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6.4 SOLEUS

Symptoms

• Active TrPs in the soleus are the most common of all TrPs.

• An active TrP1 may result in unbearable pain during heel weight-bearing and can cause nocturnal pain in the area.

• Can lead to a restriction of ankle dorsiflexion (sagittal plane block), resulting in compensations and the development of lower back pain and pathologies associated with abnormal foot pronation.

• Active TrP2 and TrP3 can interfere with the soleal musculovenous pump, leading to the formation of oedema in the area.

 

Trigger Point Examination

• It is important that the knee be flexed to slacken the gastrocnemius.

• The palpation of taut bands / TrPs is very difficult in soleus, due in part to the overlying gastrocnemius muscle.

• Tenderness associated with the more distal soleal TrPs is commonly present deep to the Achilles tendon aponeurosis.

• To aid in the differential diagnosis between a soleal and gastrocnemius TrP, extend the knee while maintaining the same ankle position. A gastrocnemius TrP will become more sensitive as the knee is extended, whereas a soleal TrP will remain relatively constant.

 

Associated Trigger Points

• Commonly occur in gastrocnemius and tibialis posterior.

• Can also occur in flexor digitorum longus and flexor hallucis longus.

 

Differential Diagnoses

• Rupture of the plantaris muscle belly

• Achilles tendonitis

• Thrombophlebitis

• Baker's cyst

• Exercise induced leg pain

• Deep posterior compartment syndrome

• Intermittent claudication and nocturnal pain of the calf muscles

 

 

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