| This month we will take a dive into pain at the front of your knee! It is tempting to focus on the usual suspects when it comes to knee pain. The main muscle that inserts into the knee, known as your quads or the opposing muscles on the back of the thigh known as your hamstrings. When a client walks in with pain in the front of their knee, its key that we explore their timeline of injuries and then go about testing them to see if there might be any correlation with these old injuries that may be predisposing them to why the knee becomes painful in the first place. For example I might test a clients hamstrings and they seem to be strong but when I test them with their calf muscles we then see a positive weakness. It’s so important to not have a bias to what we might think is going on and dive straight into treating the hamstrings. I’ll let the testing guide why hypothesis to what is going on. So while the hamstrings are undeniably important, it often gets a lot of the attention, sometimes at the expense of other key contributors. The problem might just be a little further down the muscle chain! The Soleus muscle lives deep to your main calf muscle and is a major force absorber for the likes of running, walking and climbing stairs. If the soleus can’t absorb and control load, the knee ends up doing more of the work. Just like that, simple movements, descending stairs, lowering into a squat, controlling deceleration, start to become provocative. The soleus and quadriceps share more in common than most realise. Both act as key decelerators of the knee, both work eccentrically (contracting while lengthening) to manage load, and both are critical for smooth, pain-free movement. When the soleus isn’t pulling its weight, the quads and knee joint often pay the price. Knee pain is rarely a simple “local” issue! |
| The role of the soleus in knee pain When we think about anterior knee pain, most clinicians go straight to the quadriceps and rightly so, given their role in knee control. But the soleus is right there beside them during almost every provocative task. As the knee flexes and the ankle dorsiflexes (think stair descent, squats, lunges) or even controlled walking down a slope, the soleus works eccentrically to slow down the forward motion of the tibia (your shin bone) . In doing so, it helps decelerate the knee and absorb load that would otherwise transfer up the chain. When the soleus can’t do its job effectively, the quads have to take over more than their fair share, increasing compressive load at your knee cap and creating that familiar “ache at the front of the knee.” If a client reports pain with downhill walking, stair descent, or slow squats, all these tasks demand controlled deceleration. So the issue might not be hamstring weakness at all. It could be a soleus that isn’t handling load efficiently. Recognising this early shapes my exercise selection and ensures I am treating the driver, not just the symptom. Its almost always a story of shared load and missed capacity. The soleus is one of those hidden contributors that often slips under the radar, yet it plays a massive role in controlling knee mechanics during everyday tasks. When we understand how and when it’s loading, identify those key aggravating factors, and then rebuild its strength through targeted exercises, we set our clients up for faster, longer-lasting outcomes. |
Leave a Reply