Lower Leg Trigger Points

July 17th, 2014 by Laura

As a long femured squatter with stance-width restrictions, I need better-than-average dorsiflexion to keep the bar balanced over mid-foot. When my ankles are stiff, I overarch my lumbar, can’t hit depth, get on my toes, bar path goes off and I end up with unfavorable squat angles. I’m lax just about everywhere else – my ankles are the one place where I really had to work on mobility.

It took about 6 months of dedicated work and now I can comfortably drop into a squat with plenty of knee travel at any given time. I haven’t had to revisit anything on this page since. Once the change took place, it was permanent and maintenance-free.

I made the following diagram to have handy during release sessions. It shows all of the lower leg trigger points and referred pain on one image. (Not shown is the pain on the underside of the foot, SI joint and face.)

RELEASE NOTES

This is a list of notes on individual points and methods used to release. ( I’m only logging the points that I work with regularly and have notes that I’d like to remember about them).

Peroneal Trigger Points (Peroneus Longus in particular)
My favorite way to release is to place a lacrosse ball or beastie ball under the lateral calf (under the trigger point area), and place the other leg on top for added weight. Sink into the stab, alternating with gently rocking the hips. I have to be careful to make the movement very tiny. If I keep rolling off of the trigger point, the movement is too large. I tend to tense up against the release for this point. To get around that – draw circles with the big toe, flex and release the foot, alternating with just sinking into the stab. After the release, I give a quick and gentle massage to that area as well as the calves to bring blood and keep from getting too sore.

When this muscle is not being so much of a problem, I can easily stab it with my thumb to release within a minute.

Pain in this area seems to be common among narrow squatters. During times when my hip or SI joint are flaring up, this point becomes active for me.

This point is connected to the gluteus minimus*. The pain referral pattern from that area can activate the peroneal trigger points, causing a chain reaction.

All of my other lower leg trigger points resolved quickly and easily. The peroneal points were the only ones who gave me a hard time (my gluteus minimus was also problematic at the time).

Gastrocnemius, soleus and tibialis anterior should also be treated alongside the peroneals. Weaknesses from trigger points in mentioned muscles will cause the peroneal muscles to overload.

Soleus TrP2 and TrP3
These points do not require a lot for me to release, it is easy to dig in with a thumb.

Extensor Digitorum Longus
The referred pain pattern I am currently having is most inline with the Extensor Digitorum Longus, though both extensors could also be involved, as well as the Tibialis Anterior. Much of the pain is on the shin itself. I have been doing a lot of staggered training lately and in that I try to keep my heel planted. This is much more difficult on my right side, and I think that in my efforts to keep my heel planted, I might be doing something odd with my feet. Like most lower leg points, these points usually work in cahoots with something else (hips). Hopefully as my weak hip gains strength, this point will dissolve for good, like my peroneals did when my glutes found their place in this world.

This area seems to want heavy and precise pressure. I have a hard time fully releasing my anterior shin points with my hands alone, my lacrosse and beastie ball do a much better job.
 

STRETCHES

Pistol Stretch
These stretches were only necessary for me when beginning my ankle dorsiflexion project.

When I am feeling stiff, mobilizing one side at a time seems less daunting than trying to force myself into a weightless squat. I don’t find that getting into a full pistol is imperative, but it is helpful to at least shift hips forward and get comfortable in that position pre-squat. Before I was able to get into a full pistol, I’d to start on the ground, keeling. Plant one foot in front, foot flat and lean into it, bringing butt to ankle, letting knee track forward over toe. Rock back and forth a bit to get deeper, if needed. Be careful not to come up on the toe, which will be the tendency if ankles are restricted.

If things are going well, the other leg can extend, or take it a step farther by reaching out and grabbing the foot of the extended leg with opposite hand. I like being able to get into a full pistol pre-squat, I think the balance in that position is useful.

 

Leaning Squat Stretch
Sit down in a squat and shift weight forward. Can place hands on ground or grab something to pull against. Keep heels planted and rock forward as much as possible. Hold for a second or two, then recover back to neutral. Repeat a few times.

I’m cheating here; should really be in flats 🙂

 

Deactivating the trigger point prior to stretching is key. Muscles with trigger points are shortened and can not reach their full length.

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