The calves are extremely important to the lower portions of the legs as they allow the individual to move around and help stabilize the entire body. The calves have two muscles: the gastrocnemius and the soleus, which provide plantarflexion and stability at the ankle joint. These two muscles work together to ensure that the upper body’s weight doesn’t lean forward too much to let the individual fall. However, when many people overuse the calf muscles constantly, it can cause the muscle fibers in the lower legs to be overstretched and develop small nodules known as trigger points to cause referred pain to the calves and the ankles that can affect a person’s ability to walk, run, or jump. Today’s article looks at the soleus muscle, how trigger points affect the muscle, and different methods to reduce pain while managing trigger points along the calves. We refer patients to certified providers that incorporate various techniques in the lower body extremities, like lower leg and calve pain therapies correlating to trigger points, to aid many people dealing with pain symptoms along the soleus muscles, causing muscle cramps and issues along the ankles. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is an excellent way when asking our providers intricated questions at the patient’s request and understanding. Dr. Alex Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
What Is The Soleus Muscle?
Do you feel a cramping sensation in your calves? Do your feet hurt when you are walking, jumping, or running? Or are you experiencing tightness in your calve muscles? When a person is experiencing calf pain in their legs, it could be trigger points causing overlapping issues in the soleus muscles. As stated earlier, the calves have two muscles: the gastrocnemius and the soleus. The gastrocnemius makes up the round shape of the calves and is a complex, superficial muscle. At the same time, the soleus is a large, flat muscle deep within the gastrocnemius and forms the calcaneal tendon (Achilles tendon), which can be mistaken as a nerve for the ankle. Studies reveal that the soleus muscle works together with the gastrocnemius, and these muscles constitute a plantar flexor. The soleus is part of a group of muscles known as antigravity muscles. It acts like a skeletal muscle and helps maintain good posture in the body to prevent the sheer body weight from falling forwards at the ankle when standing.
How Do Trigger Points Affect The Soleus Muscle?
The calves are essential for the movement and mobility functions of the body. When the calve muscles have been overused to repetitive movements or have been dealing with trauma, it can cause the muscle fibers to tear and develop trigger points along the calves causing referred pain to travel down the ankles. Trigger points along the soleus muscle are tricky to diagnose since they cause referred pain to the surrounding muscles. “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., mention that, unlike the latent trigger points that can affect the gastrocnemius, active trigger points can affect the soleus muscle and cause tenderness referred to the heel. When muscle tenderness affects the heels, it can cause trigger points to mimic chronic conditions like plantar fasciitis. Additional studies reveal that musculoskeletal impairments like trigger points in the soleus muscle could potentially lead to biomechanical changes in the ankle. When trigger points cause hypersensitivity spots in the skeletal muscle taut band, it can restrict the soleus muscle to allow ankle dorsiflexion. Individuals with active soleus trigger points are prone to develop low back pain due to ankle dorsiflexion restriction, leading to them leaning over and lifting objects improperly.
Trigger Point Of The Week: Soleus – Video
Have you been dealing with pain traveling down from your calves to your ankles? Experiencing stiffness around your ankles? Or do you feel like you are about to fall? These pain-like issues are associated with trigger points along the soleus muscles along the calves. The soleus is one of the two muscles (the other is the gastrocnemius) that make up the calves and acts as a skeletal muscle to help maintain good posture in the body. When trigger points affect the soleus muscle, they can cause referred pain to the calves and mimic chronic issues like plantar fasciitis at the ankles. The video above explains where the soleus muscles are located, deep within the gastrocnemius, where the trigger points are causing referred pain to the ankles, and where they are in the soleus muscle fibers in the calves. Even though trigger points can cause referred pain in the affected muscle fibers of the body, they are treatable and can be managed through different methods to help the calves.
Different Methods To Reduce Pain And Manage Trigger Points In The Calves
Even though trigger points can affect the soleus muscles and cause referred pain to the ankles, different methods can reduce the pain and help manage trigger points in the calves. Studies reveal that when there are multitudes of therapies that can help manage trigger points, it can help reduce the pain affecting the soleus muscle by optimizing muscle function and preventing the development of chronic pain syndromes. Besides therapies that target trigger points, corrective actions and stretches can help release the pain from the soleus muscle. Incorporating calf stretches, having a correct posture when sitting down, wearing long loose socks while sleeping, and wearing low heels can prevent the soleus muscle from shortening and help manage trigger points from re-occurring in the calves. When people start to take care of their calve muscles, it can help their mobility and stability at the ankles.
Conclusion
As part of the calf muscles and an antigravity muscle, the soleus works with the gastrocnemius to help with stability and plantarflexion to the ankles. This muscle is deep within the gastrocnemius and helps maintain good posture in the body that prevents a person from falling forward at the ankles when standing. When the soleus muscles have been overused, they can develop tiny knots in the muscle fibers known as trigger points that can cause referred pain to the ankles. Trigger points along the soleus muscles can cause overlapping features in the calves by restricting ankle dorsiflexion, causing individuals to develop low back pain associated with leaning forward. However, various therapies can manage trigger points through multiple treatments that can reduce the pain and allow stability back to the calves, enabling the individual to continue walking without feeling pain.
References
Binstead, Justin T, et al. “Anatomy, Bony Pelvis and Lower Limb, Calf – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 29 May 2022, https://www.ncbi.nlm.nih.gov/books/NBK459362/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.
Valera-Calero, Juan Antonio, et al. “Prediction Model of Soleus Muscle Depth Based on Anthropometric Features: Potential Applications for Dry Needling.” Diagnostics (Basel, Switzerland), U.S. National Library of Medicine, 7 May 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7277950/.
The ankles and the lower legs have a casual relationship by allowing movement to the foot that causes an up-and-down motion. The lower leg has various muscles and tendons that surround the shin bone and allows the feet to take the body from one location to another. The peroneal muscles in the legs allow ankle stability to ensure that the weight from the host’s body doesn’t cause overload to the legs and ankles. However, factors like obesity, trauma, or overexerting can cause the peroneal muscles to be inflamed and develop issues like weak ankles or trigger points that can cause referred pain to the ankles and affect how a person walks. Today’s article examines the peroneal muscles, how weak ankles correlate with trigger points, and ways to strengthen the ankles while managing trigger points. We refer patients to certified providers that incorporate various techniques in the lower body extremities, like lower leg and ankle pain therapies correlating to trigger points, to aid many people dealing with pain symptoms along the peroneal muscles, causing weak ankles. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is an excellent way when asking our providers intricated questions at the patient’s request and understanding. Dr. Alex Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
The Peroneal Muscles On The Ankles
Have you been experiencing pain when walking around constantly? What about feeling a sharp or dull ache in the back or side of your legs? Or do you feel like falling when you are just standing around? Many people experiencing these issues on their legs and ankles could be dealing with trigger points along the peroneal muscles in the ankles. The peroneal muscles consist of two muscles in the lateral compartment of the lower legs: the peroneus longus and peroneus brevis. The peroneus longus is an important long muscle in the lower legs as it is at the top of the fibula and then runs down the outer leg while connecting to the foot. One of the primary functions of the peroneus longus is allowing plantarflex and evert the foot at the ankle. This means that the peroneus longus helps provide motor strength and range of motion to the ankles.
The peroneus brevis is one of the shorter peroneal muscles in the legs that go down to the ankles and provides assistance to allow eversion to the foot and plantarflexion to the ankles. This shorter muscle is important since the ankle joint is relatively mobile and needs stability from the surrounding ligaments and muscles. These two muscles work together for ankle stability when walking and positioning when the body is moving. Studies reveal that depending on a person’s environment, the peroneal muscles allow support and stability to the ankle in various positions. A good example is if the foot is placed in a sloped position, the peroneal muscles and the surrounding ligaments help stabilize the ankle so it won’t induce pain, causing the individual not to fall over.
Weak Ankles & Trigger Points
When factors like obesity, trauma, or injuries begin to affect the lower half of the body, it can cause instability in the legs and cause the surrounding muscles, tendons, and ligaments to be overstretched, take on more of an overload to the legs, or suffer from a muscle or tendon tear. These factors are associated with various issues that can invoke pain along with developing trigger points along the lower legs. When there are issues in the peroneal muscles, it can lead to muscle weakness in the ankles or “weak ankles,” which causes instability in the body and causes the individual to sprain their ankles. Studies reveal that when the peroneal tendons have a tear in the lower extremities, it can lead to lateral ankle pain that is often missed when examined. However, to that point, if the incision has been left untreated, it can lead to persistent ankle pain, instability, and ankle dysfunction. In “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., stated that when individuals suffer from weak ankles or have an ankle sprain, active trigger points can cause pain and tenderness to the ankles and cause the person to become unstable. If left untreated, it can cause them to lose balance and have foot drop and ankle fractures to their foot. The book also mentioned that any ruptures in the tendons and muscles might cause lateral compartment syndrome. When there is instability in the ankles, many people resort to using mobility aids like a cane or a walker to be mobile to compensate for the function lost in their feet.
Trigger Point Therapy On The Peroneal Muscles- Video
Do you feel the pain from the bottom of your feet to your ankles? Does it hurt to walk around for a short period? Or have you sprained your ankle, and there is a dull ache when you try to rotate? Some ankle issues are associated with trigger points affecting the peroneal muscles. The peroneal muscles help the lower legs by allowing eversion to the foot and plantarflexion to the ankles. The two muscles that make up the peroneal muscles are the peroneus longus and the peroneus brevis, and they, along with the other tendons and ligaments, help with ankle stability. Since the ankle is a mobile joint, it can succumb to sprains, tears, and instability in the body, allowing trigger points to develop and causing even more issues. The great news is that there are ways to manage trigger points along the peroneal muscles and reduce ankle instability. The video above shows where the peroneal muscles are located on the leg, where the trigger points are, and how to use K-tape to help support the ankle and prevent more injuries on this moveable joint.
Strengthening The Ankles & Managing Trigger Points
Instability in the ankles can be a bummer to many individuals that are on the move, but when it comes to treatment, it can prevent future injuries from re-occurring. Studies reveal that when pain specialists incorporate joint mobilization techniques and dry needling therapy into their patients, it can allow them to reduce the pain and disability to the ankles, thus managing the trigger points along the peroneal muscles. Another way many people can reduce pain in their peroneal muscles is by incorporating stretches and exercises to strengthen their ankles. This allows the peroneal muscles to be loose and gently stretched while slowly strengthening the ankles in a semi-lock position. When people utilize these techniques on their legs and ankles, it can bring mobility and stability back to the body without fear of falling or causing more issues in the ankles.
Conclusion
As one of the most mobile skeletal joints in the lower body, the ankles work together with the legs to provide mobility and stability to the body. The lower legs have various muscles, tendons, and ligaments that travel down and help support the legs and ankles. One of the muscles that provide that support is the peroneal muscle. The peroneal muscles consist of two muscles known as the peroneus longus and peroneus brevis help with eversion to the foot and allow plantarflexion to the ankle. When a person has sprained their ankle, it causes the peroneal muscle to become overstretched and develop trigger points. The great news is that trigger points are treatable, and various treatments can reduce pain in the affected muscle. This allows stability and mobility back to the ankles and improves the body’s functionality.
References
Abd-Rasid, A F, and M Y Bajuri. “Isolated Peroneus Longus Tear – Commonly Missed Diagnosis of Lateral Ankle Pain: A Case Report.” Malaysian Orthopaedic Journal, U.S. National Library of Medicine, July 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7513650/.
Basit, Hajira, et al. “Anatomy, Bony Pelvis and Lower Limb, Foot Peroneus Brevis Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 8 Feb. 2022, https://www.ncbi.nlm.nih.gov/books/NBK535427/.
Lezak, Bradley, and Matthew Varacallo. “Anatomy, Bony Pelvis and Lower Limb, Calf Peroneus Longus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 25 Aug. 2022, https://www.ncbi.nlm.nih.gov/books/NBK546650/.
Salom-Moreno, Jaime, et al. “Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial.” Evidence-Based Complementary and Alternative Medicine : ECAM, U.S. National Library of Medicine, 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4430654/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.
Of course, I’m prone to injuries and Dr. Alex Jimenez has been helping me. I’ve known him for about six years and every time something comes up, either it’s a small injury or a major one, he’s always been there and he’s always helped me get back to my feet to start playing sports again really fast.
Madison Hill
Ankle pain refers to any type of pain or discomfort in the ankle. This pain could generally be due to an injury, such as a sprain, or due to another health issue. As stated by the National University of Health Sciences, or NUHS, an ankle sprain is one of the most frequent causes of foot pain, making up 85 percent of all ankle injuries. A sprain occurs when the ligaments tear or are overstretched.
Most ankle sprains are lateral sprains, which occur when the foot rolls, causing the ankle to twist toward the ground. This action rips or stretches the ligaments, which connect two bones or cartilages and holds a joint together. A sprained ankle often swells and lumps for a temporary amount of time. However, it might take a couple of weeks to get a severe injury like this to�heal completely.
Once healed, the sprained ankle is occasionally permanently weaker and less stable compared to the other ankle. According to a paper released by the American Academy of Family Physicians, or AAFP, the highest risk for ankle sprains includes a previous ankle sprain. Although, ankle sprains are not the only cause of foot pain. Below, we will discuss several common causes of foot and ankle pain as well as their treatment.
Causes of Ankle and Foot Pain
The ankle is a hinge joint formed by the assembly of three bones: the tibia, the fibula, and the talus. The bony knobs on both sides are called the malleoli. Overall, the ankle is an intricate structure. These constructions provide support for walking and standing. Also, stability is provided by the ligaments on the surface of the ankle. Additionally, some tendons also attach to the muscles of the ankle.
Ankle pain may be brought on by various ailments, such as sprain, strain, arthritis, gout, and tendinitis, among others. These kinds of injuries can occur on both sides of the joint. There can be pain and discomfort as well as swelling. A sprain is considered to be the most frequent cause of foot pain. As�mentioned above, a sprain is generally caused when the ankle rolls or twists so the ankle moves toward the ground, tearing or overstretching the ligaments of the ankle that hold the bones together.
An x-ray is typically done to rule out a fracture. The remedy for an ankle strain or sprain generally includes restricting the total amount of weight-bearing on the ankle, getting rest and applying ice. Drugs and/or medications can reduce symptoms. Chiropractic care can also help diagnose and treat ankle sprains and strains. Ankle and foot pain may also be due to:
Arthritis, specifically osteoarthritis,
Gout
Tendinitis
Nerve injury or disease, such as sciatica
Blocked blood vessels
Infection from the joint
While ankle strains and sprains are the most common form of foot pain, arthritis can also frequently lead to ankle pain. Arthritis is the inflammation of the joints, although multiple kinds of arthritis may lead to pain in the joints. Foot pain can be caused by three common forms of arthritis: osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis.
Osteoarthritis is a degenerative condition where the cartilage slowly begins to wear away. Osteoarthritis�causes the natural wear and tear of the joints associated with age. Older adults are more inclined to develop osteoarthritis. In most cases, an individual’s pain and discomfort, including swelling and�stiffness, among other symptoms may worsen over time.
Rheumatoid arthritis is a chronic autoimmune disease. This health issue may severely impact the foot and ankle joints. With rheumatoid arthritis, the human body’s immune cells attack the synovium covering the foot joints. Joint deformity is common with rheumatoid arthritis. A fungal or bacterial infection causes septic arthritis. If the septic arthritis is among the ankle regions, this may result in foot pain.
Following an injury, post-traumatic arthritis can develop from trauma or damage to the ankle or foot. Previous fractures and dislocations are the most common ailments that may lead to post-traumatic arthritis. Like gout, which we will discuss further below, the joints begin to wear away, although it may take several years for this to happen after the injury.
Gout occurs when uric acid accumulates in the human body. This higher than average concentration of uric acid, which is generally a by-product of the human body’s normal breakdown of older cells, can deposit crystals in the joints, causing sharp pain. Pseudogout is a similar illness where calcium deposits build up in the joints. Indicators of gout and pseudogout include soreness, swelling, and redness.
Tendinitis is a swelling of the tendon. In the ankle, it may frequently involve the anterior tibial tendon or the Achilles tendon. Tendinitis can result from an overuse injury or disorders like rheumatoid arthritis and ankylosing spondylitis. All types of tendinitis trigger pain, inflammation, and tenderness. Drugs and/or medications, applying ice and immobilizing the region are often the first line of treatment for tendinitis. Chiropractic care can also be helpful in the treatment of tendinitis. Casting may be required if the patient’s tendinitis is severe or advanced.
�
Foot pain can commonly occur due to ankle injuries. In the United States alone, approximately 2 million acute ankle sprains occur every year, one of the most prevalent causes of ankle pain. Chiropractic care is a popular alternative treatment option which can help treat a variety of health issues, including foot and ankle pain.
Dr. Alex Jimenez D.C., C.C.S.T.
Chiropractic Care for Foot and Ankle Pain
Chiropractors utilize a mixture of treatment techniques and methods to ease ankle and foot pain. Chiropractic care is a safe and effective, alternative treatment option which focuses on the diagnosis, treatment, and prevention of a variety of injuries and conditions associated with the musculoskeletal and nervous system, including foot and ankle pain.
Soft tissue and joint mobilizations are done to restore proper mechanics and muscle activation. Manual therapy may be used to improve the mobility of the ankle and foot along with reducing pain. Furthermore, a chiropractor may recommend a series of lifestyle modifications to help promote a faster recovery process. Exercises are targeted to the areas that were affected. Balance training might also be implemented.
Some treatment modalities that chiropractors utilize to treat injuries to the foot and ankle include ultrasound, electrical stimulation, heat and ice treatment, and massage. These treatment methods increase circulation to enhance recovery, decrease inflammation, reduce pain and improve mobility. When you visit a healthcare professional, a full evaluation is done, goals are discussed along with an individualized treatment program which is intended to target your specific treatment requirements.
Home Treatment for Ankle and Foot Pain
For immediate at-home treatment of foot and ankle pain, the RICE system is generally recommended. The RICE treatment includes:
Rest: Avoid putting weight on the ankle. Try to move as little as possible for the first couple of days. If you have to walk or run, consider using a cane or crutches.
Ice: Begin by putting a bag of ice in your ankle for a minimum of 20 minutes at a time. Repeat this three to five times every day for three days. This�treatment helps decrease pain. Give yourself about 90 minutes between sessions.
Compression: Wrap your injured foot with an elastic bandage, such as an ACE bandage. Don’t wrap it too tightly to where your feet turn blue or your ankle becomes numb.
Elevation: Whenever possible, keep your ankle raised over heart level on a pile of pillows or another type of support arrangement to promote healing.
It’s possible to take over-the-counter drugs and/or medications, such as acetaminophen or ibuprofen, to relieve swelling and pain, however, these are often only offer temporary relief from the symptoms. Make sure to talk to a certified and qualified healthcare professional regarding any home treatment options to prevent further injury and symptoms.
If�you are suffering from foot pain or ankle pain, do not delay anymore. Chiropractors can help patients who suffer from foot, and ankle pain and they can help you, too. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Acute Back Pain
Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain is attributed�to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
