to help for a bit. But then I strained it again somehow.

If you don't have access to a good sports-focused doctor/physio, I'd recommend resting it longer than you think you need to. Then when you get back into things, take it slower than you think you should.

Personally I'm just hoping mine won't keep me out all year.

Edit - Btw, if you're still having immediate pain with it, don't stretch it. Ice that puppy. Ice and rest. Then ice it more.

@brad_glasgow
Last edited by: iyapo: Mar 18, 18 19:40
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Re: Soleus strain. Now what? [mpderksen] [ In reply to ]
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Stop running. Don’t be stubborn. Fix this now and fix it for good or this can last months

Rest it completely and ramp up your swim/bike

Do not stretch. After a couple weeks and pain is gone, begin extensive strengthening and deep rolling then a gradual return to running

Good luck.
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Re: Soleus strain. Now what? [randomtriguy] [ In reply to ]
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Rest it. Ice it. Let it heal. Don’t stretch a strained muscle. Got it. A few weeks of extra bike/swim. Great!
What makes me most frustrated is that I’ve been running pretty consistently since last July. Only a few days/week while doing other stuff, but there were 10 milers, and some tempo runs in there. No problems. This has happened before, but it was when I went from 0-60, not when I’ve had a base. The only thing I can think of is that the bike intervals made me tighter than my normal hour of riding, and the next day I was right on the edge. Long term, I suspect I need to get my hamstrings and calves more flexible (unless that’s not really the issue....????). Over the years, my calf issues always seemed connected with periods of lots of driving, lack of stretching, or both. Lately I’ve been having lower back pain too. I think everything is connected, but I am not clear how to get this going the right direction.
Season starts, for me, June 10th. I have time, but not if I keep setting myself back.
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Re: Soleus strain. Now what? [mpderksen] [ In reply to ]
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Did you recently switch to low, zero drop or Hoka shoes?
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Re: Soleus strain. Now what? [mpderksen] [ In reply to ]
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Out of curiosity, where exactly is your pain/discomfort? Inside of leg? Posterior?

blog
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Re: Soleus strain. Now what? [stevej] [ In reply to ]
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Mdtrihard - Same shoe for the last few months, which is the same as the last pair that I got last July. ASICS Kayanos.

Stevej - The pain is at the bottom of the inner head of the calf muscle. The tenderness is about 45 degrees between directly behind and the inside of the leg.

Michael
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Re: Soleus strain. Now what? [mpderksen] [ In reply to ]
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I had a similar injury right after Duathlon Nationals last summer. Rest, and later increases flexibility, didn't cure it. It came back again and again. Got into my trusted PT and she started up the chain at my hips and found "stuff." Spent 6 sessions (plus home exercises) primarily on hips/glutes/hammy. Did some calf raises. Now I'm back to good. For good measure I use Running Rewired to rotate through my prehab exercises. Jay knows his stuff and operates out of the PT 'lab' I go to.
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Re: Soleus strain. Now what? [mpderksen] [ In reply to ]
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I've had this injury probably 6-7 times in the last 6 years. Things can be going well and it happens fairly unpredictably but usually when increasing volume or intensity.

I can get it to heal fairly quickly ie a month or two by doing the following. First as soon as it starts to hurt in the soleus stop and walk home. Then I don't run until it is pretty well pain free. Walking fast biking and swimming are all okay but pushing hard off the wall in the pool isn't good. Doing soleus stretch as well as regular Achilles tendon stretch (static stretching) right before running helps prevent it.

For years I bought into the static stretching doesn't work theory but I think it does help. Funny because when I started running in my teens static stretching keep me going good. On the other hand a fifty year old and a teenager are different animals.

They constantly try to escape from the darkness outside and within
Dreaming of systems so perfect that no one will need to be good T.S. Eliot

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Re: Soleus strain. Now what? [len] [ In reply to ]
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For those of you with soleus injuries, is biking ok? By that I mean you don't reinjure it biking?

Saw my doctor about my issue today. She's going to begin OMT (osteopathic manipulative treatment) on Wednesday while I wait on her referral to a chiropractor/physio therapist who does ART (Active Release Technique, which is a type of OMT I guess). I plan on getting back to running *very* slowly, so I'm hoping the bike will compensate.

@brad_glasgow
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Re: Soleus strain. Now what? [iyapo] [ In reply to ]
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Biking is probably ok as long as you don't do any sprint work.
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Re: Soleus strain. Now what? [mpderksen] [ In reply to ]
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My protocol for soleus strains, and have had several over the last couple of years, is no running for 3 weeks and if feels good then and no pain from one legged squats and calf extensions, I take one more week off from running. Then run walk for two weeks, and back good to go with normal running after that. Biking and swimming ok, but no mashing on pedals.
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Re: Soleus strain. Now what? [iyapo] [ In reply to ]
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My experience with the soleus is it needs rest. Cycling can be ok and I would not push hard or stand up. But I prefer a week off from all activity. Then swimming and pool running for the first week. Slowly add more running and back if you feeling any discomfort.

week 1 -rest- do nothing
week 2- swim/pool run
week 3- add light cycling.
week 4- add some alternating walk jog (like alternating between 3min walk and 30 sec-1 min jog) maybe 3 miles in total or so. (3 days)

You won't lose that much fitness. But you don't want this to be 8 weeks of no running or worse.
Last edited by: hhtdp0: Mar 19, 18 15:42
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Re: Soleus strain. Now what? [AKCrafty] [ In reply to ]
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AKCrafty wrote:
I had a similar injury right after Duathlon Nationals last summer. Rest, and later increases flexibility, didn't cure it. It came back again and again. Got into my trusted PT and she started up the chain at my hips and found "stuff." Spent 6 sessions (plus home exercises) primarily on hips/glutes/hammy. Did some calf raises. Now I'm back to good. For good measure I use Running Rewired to rotate through my prehab exercises. Jay knows his stuff and operates out of the PT 'lab' I go to.

I've had this issue repeatedly over the years and second this including the exercises in Jay's book.
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Re: Soleus strain. Now what? [bglasgow] [ In reply to ]
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I find biking is quite alright as long as you don't do big watts. Long low to medium intensity bike rides are okay for me.

They constantly try to escape from the darkness outside and within
Dreaming of systems so perfect that no one will need to be good T.S. Eliot

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Re: Soleus strain. Now what? [len] [ In reply to ]
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Thanks!

I went to a sports-specialist chiropractor yesterday and discovered that what the physical therapists had called a soleus strain was actually fibular head pain, caused by the impact of my fat ass pushing my fibula up on the nerve. It's somewhat related to the IT band issue I had some time before that injury. So it's foam rolling and loosening of the glutes and hip for me, as well as whatever chiropractic "adjustment" voodoo they do. He actually had me go ahead and run today and it felt good, so I'm as pleased as punch.

Hope the OP is finding some relief. I really think there's a huge difference in finding someone who specializes in sport vs. normal doctors and even physical therapists who mostly deal with old people. My chiro is even doing the same Tri that I'm doing in August.

@brad_glasgow
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