This Sock Doc Video was made by Altra Zero Drop Footwear as part of their RunTalks series. I discuss how to naturally assess, treat, and prevent common lower leg injuries specifically related to the soleus muscle. Many athletes, especially runners, suffer from shin splints, Achilles tendinitis, plantar fasciitis, and other injuries due to a poorly functioning soleus.
Stretch it? No.
How about ice? No.
Orthotics or thicker shoes? Of course not.
Check out the video, heal up, and run.
Video Transcript
Cool. Here I am live feed, sweet. All right, tonight I wanted to talk about injury treatment prevention. That’s a big part of my sock-doc site, obviously. One of the big limiting factors of athletes improving is they get injured. You’re training well, you’re living well, everything’s going well, what sets you back, it’s typically not because you went on vacation or you decided to rest for a prolonged period of time, it’s that you were actually forced to rest. So if you can actually prevent an injury while improving, while running more and running intensely and running for a longer duration, that’s gonna make you a better athlete overall, and you’re not actually being forced to sit on the sidelines.
So you know, what do you think about what the most common injuries that athletes get? They get ITB syndrome, like Tyse [SP] did, that’s super common. They get plantar fasciitis, probably one of the most common injuries. Achilles tendinitis, shin splints, these lower leg, foot, ankle injuries, super common. So since we have kind of a short time tonight, I wanted to think, or I thought about one muscle that a lot of people underestimate, maybe undervalue, and can make a pretty big difference in how you can prevent an injury, and also how you train, and that’s your soleus muscle. Maybe you’ve heard of that muscle before. It’s one of your two calf muscles. It’s the lower one that eventually makes up your Achilles tendon that inserts into the back of your heel, and that’s, you know, people get Achilles tendinitis? They’re really talking about the tendon, that’s the part of the muscle that attaches to the bone, that is strained or maybe inflamed or maybe has some chronic dehabilitating type of injury there.
So the soleus is super important for power and stability, and it also helps you pronate properly. A natural elongation of your soleus muscle, and therefore the Achilles tendon, to pronate properly, not overpronate, like a lot of people maybe do, or they’ve heard that they do, but actually so you pronate properly. That’s the natural way that you walk. You pronate and supinate or hopefully you do or you’re going to get injured. And if you pronate properly, then you naturally absorb shock. If your Achilles tendon isn’t elongating properly, then you’re not going to absorb shock well, and it’s going to go right up to you ankle, knee, hip, and you’ve got a new injury to deal with. The aerobic muscle, sorry, the Achilles tendon and the soleus itself is super high in aerobic muscle fibers, about 90% at least. Even in sprinters, people who are very anaerobic and doing high intensity type training, it’s still mostly an aerobic type muscle fiber. So aerobic, we tend to think of longer, slower duration, at least not high peak intensities, and you know, you can run longer using your aerobic muscle fibers. But actually, hopefully all of us right now are using our aerobic muscle fibers just to sit. Me standing like, my soleuses are firing right now to support my body. That’s what aerobic fibers do, they support our body. So if you’re feeling like your feet ache at the end of the day and you want to like but them up, or you can’t walk around barefoot, or you need an orthotic, or you need a cushiony shoes, or you need to elevate your heel, then most likely you have a fatigued soleus and Achilles tendon, because you need to support that dysfunction in your foot. So sore calves will do it do, too, and like I said achey feet even during the day. Basically, if you have healthy feet and you have a healthy soleus muscles, you should be able to stand barefoot like I am, all day long, even if you’re on rock. You shouldn’t need to stand on cushion. It might make it feel better, but it’s because you’ve got a problem. You’ve got something going on with your foot or your lower leg.
Another point I wanted to make real quick, before I move on, is that you don’t just wake up injured one day. You know, these injuries that happen, whether you have Achilles tendinitis or whether you have shin splints, or plantar fasciitis, or whatever injury you have, you know, you might be out running one day and all of a sudden you’re like, “Ah damn, my Achilles is just strained,” or you wake up one day and your foot hits the ground and your heel hurts, and your like, “Ah, I’ve got plantar fasciitis.” That obviously didn’t happen just right then and there. This was a developing injury over time because you screwed up your injury equation, which is a balance between training and rest, meaning you trained too hard, you didn’t rest enough, maybe you trained too intensely or too long of a duration, and now your aerobic system can’t keep up with the type of stress that you put on it. So now all of a sudden these aerobic muscle fibers start to fail, your soleus fails, now your foot’s imbalanced, now you’ve got an injury. And that’s what we want to prevent. And the better you can do that the better runner you’re going to be, and not only that, the better you’ll feel throughout the day because you’ll move better, you’ll perform better. Okay?
So, a good way to look at or to treat the soleus is to work the trigger points out in that area. Foam rolling is really good, like Tyse said, but I’m a big hands person, I don’t use devices in my office much because I don’t like them. I like using my hands. So I wanted to show you how to treat the soleus, and we’ll see how my one leg balance is today. But your soleus is, boom. Lower part of your calf here, so right where your calf, your soleus starts to, where your calf starts to narrow out is your soleus. This is the gastroc up here, soleus is lower. They both go into your Achilles tendon. So when you deal with your soleus, I am going to stand on this one foot the whole time. What you want to do is squeeze it like that, go down, and and work on the sides of the soleus all the way down to your Achilles tendon on either side. Same with back here, just like that, working your thumb up and down the soleus. Okay? What you want to do is stay off the Achilles tendon. I always tell people to stay off the are where the injury is felt. So if you have Achilles tendinitis, then you actually want to stay off the actual Achilles tendon. So you don’t want to be pushing around here on the Achilles, you want to go on the sides of it, where the soleus muscle fibers attach to the tendon, or become the tendon. Okay? So what you’re doing is you’re looking for tender spots in there, holding them, working out the myofascial release, trigger point therapy, you might have heard, and you’re going to work out those tender spots, until there’s hopefully some relief. And you’ll know you’re on the right spot, talking like 20, 30 seconds, because what will happen is, you’ll feel a reduction in your symptoms, at that same exact time. So if I notice that my foot hurts or my foot aches maybe anywhere, even in the ball of my foot, and I work out the soleus and my foot feels better, then I know I’m in the right spot. And that’s a good way to help to heal up the tissue.
One thing we don’t want to do is stretch. We do want to elongate the tissue of the soleus, but stretching actually pulls these muscle fibers away from each other. And the more you stretch, and I know its a big stretch people like to is this stretch against the wall where you stretch out your calves. I think that’s the worst thing you can do, because you’re pulling the fibers away from each other when they’re trying to heal. Now we do want to increase flexibility in our soleus, but the thing is when you stretch muscle fibers, like if this was my Achilles and I stretched it like this to try to elongate it as an artificial method like that, I’m actually decreasing stability in the joint. And the more you decrease stability, your create obviously more instability, and then you’re gonna end up with a chronic weakness in the ligaments that make up that joint. So stretching is, in my opinion, contraindicative for any injury, or that also includes preventing an injury. So we want to naturally stretch, naturally elongate the muscle fibers of our calf, making up our Achilles tendon, by naturally increasing the flexibility, while improving stability.
So how do we do that? Well we do it with trigger point therapy, but we also do it by, and this is why I like Ultra, and I’ll give them a plug, and those of you who have seen my videos and by website, I don’t give company plugs unless I like them, but Ultra is all zero drop. So the great thing about that is, like I said earlier, people who need an elevated heel, they feel better with that because they’re now shortening the soleus, their shortening the Achilles tendon, taking the strain off the Achilles. Now if you’re trying to heal up because you injured yourself and you need to do that, that’s cool. But if you actually want to increase the power of your foot, the stability of your foot, and naturally elongate, naturally elongate, not by stretching, then what you want to do is slowly lower your heel to the ground, and start going from a ten to an eight to a four to a zero drop type shoe.
And what you’ll notice if you do this to quick, even when I started barefoot running, you’ll wake up the next day and your calves will be a little bit sore. So you want to slowly transition out of these types of shoes that you might be used to or maybe the orthotics, too, and start using a zero drop type shoe if you can do it, obviously as quickly and as comfortably as you can without getting injured, so you don’t create an injury as it’s happening. And the more you can do that, then the better your foot will be with regards to stability, mobility, and especially power, okay? So now you’ve naturally elongated that soleus, and you’ve decreased the chances of it injuring.
And the other thing to do is look at your training, because you only get injured when you’re training to hard. You’re either training too intensely, too often, or both. So check out the frequency, you know, are you putting in too many miles too quickly? Are you training too intensely, too much? Too much anaerobic work? Because remember, it’s all about aerobic and anaerobic with the soleus muscles. If you’re jacking up the anaerobic system and throwing off that aerobic/anaerobic balance, then you’re gonna effect your aerobic muscle fibers in your soleus. Next thing you know you’re injured. That’s all I got, thanks.
Peter Wood says
Hi Steve
Great talk, as always helps reinforce the key principles I have gathered from you.
Please, please try to get your video angles better so when you give examples, all we can see is someone’s head: if that is your soleus, you are in a bad way 😉
Thanks again
Peter
Sock Doc says
I did not shoot or edit this video. Though I thought it was done very well. What could you not see?
Rusty Kennedy says
When you pointed out the soleus, all I could see was the foot and someone’s head. I have an injury on the inside of my left leg below the calf next to the shin bone. Is that the soleus?
Dr. Stephen Gangemi "Sock Doc" says
Most likely the tibialis posterior.
Susan says
Thank you so much for the video and website. I’m learning a ton. I am suffering through a bone spur (confirmed by xray) / Achilles tendonitis on my right foot.
I got the way too expensive custom orthotics from the podiatrist only to suffer horrific hip pain in the opposing hip as a result. Got myself educated through this site, ditched the orthotics, and have transitioned quite easily to the zero drop shoes (barefoot at home has always been my norm and I never did heels).
My entire life I have had large, super tight calf muscles. I’m not an athlete at all (quite the opposite sadly, though I think me trying to change and start a walking program caused the bone spur this summer).
I suffered a soleus tear on my right leg years ago (same one that now has the Achilles tendonitis/bone spur) and the doctors all told me no connection. Somehow me thinks differently now.
Two questions: I still have some sharp pain in my heel. Some days are fine, others not so much. Given I’m not walking any extra, I spend a fair amount of time on my feet in my normal day to day so there isn’t really much “resting” I can do. Is this normal? Do I still need a bit of a heel rise until the pain goes away? The trigger points I’ve found are actually higher up, about two inches or so below the knee on the outside/back of the calf. Is this the soleus too or another muscle that may be contributing?
The rolling with “The Stick” and trigger point work has reduced the tightness of my calf muscles significantly but there is still room for improvement. I do not want to further contribute to a growing bone spur on my right heel and definitely want to get back to walking pain free again. Any advice would be greatly appreciated! And thanks again for all you do.
Sock Doc says
Check out the other foot/lower leg videos and the articles on barefoot walking/running.
justsomeguy says
I did not watch the video. But for this type of condition “eccentric heel drops” have helped me a lot. 4 varieties, only drop to “flat” level, drop below flat (using a step), and bent knee version of both.
Melanie J. says
The timing of this video was terrific! I’ve been suffering through an arthritis flareup for days after too much hiking, and the trigger point therapy you illustrated brought back my flexibility in the joint like magic! Every time I read or watch something of yours, you get me more interested in kinesiology. Thank you!
Sock Doc says
Cool. Thanks Melanie!
Dave says
For Susan,
there is injury prevention forum on this site,there You will find a lot of answers,
now one short from me,I have suffered this year from achillies tendonitis for months,heel pain.
Dont rush Your transition and if You will notice and discomfort after running in minimalistic shoes get back to higher running shoes.In fact in the period of transition try to run in minimalistic shoes once a week.slow,short distance.It takes a time for soleus muscle to grow and stretch.I was amazed when I was transitioning how sudden my soleus muscle started to grow!The problems You have,it would be even dangerous to run in minimalistic all the time.
Now after for one year of transitioning I am running once a week in a minimalistic shoes and its better and better,yesterday I was running in fast pace after it no any pain!
I adore zero drop shoes but for trail marathon races I will take higher shoes ,I need at least some support.
Susan says
Thanks (to all) for the additional info – very helpful. I’m not a runner, so overdoing is not an issue. Just struggling with my normal day-to-day walking. The minimalist shoes are fantastic and very comfortable. I don’t have calf pain or anything like that after walking in them all day. Several days in a row, no Achilles pain and then, seemingly, out of the blue, the Achilles acts up and is painful. I don’t know if that means I still need to waffle back and forth between “normal” shoes and minimalist shoes or what. I can’t make any correlation of activity (lack of activity or whatever) that triggers the Achilles pain. It is still MUCH better than when it originally hit back in July but how frustrating and terribly confusing this is to treat.
Sock Doc says
Probably muscular imbalances in your lower leg that need to be dealt with.
Dave says
Try to strengthen Your soleus muscle as much as You can,there are many
excellent Dr.Gangemi advices on this great site,follow them!
Achillies pain will pass away sooner or later,You can use “normal” shoes
in the meantime with minimalistic,too ’till it heals.
I am very curious about muscular imbalances iin thethe lower leg,I do hope that
Dr.Gangemi will publish some nice video and article about it,I how to deal with it,I have the same issue in my right leg,there is something wrong,the way the leg hits the ground or something else,some imbalance,with a left leg I dont have any problems at all.
It would be great to visit him,but for me isnt easyhe is on the
other side of the globe.
Nicole says
Thanks for the video. It really helped to explain a variety of conditions that can be prevented by running properly.
Donna says
I’ve a sore soleus when running – I can still run though worried I could make it worse or prolong injury, should I cross train and massage as you have suggested here or continue running & massage? Thank you
Dr. Stephen Gangemi "Sock Doc" says
If you feel the training is making it worse and/or you’re not improving, then you shouldn’t be running until your problem improves!