Trigger Point Therapy for Calf, Ankle & Foot Pain


by Dr. Laura Perry

Trigger points are those tender lumps in your muscles therapists find. They are arguably the biggest cause of musculoskeletal pain such as back, neck, and shoulder pain, yet are so often either not diagnosed or poorly treated that they progress to become chronic debilitating pain syndromes, including fibromyalgia.

The muscles that commonly cause calf muscle pain

Pain in the calf and Achilles tendon regions is frequently caused by trigger points in the calf muscles. Women who experience calf pain on a regular basis should avoid wearing high heels, as these muscles are easily overloaded by the foot position that these shoes require. Trigger points in the calf muscles are also very likely to become activated by stress or emotional tensions.

The muscles involved in these pain disorders are:

  • The Gastrocnemius
  • The Soleus
  • The Peroneus
  • The Tibialis Anterior

The Gastrocnemius Trigger Points that Cause Calf Pain, Calf Cramps, and Foot Pain

The Gastrocnemius muscle attaches in the back of the knee region and runs downwards to connect to the Achilles tendon. Contraction of this muscle will lift you up onto your toes (plantar flexion).

Trigger points in this muscle cause calf pain and also on the bottom of the foot. Additionally, the trigger points can cause the muscle to cramp, frequently at night. People with Gastrocnemius trigger points will have difficulty walking up stairs or on steep slopes.

Gastrocnemius Trigger Point Symptoms

Patients with active gastrocnemius trigger points will complain of calf cramps, typically at night (these may also occur with gastrocnemius trigger points that aren’t active).

They may also complain of back of knee pain, especially when walking uphill or upstairs, and pain in the instep region on the bottom of the foot. The foot pain can mimic plantar fasciitis.​

The Soleus Trigger Points that Cause Calf Pain and Achilles Pain

The Soleus muscle lies beneath the Gastrocnemius muscle in the calf region. It attaches just under the knee and also connects to the Achilles tendon. Contraction of this muscle will lift you onto your toes. Additionally, the rhythmic contraction of this muscle assists the return of blood to the heart.

Trigger points in this muscle cause pain in the calf region, extending down to the Achilles tendon.

Soleus Trigger Point Symptoms

Patients with active soleus trigger points will often complain of heel pain and tenderness during and after running or jogging. The heel can become extremely sensitive (tender) to the pressure of the body’s weight and will ache at night. This heel pain will usually extend up into the Achilles tendon region.

These patients may also have calf pain and swelling in the calf. They may not be able to squat down to pick something up because their ankle will not flex without pain.

In children, the pain from soleus trigger points is often confused with “growing pains” in the legs.

The Peroneus Trigger Points that Cause Ankle Pain

The Peroneal muscle group is composed of the Peroneus Longus, Peroneus Brevis, and the Peroneus Tertius muscles. They attach just below the outside of the knee and run down through the ankle joint and connect to the outside of the foot. When they contract, they raise the outside of the foot (eversion of the foot).

Besides ankle pain, trigger points in these muscles make your ankles feel weak and unstable.

Peroneus Trigger Point Symptoms

Patients with active peroneal trigger points will complain of pain and tenderness on the outside of the ankle, around the ankle bone. Their ankle will be weak and unstable, and they will have a history of ankle sprains and maybe ankle fractures.

The patient may be unable to lift their foot properly while walking, called foot drop, causing it to drag behind. This may occur if there is an active trigger point in the tibialis anterior muscle, or if the deep peroneal nerve is entrapped by tight peroneus longus and brevis muscles.

If the Peroneus Tertius trigger point is active the patient may experience pain on the front of the ankle and top of the foot.

The Tibialis Anterior Trigger Point that Causes Ankle Pain and Foot Pain

The Tibialis Anterior muscle is found in the shin region of the lower leg. It attaches to the larger lower leg bone (the tibia) just below the knee and runs downward to attach to the smaller bones on the inside of the foot. This muscle contracts to lift the foot (dorsiflex) and stabilizes the foot during walking and running.

The trigger point that develops in this muscle refers pain to at the top of the foot, ankle, and to the big toe.

Tibialis Anterior Trigger Point Symptoms

Patients with an active tibialis anterior trigger point will complain of pain and tenderness on the front and inside of the ankle, even though they haven’t sprained their ankle recently.. Their pain will often extend down the top of the foot and concentrate on their big toe.

These patients will have difficulty walking because as they lift their leg they may not be able to raise their foot properly. This can mimic a condition called foot drop that may or may not be caused by entrapment of the peroneal nerve in the calf. They tend to throw their foot forward as they step and then it slaps down hard on the floor, also known as a foot slap.

Credit & Source: Dr. Perry is a chiropractor in Houston Texas that specializes in Clinical Trigger Point Therapy. Over the last 20 years, Dr. Perry has gained a reputation for her remarkable ability to understand and relieve many types of physical pain. She continues to practice and teach her system of Clinical Trigger Point Therapy to fellow healthcare professionals.

The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.


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