The soleus is predominantly slow-twitch (type I), making it the primary postural plantarflexor. Unlike gastrocnemius, it acts only at the ankle. The Silfverskiold test distinguishes gastrocnemius from soleus tightness.
| Origin | Posterior fibular head and neck; Soleal line of the tibia and posterior tibia below |
|---|---|
| Insertion | Calcaneus via Achilles tendon — deep component |
| Nerve Supply | Tibial nerve (S1, S2) |
| Blood Supply | Sural arteries and posterior tibial artery |
| Actions | Plantarflexes the ankle — primary slow plantarflexor; Postural stabilisation — tonic activity maintains standing balance |
|---|
Isolated soleus contracture requires a different surgical release from gastrocnemius recession (intramuscular lengthening). Soleus tears occur in middle-aged athletes — the medial soleus is most commonly involved, mimicking DVT.
The deep posterior calf belly — palpable below gastrocnemius with knee flexed.
Partial soleus tear producing acute posteromedial calf pain mimicking DVT, distinguished by ultrasound and managed conservatively.
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