Runner Therapy: Soleus Strain and Running

Question from Twitter: @iRunnerBlog Hi I need  help.I’m 5 day away from my first full marathon & have a soleus strain. Any suggestions?I’m kind of freaking out

Runner Therapy Says: Generally runners think they have a soleus strain…either from searching the web, their friends or such.

Soleus strains are not really that common for runners. What is a lot more common is a common flexor strain from chronic tightness and subsequent fatigue of the posterior muscles of the leg. These are generally the ones that sit just under the calf muscle. These tend to get very fatigued with running, especially from long runs without good recovery. Thus, ’tis the season for this problem!

The pain is generally in the back of the leg, mostly to the inner side. (See previous blog on calf injuries)

My advice?

  1. Stretch the heck out of your gastroc AND soleus, as this will get the entire posterior muscle set. All day, every day!
  2. Make sure your toes are completely relaxed when you run, not gripping the bottom of the shoe. They should be together snugly (not able to separate apart) and not bending down with tension as you run. (You may need a more narrow toebox if you are able to separate your toes in your current one). However, don’t change your sneaks if you are this close to the marathon!
  3. Find a PT or very good massage therapist you can see 3-4 times to restore the soft tissues.
  4. No flip-flops, clogs, crocs without the back, or any other shoe you have to ‘work’ to hold onto
  5. Ice 15 min, several times a day
  6. Rest. Try not to walk, take stairs, or do any other calf-related activity as much as possible

Have no fear…it doesn’t have to be a game changer. However, left alone and untreated, it may be. Deep massage and helping to release the tension on the toe and foot flexors back there is crucial.

Have you ever had this issue before?  What did you do to help with the pain? What did your PT say? Do you find yourself wearing flip-flops too much?


(Marisa, a MS PT SCS ATC, is a member of  iRunnerBlog’s team and writes the Runner Therapy column, she is a physical therapist in private practice in midtown NYC called Dash Physical Therapy.  She one of only a dozen or so physical therapists  in the state of NY to be board certified in sports.)

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