National Academy of Sports Medicine

Athletics and Fitness Association of America

Canadian Fitness Professionals

International Sports Sciences Association

ACE Course ID: {{aceId}} and Credits: {{aceCredits}}

American Council on Exercise

American College of Sports Medicine

The Brookbush Institute (BOC AP# P10038) is approved by the Board of Certification, Inc. to provide continuing education to Athletic Trainers (ATs). This program is eligible for a maximum of {{credits}} hours/ Category A CEUs. ATs should claim only those hours actually spent in the educational program.

Board Of Certification

PTA Global

Provider #1315 Home Study and Credits: {{ncbtmbCredits}}

National Certification Board for Therapeutic Massage & Bodywork

Providers of Approved Continuing Education

REPs Ireland

World Instructor Training Schools

Completion of this course will earn you {{credits}} non-contact hours of continuing education in "Anatomy and Physiology" with Yoga Alliance

Yoga Alliance

Australia Physiotherapists

AUSactive #: {{ausActiveId}} and Credits: {{ausActiveCredits}}

AUSactive

This activity is provided by the Texas Board of Physical Therapy Examiners Accredited Provider 2309052TX and meets continuing competence requirements for physical therapist and physical therapist assistant licensure renewal in Texas.

Texas Physical Therapy Association

New York Physical Therapist just a disclaimer The Brookbush Institute (B2C Fitness) is recognized by the New York State Education Department's State Board for Physical Therapy as an approved provider of physical therapy and physical therapist assistant continuing education.

New York State Education Department's State Board for Physical Therapy

CIMSPA course ID: {{cimspaId}} and Credits: {{cimspaCredits}}

Chartered Institute for Management in Sport and Physical Activity

The Brookbush Institute is an AOTA Approved Provider of professional development. PD activity approval ID# {{aotaCourseApprovalNumber}}. This distance learning-independent activity is offered at {{aotaCredits}} CEUs {{aotaLevel}} {{aotaCategory}}.  AOTA does not endorse specific course content, products, or clinical procedures.

American Occupational Therapy Association

Integrated functional anatomy of the soleus. Attachments, nerves, palpation, joint actions, arthrokinematics, fascia, triggerpoints, and behavior in postural dysfunction. Examples of common strength exercises, foam rolling, and stretches for the calf muscles.

Soleus

Access to all courses with monthly membership

Brookbush Institute

I have almost completed my CPT certification and am half-way through the Human Movement certification to inform my massage practice. The different modalities of reading, watching audiovisual materials, and attending live or recorded webinars have been important to my learning style and for review.

Brookbush Institute has the most detailed, specific and effective tools for online learning for movement and/or bodywork professionals. I love the combination of the videos as well as the text available online.

I recently completed the CPT course. It was demanding yet practical. I would highly recommend it for anyone wanting an education about human movement.

I have my personal trainer certificate through here and am almost finished my human movement specialist certification. Overall, the education that Brookbush has packaged together for clinicians and trainers is invaluable. I am a physio assistant so coming from more of a rehab background I appreciate that this education has been beneficial both as a trainer and in a rehab setting. I love that I have been able to do all learning at my own pace and able to work around my schedule. Thank you for setting up this platform! Highly recommend :)

I have been a massage therapist for 10 yrs and I feel like all the “pieces” I’ve learned throughout the yrs have been put into place and can see the full picture. I am also a member to tons of great content since I love to learn! I plan to get my CPT through them as well.

I have been following Brent Brookbush for nearly a decade- back when I was a personal Trainer and now as a Physical Therapist. BBI is an incredible resource for any movement nerds and corrective exercise specialists! The information is thorough with multiple real world applications. I am looking forward to an in-person Manual Therapist course the second they do one a little bit closer to Virginia ;)

I have taken both the Human Movement Specialist and Certified Personal Trainer certificate programs and have found the value in understanding the how and ways the body moves and functions and from evidence, non-biased, outcome, conceptual, theoretical, and practical approach to helping my clients/patients look better, feel better, and move better.

Over the last years I've returned time and again to Brookbush Institute for stellar coursework as I've worked toward a Human Movement Specialist certification. (I'm currently ACE CPT, and in training with Anatomy Trains for Structural Integration Manual Therapy.) Every Brookbush Institute module is fantastic and each one includes detailed informational videos, written descriptions of how to-do, and, more importantly, why to-do!

I am a 70 yr old chiropractor and no other healthcare provider was able to come up with an exercise protocol particular to my structural and balances and muscle deficits and keep me in the game. And as for continuing education on human skeletal movement, the website is phenomenal full of great exercises for particular mechanical dysfunction.

The H.M.S. is the most valuable certificate I have earned and was a fraction of the the cost of my others. Define the best bang for your buck!

Brookbush is the most efficient Personal Training Certification I have ever come across. All the lessons are well thought out and very straight to the point.

I am getting my Master's degree in Kinesiology, and I would like to say that I have benefited greatly from the rich, comprehensive, well-documented scientific content of Brookbush Institute that links theory to practical applications. Proudly I've got my CPT certificate, and I am on my way to get my HMS certificate.

Having courses count towards different certifications makes it so users can transition seamlessly from one certification to another. In my case, going from earning the BI CPT to earning the BI HMS was an easy decision and I am proud to have earned both certifications. I have also had the pleasure of going to a Live HMS workshop that was well taught by Instructor Boettcher and that was excellent to see how the methods and techniques are implemented.



I have been a member of BBI for years and every course I have taken has been incredibly informative. I learn more from these courses than I do at local CEU courses for my PTA license. I also earned my CPT and HMS certifications through the platform. It was so convenient and the content was top notch! Forever member.

We learn principles in academia, we learn cool new modalities via whatever specialty certification, but BBI really concentrates on the nuances of passive treatment and they do a fantastic job. The format in which BBI instructs soft tissue specialists (DPTs, Chiros, ATs) like myself feels like almost like an apprenticeship. You get a thoroughly detailed explanation of the “why’s”, and a visual comprehension of how to apply. Personally, I believe application is where the good and the great are distinguished.

Brookbush has been incredibly helpful since I was in massage school and now as I’m in my career! I run my own practice and it gives me the resources I need to not only improve what I already know, but also help me navigate better, more efficient ways of treatment.

Totally loving the convenience and affordability of this program with my crazy lifestyle! I feel like I am getting a quality education without a massive cost! My favorite part is the videos I can watch in the courses. I learn so much better that way. Once I really spent more time on the site, I figured out how to maneuver around a lot better! I enjoy the sense of humor, as well as the easy explanation, and short tests. And if I am really tired, I can have the computer read me the lessons. 😁

Challenging concepts are explained in very understandable terms without dumbing down the material, and I find this program to be superior in quality to other personal training programs.

Home

Courses

This course describes the anatomy and integrated function of the soleus muscle (a.k.a. deep calf muscle, calves). This muscle is located on the posterior tibia and fibula, in the posterior compartment, joins the gastrocnemius muscle at the Achilles tendon to form the calf complex, and inserts into the calcaneus (heel bone). This muscle is innervated by the tibial nerve, composed primarily of type I muscle fibers, and unlike the gastrocnemius muscle, only crosses the ankle joint (a.k.a. talocrural or tibiotalar joint).

The soleus is the primary plantar flexor of the ankle, and some research shows it may play a role in inversion or eversion depending on the position of the calcaneus (heel bone). This course also describes the role of the soleus in ankle joint arthrokinematics, fascial integration (Achilles tendon and posterior crural fascia), postural dysfunction, and subsystem integration. Additionally, the location of the soleus is discussed relative to the posterior popliteal artery, tibial artery, peroneal artery, tibial nerve, peroneal nerve, sural cutaneous nerves, and fascial sheaths that comprise the anterior and posterior borders of the posterior compartment.

Sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) must be aware of the soleus and ankle plantar flexors for the analysis of human movement, and the development of sophisticated exercise programs and therapeutic (rehabilitation) interventions. Further, this course is essential knowledge for future courses discussing injury prevention and physical rehabilitation including muscle pain (e.g. muscle pain, posterior compartment pain, calf pain, knee pain), soleus injuries (calf strain, soleus strain, accessory soleus muscle strain), and other associated lower limb injuries (tibial nerve entrapment, plantar fasciitis, ankle impingement, shin splints, Achilles tendinopathy, Achilles tendon rupture). This course also begins by introducing a repertoire of soleus-specific exercises and techniques with the intent of improving ankle dorsiflexion, or enhancing lower limb muscle strength and force development during plantar flexion (e.g. calf foam rolling, soleus release, soleus stretching, neuromuscular re-education, and strength exercises for enhancing daily physical activity).

Brookbush Institute’s most recommended techniques for the Soleus (see videos below):

Calf Stretch on Slant Board (or Modified Calf Stretch)

Single Leg Cobra to Balance to Calf Raise

A cadaver dissection of the soleus muscle 

 Course Description: Soleus

Introduction

 common European flatfish, mid-13c., from Old French sole, from Latin solea "a kind of flatfish," originally "sandal" (see 

 (n.1)); so called from resemblance of the fish to a flat shoe.

 "bottom of the foot" ("technically, the planta, corresponding to the palm of the hand," Century Dictionary), early 14c., from Old French sole, from Vulgar Latin *sola, from Latin solea "sandal, the bottom of a shoe; a flatfish," from solum "bottom, ground, foundation, lowest point of a thing" (hence "sole of the foot"), a word of uncertain origin. In English, the meaning "bottom of a shoe or boot" is from late 14c. (

Perhaps named for its shape - like a sole fish

The soleus is named after the flat appearance of the sole fish

https://upload.wikimedia.org/wikipedia/commons/thumb/c/cd/Solea_solea_1.jpg/1280px-Solea_solea_1.jpg

Attachment and Innervation

The origin of the soleus on the fibula and tibia bones in the lower leg

Attachments & Innervation: Soleus

Relative Location

Cross section of the muscles attaching to the fibula and tibia including the soleus, gastrocnemius, and fibularis muscles

Where is the Soleus Located?

Palpation

Surgical dissection of the lower leg displaying the attachment of the soleus on the fibula

Palpating the Soleus 

Introduction to the Soleus

Actions

Ankle: Plantarflexion (primary plantar flexor) and inversion. 

The soleus is comprised of 70 - 75 % Type I fibers (8). This makes the soleus incredibly fatigue resistant and is advantageous for the nearly continuous contraction required to maintain an upright standing posture. Further, efficient gait requires repeated contractions for eccentric control of tibial motion during midstance and propelling us forward during the push-off phase of gait.

The gastrocnemius and soleus are the primary plantar flexors contributing up to 80% of plantar flexion torque (11), however, the soleus is the true "workhorse" of the lower leg. With the resistance to fatigue mentioned above, and nearly twice the cross-sectional area of the gastroc (3), the soleus provides the majority of plantar flexion torque for most of our more common movement patterns. The exceptions are likely low-intensity open-chain activities of the ankle which may rely on smaller plantar flexors for reasons of energy conservation, and powerful (explosive/fast) movement patterns that require preferential recruitment of Type II fibers and therefore more contribution from the gastrocnemius.

Due to a 90° rotation of the Achilles tendon, the fiber contribution by the soleus to the Achilles tendon invests on the medial 1/3 of the calcaneus - resulting in this muscle acting as an invertor, as well as, a plantarflexor (16). Further, this rotation of the Achilles tendon explains the marked inversion noted in soleus contractures, specifically equinovarus deformity.

But, then again…. If you consider the changes in arthrokinematics normally seen in 

 (discussed below): Excessive pronation, eversion, and/or calcaneus valgus, place the entirety of the Achilles tendon lateral to mid-line of the ankle, resulting in any activity of the soleus or gastroc contributing to eversion. Although most texts will note the soleus as an invertor, recent research and a prior study support the variable contribution of the soleus based on the position of the calcaneus (17,18).

Stabilizes the ankle (both tibiotalar and subtalar joints), and proximal tibiofibular stability.

The soleus eccentrically decelerates dorsiflexion. Most notably, this occurs as the soleus decelerates the anterior translation of the tibia (tibia on foot dorsiflexion) during the stance phase of gait. Optimal mechanics and calcaneal position will allow this muscle to eccentrically decelerate eversion, potentially playing a role in preventing excessive pronation. The preferential recruitment of the soleus for eccentric control of eversion, pronation, and/or calcaneus valgus seems to be more prominent in the trained athlete when compared to the sedentary individual (8).

As the soleus shares the Achilles tendon with the gastrocnemius, these two muscles must work synergistically during most activities. These two muscles are generally given dual credit as the primary force generators for plantar flexion (eccentric dorsiflexion).

If acting as an invertor (discussed above) the soleus works synergistically with the 

flexor hallucis longus, and flexor digitorum longus

In a closed chain, this muscle may work synergistically with the quadriceps (vastus muscles and rectus femoris), and 

 to create knee extension torque (23). In this phenomenon consider how the soleus would contribute to posterior translation of the tibia, and how that would affect the knee when rising from a semi-squat position. Physical therapists working in neuro-rehab are well aware of this phenomenon as calf contracture associated with foot drop and/or increased extensor tone, may also contribute to genu recurvatum.

Note the flatter soleus under extending more distal from underneath these well developed gastroc.

Arthrokinematics

The soleus, nerves, and blood vessels of the lower leg in a cadaver dissection

Soleus Muscle Actions

Fascial Integration

My Fascial Hypothesis: Large fascial sheaths not only play a role in the transmission of mechanical force but may also play a role in dictating the function of muscular synergies. This is likely caused by reducing or increasing tone of invested musculature via reflex arcs formed between mechanoreceptors embedded in the connective tissue and the attached musculature. In this way, my view of fascia differs slightly from noted expert on the subject Tom Myers. I think of these large fascial sheaths (specifically the thoracolumbar fascia, iliotibial band, and abdominal fascial sheath) as nature's "motherboard." A place for mechanical information to be communicated to the nervous system for more efficient recruitment of the muscular system. Despite having a slightly different philosophy it does not change the fact that fascia plays an important communicative role in the human body and we have Tom Myers to thank for his work.

Image of the fascial system of the body connecting muscles

 The common insertion into the Achilles tendon implies an obvious, but important fascial synergy between the plantar flexors – the gastrocnemius, plantaris, and soleus. This may be an interesting point to begin research on the effect of increased tension on fascial structures, activation of fascial receptors, and synergistic muscle activation.

 The fascial archway (entrance of the soleal canal) at the origin of the soleus does tease at more complex fascial integration at the fibular head; however, based on my scouring of texts and research I could not find an inference to an integrated relationship. In fact, in the lower leg much the origin of the soleus acts to end fascial lines rather than continue them. For example, the origin of the soleus acts as the superior border of the deep posterior compartment and the end of the transverse intermuscular septum - separating the posterior compartment from structure posterior to the knee, like the capsule of the knee, 

Behavior in Postural Dysfunction

 (specifically frontal plane mechanics) is complex, the changes in relative length and activity adopted occur with such regularity, and the techniques implied (release and lengthening) are so widely used, little controversy exists regarding its role in compensatory patterns of the lower extremity.

Lumbo Pelvic Hip Complex Dysfunction (LPHCD)

, over-active and adaptively shortened solei contribute to the loss of dorsiflexion, which may be the "driver" of further compensation in more proximal joints of the lower extremity (19-21). Consideration of frontal plane mechanics (specifically eversion and forefoot pronation) as the root cause of dysfunction, may lead to the conclusion that this muscle is actually long and under-active. However, the contribution to a loss of dorsiflexion is so problematic to function, further consideration must be given to changes in activity and length, as well as the role of the soleus in frontal plane mechanics. The soleus is commonly described as invertor in various texts leading to an inconvenient incongruence in this predictive model of postural dysfunction; however, in a study by Klein et al.(18), it was found that the soleus can contribute to eversion when calcaneal eversion is sufficient enough to pull the insertion of the Achilles tendon lateral to the mid-line. That is, once LLD results in sufficiently excessive eversion and pronation the soleus not only will restrict dorsiflexion but contribute to dysfunction in the frontal plane (24).

In short, the soleus adopts a compensatory pattern of 

. This implies that this muscle should be released and lengthened. Further, the discussion above on arthrokinematic may imply that ankle mobilization will assist in returning optimal motion and aid in returning this muscle to its optimal length and activity.

The impact knee valgus (knee bow in) or knee varus (knee bow out) has on movement

Notice how the valgus disappears after the addition of a heel lift. This indicates that the soleus is short and overactive, contributing to the dysfunctional movement pattern. -http://www.somastruct.com/knee-valgus-collapse-squats/

Peroneal nerve entrapment (at fibular head)

Achilles tendonitis (long term over-activity = rupture?)

Signs of Altered Length/Tension and Tone:

Excessive Forward Lean - Short/Over-active

Asymmetrical Weight Shift - Short/Over-active

Dorsi Flexion: < 20° (Active Assisted Range of Motion)

 - Decreased dorsiflexion with the knee extended and/or flexed

Palpation results in tenderness (trigger points or tender points) and may result in radiating symptoms along the posterior leg up through the popliteal fossa or along the Achilles tendon. Based on the theoretical model of trigger point development (8) it would seem likely that “trigger points” are dysfunctional at the “motor point” of a muscle. You may find the motor point map created by this research study helpful in directing patients/clients to the appropriate location for self-administered release techniques – Motor Point Map

Location of Soleus Trigger Points - In my humble opinion TrP 1 is likely an FHL TrP and not a soleus TrP. http://rpm-therapy.com

Lateral gastrocnemius, medial gastrocnemius, and soleus muscle

From top to bottom -
Lateral gastroc, soleus and Flexor Hallucis Longus trigger points.

Postural Dysfunction and the Soleus 

Gastrocnemius and Soleus Self-administered Static Release

Gastrocnemius and Soleus Self-administered Dynamic Release a.k.a Pin and Stretch

Gastrocnemius, Soleus, and Fibularis Static Stretch (Wall Stretch)

Gastrocnemius, Soleus, and Fibularis Static Stretch (Slant Stretch)

Gastrocnemius, Soleus, and Fibularis Active Stretch

Manual Calf Stretch

Self-Administered Ankle Mobilization

Exercises and Techniques for the Soleus

Phillip Page, Clare Frank, Robert Lardner, 

Assessment and Treatment of Muscle Imbalance: The Janda Approach

NASM Essentials of Corrective Exercise Training

NASM Essentials of Personal Training: 4th Edition

Diagnoses and Treatment of Movement Impairment Syndromes,

David G. Simons, Janet Travell, Lois S. Simons, 

Travell & Simmons’ Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1. Upper Half of Body: Second Edition

Joint Structure and Function: A Comprehensive Analysis: Fifth Edition

Florence Peterson Kendall, Elizabeth Kendall McCreary, Patricia Geise Provance, Mary McIntyre Rodgers, William Anthony Romani_

Fitness or Fiction: The Truth About Diet and Exercise

Carolyn Richardson, Paul Hodges, Julie Hides. Therapeutic Exercise for Lumbo Pelvic Stabilization – A Motor Control Approach for the Treatment and Prevention of Low Back Pain: 2nd Edition (c) Elsevier Limited, 2004

Movement, Stability & Lumbopelvic Pain: Integration of research and therapy, 2e (c)

Michael RH, Holder LE: The soleus syndrome a cause of medial tibial stress (shin splints). 

Klein P, Mattys S, Rooze M: Moment arm length variations of selected muscles acting on talocrural and subtalar joints during movement: An in vitro study. 

Les SS, Piazza SJ: Inversion-eversion moment arms of gastrocnemius and tibialis anterior measured in vivo. 

Souza, T. R., Pinto, R. Z., Trede, R. G., Kirkwood, R. N., & Fonseca, S. T. (2010). Temporal couplings between rearfoot–shank complex and hip joint during walking. 

Franettovich, S. M., Honeywill, C. O. N. O. R., Wyndow, N., Crossley, K. M., & Creaby, M. W. (2014). Neuromotor control of gluteal muscles in runners with achilles tendinopathy. 

Medicine and science in sports and exercise

Padua, D. A., Bell, D. R., & Clark, M. A. (2012). Neuromuscular characteristics of individuals displaying excessive medial knee displacement. 

Pedret C, Roads G, Balius R et al. (2015). Return to play after soleus muscle injuries. 

Lenhart RL, Francis CA, Lenz AL, Thelen DG. (2014). Empirical evaluation of gastrocnemius and soleus function during walking. 

Macrum et al. Effect of limiting ankle-dorsiflexion range of motion on lower extremity kinematics and muscle-activation patterns during a squat. 

Bibliography

Questions, comments, and criticisms are welcome and encouraged

Soleus

Related Courses:

Course Description: Soleus

Introduction to the Soleus
3 Sub Sections

Soleus Muscle Actions
1 Sub Section

Fascial Integration

Postural Dysfunction and the Soleus

Exercises and Techniques for the Soleus
7 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Soleus

Related Courses:

Course Description: Soleus

Introduction to the Soleus3 Sub Sections

Soleus Muscle Actions1 Sub Section

Fascial Integration

Postural Dysfunction and the Soleus

Exercises and Techniques for the Soleus7 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Introduction to the Soleus
3 Sub Sections

Soleus Muscle Actions
1 Sub Section

Exercises and Techniques for the Soleus
7 Sub Sections