x trigger point and referral sites

Trigger Point Therapy

Myofascial trigger points (tiny contraction knots) in overworked or poorly conditioned muscles are the most frequent cause of pain in the ankles, feet and toes. Trigger points should be at the top of the list during any examination for pain, numbness and other abnormal sensations in the lower legs, ankles, feet or toes. When healthcare practitioners have had adequate training and experience, trigger points are easy to locate and treat. In fact, there are ways to treat them yourself quite effectively.

Misdiagnosis of Plantar Fasciitis

Travell and Simons believe that a diagnosis of heel spurs is often mistakenly applied when physicians are uninformed about myofascial pain. Trigger points typically refer pain; that is, they send pain to some other site. Physicians and other healthcare workers are commonly led astray by this phenomenon.

Heel pain is often falsely blamed on heel spurs. Heel spurs can be present and actually not be the cause of the pain. Indisputable evidence of the harmlessness of a heel spur is when trigger point therapy stops the pain. Trigger points in the soleus muscles of the calves are the primary cause of heel pain and therapy by means of self-applied massage is incredibly simple, quick and long-lasting.

Referred Pain

Doctors Travell and Simons point out that the eleven muscles of the lower leg are actually foot muscles. Anatomists call them “extrinsic” foot muscles, meaning they operate from outside the foot. So foot pain may not be coming from the feet themselves, but may be referred pain from trigger points in muscles of the lower leg. You can waste a lot time rubbing and soaking your feet, if your foot pain is coming from somewhere else.

Examples of Pain Referral

Most of the familiar pain in your arches comes from trigger points in the calf. These same trigger points cause calf cramps. Pain in the toes frequently comes from trigger points in the longus muscles of the the lower leg. The extensor hallucis longus muscle in the front of the lower leg is the most common cause of pain in the big toe joint that is so often misdiagnosed as gout. When your feet hurt at the end of the day, it may not be foot massage that you need, but lower leg massage!

Achilles Tendinitis

According to Travell and Simons,  “tendinitis” is largely a wastebasket diagnosis, employed when the true cause of the problem isn’t clearly understood. Pain in or near a tendon is almost always simple referred pain from trigger points in associated muscles. The tibialis posterior, a very deep muscle in the calf, is the true source of the disabling pain and stiffness in the back of the ankle so often mistakenly labeled Achilles tendinitis. Interestingly, trigger points also weaken this muscle, allowing your ankle to turn inward and making it appear that you have fallen arches.