DR COLIN GRIFFIN PHD ASCC 

Introduction

Calf muscle strain injuries (CMSIs) are a significant cause of time-loss in professional football, consistently representing 6–12% of all muscle injuries in UEFA and FIFA surveillance studies.1,2

However, these datasets rarely differentiate between gastrocnemius and soleus involvement, masking the true contribution of soleus pathology in elite football.

Clinical experience and smaller imaging- based studies suggest that soleus injuries are both common and under-recognised, in part due to their deep location and the subtle, often delayed onset of symptoms.

When the intramuscular aponeurosis (IMA) is involved, recovery can be prolonged and reinjury risk elevated.

This article explores why soleus strains are so disruptive in football, highlighting key anatomical, mechanical, and biological factors, and presents a practical rehabilitation model informed by tissue healing and performance demands.