what to do for soleus strain?

Expert Discussion Recovery and Regeneration
1

My daughter had a meet Tuesday night. She ran in the open 100/200/400m sprints.
She had about an hour rest/warmup between each event, so she did get full recovery, but it was very windy and cold and hard to keep her core warm.

As best she could, she did stretching, buildups etc. trying to keep warmed up.

Her first race was 100m, then the 400m.
After walking around for about 30 minutes after running the 400m, she remembered her left Soleus felt a little tight and slightly sore. She continued stretching and didn’t really pay any more attention to it… her shins were actually hurting her more, as they were both pretty “beat up” after landing hard on them doing box jumps on Sunday, a couple days earlier.

After running the 200m, she noticed a little more pain in the right Soleus area.

During the meet she had PR’s in each event, in spite of the very cold and very windy conditions… in the 100m she had a .7 second drop in her PR from anything she ever ran in High School outdoor, the same for the 200m, she had a .17 second drop in her PR from any previous High School outdoor 200m… the 400m was a .79 second drop in her present outdoor season PR, so she was running at a higher intensity.

Last night after doing EMS and giving her massage, I could see it was slightly swollen in the right calf/soleus and it was sore. I told her she would not be able to run in Thursdays (tonight) meet because of this.
During school today, she went to the trainer, who looked it over, and said it was a soleus strain, and she could see faint bruising. She did Kinesiology taping to the area.
She did not run in the meet.

She started on a new schools track team 3.5 weeks ago. the workouts are light, with no real accelerations or speed… mostly speed/special endurance and tempo type stuff with drills.
Previous to changing schools, she trained to one of Charlie’s 12 week, modified L-S 400m program, which ended in February. She had huge gains while working to this program.

Since then, it was just random workouts to try to keep from losing fitness…as, one thing after another happened and she was not able to train regularly or with a consistent program.
On Saturdays, we do a short speed workout
I give her massage about 2 times a week, sometimes more… plus, EMS “active recovery” 2 times a week and deep massage “stretch relax” every other week or so.

She lifts at least 2 times a week, as homework allows, but this is the first to go if there is time constraint.

What would recommendations be for the next few days, week, or?

2

I would recommend that she take at least 1 week off, then ease back into things. When are your important meets this year? She can do some bike workouts while she stays off it, though I’ve found that while I can keep my athletes from re-injuring themselves training or at meets, I can’t always keep them from re=injuring themselves during PE class at school. One of my runners was out for 12 days last year with the same injury, and we had to be cautious the rest of the season: high socks, soleus stretches and rolling or massage in every warmup after that. It probably didn’t need to be 12 days, but she twice thought she was fully recovered, and made it about 10mins into a workout before having to stop again.

3

The school has Sunday practice? So the track workouts are light as you say but they do explosive box jumps on the weekends?

4

Thank you for all the great information. She is also doing upper body lifting for now. End of January she had the same problem in the left calf soleus, but the pain did not originate from the calf, it was at the base of the knee… after looking through the “trigger point” ebook that I downloaded a couple years ago here, I found her problem in the left soleus and did lots of massage, and ems with lifting and bike work. A couple days later, she was fine.

I think this time, it is a little more strained though, so will be extra careful.

She only has one more school meet, which is next Thursday. Since she transferred from another school, her time is automatically DQ’ed per WIAA rules until next season… technically, she is supposed to only run in the JV races per WIAA rules.
She has been a good sport about it all, but as competitive as she is, it really does get to her sometimes…especially when she wants to run against the competition, and she has to get her time in a JV race, running against herself.

In June there will be a couple big meets, and 2 more big meets in July… then a break for the rest of summer before starting a GPP program in September, (which will be the first time in 2 years she did not run cross country, should be quite noticeable the following outdoor season) followed by a 12 week modified CF 400m S-L program… This coming Winter season she will get to run in most of the indoor meets.

Again, thank your insight and help.

5

On Sundays she is seeing a trainer to help with some backside running mechanics issues… this is separate from school practice.

6

Rich
Injuries are a reality for anyone who spends a great deal of time training.
Stay positive as this will be your challenge despite your daughter’s possible loss of faith.
She will look to you to see if everything is going to be okay. Everything will be okay. You are aware of a problem. Now you need to learn to fix it.
The only way things won’t be okay is if you ignore the obvious signs of what is currently going on. You are not doing that.
Unless she has had an acute injury , this issue appears to be related to high use, high wear and tear.
That is okay as well but you need to manage what is going on NOW.
Likely the shoes are more than 2 months old and or there is wear on the rubber of the shoe when you turn it over. If this is the case , toss the shoes and replace them asap.
Therapy. Several things you need to start doing now. At night , rub the calves from the achilles down and up the entire calves with heat and gently wrap with saran. She can wear a light sweat pant to bed or gently wrap with a tensor over the saran.
Before school, after school and after training do some ice baths up to her knee. Buy 2 pales at home depot that are high enough , buy commercial ice to have enough on hand and dip the entire lower leg into the ice bath. Try not to make it too cold or she won’t be able to tolerate it . You will need to experiment and possibly take the temperature of the water so it’s not too cold but cold enough to create a therapeutic effect. I like the idea of treating up to the knee for several reasons.
ARe you doing enough work around the hip area? Trail leg exercises, side leg raises? leg swings? how tight are the hamstrings? ARe the calves working too hard because the hamstrings are so tight? or is the core not functioning the way it needs to? Ask yourself these questions. This information does not need to be passed on to your daughter. Let her focus on other things.
Is your daughter recovering from the work? Is she sleeping well? Is she able to focus easily? How is her appetite? If there are issues with any of these areas than you can address each one as a possible function of over training.
You don’t need to stop for one week but one week of active rest doing something off her feet might be good / see how she feels about that. How do you feel about that?
When you are doing EMS active rest, where are you doing this? Culprits of tightness would be glutes, hams, back and quads and calves in that order. Glutes and hams likely contributing to a great deal of the issue.
Tell her school the doctor says she is not able to do x, y , z. GEt a note if need be. Don’t tolerate PE teachers making her do something that will compromise her passion. Negotiate a plan with PE teacher if need be. Most teachers are motivated to deal with what ever they need to.
Use down time as an opportunity to work on things that might not otherwise be doing.
Your primary goal… STAY off her feet as much as possible and train around the issue . One week won’t cut it by the way. I will assure you this accumulation did not take one week to occur.
Let me know what you think and if you need further ideas about how to replace specific training.

7

Ang has great info, and makes a good point about get a note or just say the doctor says then get a note if they call you on it. I’m a teacher and I’ve had a PE teacher ignore my request for alternative exercise (they were doing something like 300 jumps on the gym floor over an hour), and I had a long/triple/100m athlete with shin splints I was trying to get fixed.

8

calf strains are a pain is the @$##s.
I have chronic calf problems, mainly soleus related.
Take your time for recovery. I know from experience soleus can handle allot of work even when its not yet 100% recovered. Better to take a week too much off running to be sure than getting a chronic problem with nagging calfs like me for over 15 years.

9

Are you sure it is a soleus strain and not a posterior shin splint? The posterior tibialis is affected with the latter and could easily be mistaken as a soleus issue.

I like everything Ange said and would also recommend some isometric calf raise in stretch (not fully stretched) and contracted position. You can do it to focus on gastroc and soleus. The other thing you may want to add in later are some different line hops type activities. Mark McLaughlin posted on elitefts.com some of the hops he had his athletes doing with boxes of different angles a few years ago. That may help her get some different muscles stronger and better conditioned around her ankles.

I would expect her to be able to do the isometrics and ankle dorsiflexion, eversion and inversion activities now. You can start with isometrics for all if active movement reproduces pain and remember to begin with less than maximal contractions. Progress by increasing contraction and or resistance as tolerated and then later on add in some of the different hops.

10

Ange always has great insights to these things. I’ve come to conclusion injuries happen for reasons which I may or may not fully understand why. Doing a lot of hands on work, I try to not only treat the area (calf) but elsewhere as I feel. I believe I have a good understanding on muscle tone and often can easily tell where to work. As Ange hinted, it could be other issues and could be related to arm swing differential which might cause one foot to land slightly different than the other, or maybe just excessive running on turns etc.

In a time like this, there are options for training. Pool work not touching the ground can help keep fitness up. Bike tempo as well as long as no irritation during pedal cycle. Med ball wall throws (chest pass, side throws, overhead etc), weights both upper and lower body as tolerated, and also try to get a few massage treatments if possible. If so, I would ask the therapist what their beliefs are as to treatment. Too many want to jam fingers doing trigger point or ART style work and I find it is not very effective. A nice Swedish style would probably work best for most common masseurs unless there is a specialist in sports massage around who understands these things.

Just two weekends ago I had to sit about 6 athletes due to nagging issues that were not quite injuries. They came to the meet to get treatment from me. I spent 8 hours doing massage on nearly 12 athletes, most got 2 sessions that day and felt 200% better afterwards. Although I know many still need more work, sometimes things like this are blessings in disguise!

11

Thanks everyone for the help and suggestions.
Was out of town over the weekend, and started typing a reply a number of times only getting pulled away to do something else and then getting side-tracked.

She is doing better, still has some pain and will be going to a sports doctor today.

She has been doing upper body lifting, bike work about every other day, with stretching everyday… she has a lot of homework lately, so doesn’t have time for both therapy and workouts everyday, having to compromise.

Using the SpeedCoach Plus EMS settings on “Massage”, she is getting EMS every third day. The massage table is set-up in the basement. There is a large screen tv in the same room with a stereo, but she usually “naps” when getting EMS or massage.
I have been massaging her about every other day.
Last night, I did both EMS massage and hand massage. The soleus area at first was sensitive to massage, but after working lightly and then a little more pressure later she was not sensitive to the massage.
She has also been getting ice buckets.

Yes, her shoes were needing replacement…and she now has a new pair.

I missed the cellophane part of your post at first, Ange, and not sure how that should be used?

What about Compression Socks? Would that be something she should wear now or in the future?

She is still not happy about changing schools, even though she knows she had to do it and that it was for the better…all her friends are at her old school, and she doesn’t know anyone at the new school, plus it’s very cliquish and she doesn’t feel she fits in. But, other than that, everything else is fine.

I am wondering if this injury could be caused from not enough in her workouts, and then during the past 3 meets that she ran in running 100m/200m/400m? I actually feel that the very cold and windy day had a lot to do with the strain.

Daughter can only run in JV heats or meets, as per State WIAA rules because she is a transfer student…this has had a big effect on her enjoyment level, but she has been a good sport.

This is what her daily High School workout looks like:

Monday:

“Speed Circuit”
2 x 2 x 10m block starts
2 x 2 x 10m Hills (hill is tiny, and about 10 degrees)

2.5 hours.

Tuesday:

3 x 200m
or
300/200/150m

2.5 hours

Wednesday:

Warmup, no workout

Thursday:

Meet (Daughter only ran in JV races, and last meet was only meet #3)

Friday:

Warmup, no workout

Saturday:

Meet (Varsity meets that have no JV heats, so daughter cannot participate, so does not attend)

About every other Saturday I take her out and do a short speed workout.
For a couple Sundays, she has gone to a trainer to help with her mechanics.

The intensity of the school workouts are low and a lot of time passes, with sprinters at rest between different exercises.

She had been doing only stretching during the workouts since injury…then Tuesday of this week at practice, the trainer told her she could run a 350m/200m/150m @ 50% effort, and on the track instead of grass…which she did, and into the 150m her soleus started hurting.

I told her the week previous that she was not to run, so I talked to the coach yesterday.
Coaches wanted her to run 200/400m in tonight’s meet and to be “pace” runner for sprinters during the next couple weeks to get them ready for Districts/State championships.meet.
I told the sprint coach daughter had appointment with her doctor today, that she was still experiencing pain and still needed rehab and we would see what the doctor had to say.

I should have talked to the coaches last week myself, as they are busy dealing with many kids and different personalities, and probably needed to hear from the Parent instead of the athlete.

Addition:

Actually, I did talk to the sprint coach the day after the injury, but there was no clear communication as to when she would start running. Next time, this will be clear so that there is no confusion later.

12

I have a question…

On a Sunday, 2 days before my daughter strained her soleus, she had a bad fall doing “resistive” box jumps using a 24" box and a verti-max… I know, I know, after it happened it dawned on me not the safest thing to be doing.
She did not land on the top of the box and landed midway on her shins on the top edge of the box, causing scrapes, bruising and swelling and a lot of pain.

On Tuesday, 2 days later at the meet, her shins were still very sore, scraped/black/blue, slightly swollen and still healing. She also noticed on the same day of the meet when she injured her soleus, that the same leg as her injured soleus, a large area of the shin is “numb”. This same area is still numb, and her calf is somewhat tender to the touch. The past 2 days is the first running, she has been running slow, small circuit, today bike and upper body weights.

Could the nerves of the shin being temporarily damaged have something to do with the light pain she still feels in her calf?

Also, I just noticed this thread should be in the “Injury” Forum… could the Administrator please move this thread ?

13

I don’t really have much to add to this in terms of your specific question. I remember though, a good friend of mine strained his soleus at the very end 2006 and it took ages before if fully recovered, I believe it was March at the earliest he was fully confident on it. He was receiving regular therapy throughout the whole period and dealt with it professionally. I am not sure why it would take so long, perhaps because it is a postural muscle and therefore gets more taxed by daily life.

14

No one can really answer your question without seeing her. It is important information that should not be overlooked. I would tell everything that you know to the doctor or therapist treating her. They should assess her strength, reflexes, etc on each side. This will give them some information in regards to how the nerves are functioning, what the issue is and how to treat it.

15

It has been almost 4 weeks since the initial calf strain (April 30), still slight pain/tightness and at the thickest part of the calf is about 10 -15% larger in circumference than the other calf. Especially noticeable when giving massage.

She has been seen by a local chiro/ART doctor, but she will now go to a different sports chiro/doctor in the Seattle area whom has always almost instantly fixed what we thought and were told by other doctors/therapists as being long term healing injuries, which, after adjusting, he explained were not injuries, just maladjustment… hopefully this will be another case of that.

She has been doing upper body lifting, bike work and Ange’s core workout. The past 2 weeks, added stair raises and step ups (body weight).

She has only been able to run on the grass a couple times, at about 50% and low volume, as I have told her to stop as soon as she feels pain.

Yesterday she was able to run on grass @ 50% and finished small circuit, she said she felt good, but she still could feel a little tightness and a dull light pain.

Any suggestions or comments?

16

Has she been wearing compression socks? Have they helped? I hate to say it, but I suspect this may end up being an on/off issue for the rest of this summer.

17

I wasn’t sure about compression socks so I haven’t ordered any…I asked 2 weeks ago, if I should get compression socks in a previous post on this thread at the top of this page, but I don’t think anyone seen it.

18

Yeah I didn’t see it until I re-read the thread just before I replied. :frowning:

19

Thanks for bringing up the compressions socks, rainy.here. I Went to the local walmart/riteaid/walgreens and all I saw was inexpensive diabetic socks that didn’t look like they gave much support. Any recommendations?

20

Judgement call on your part on how much to spend (if anything), since they may help, but they may do nothing.
2XU and CEP make very good compression gear, but they are also pretty damn pricey.