Understanding Trigger Points – Pain in the Achilles Tendon

This trigger point creates pain that focuses on the Achilles tendon. Referral can also spillover into the calf and bottom of the foot. It is associated with the tibialis posterior, a muscle located deeply in the low leg, between the bones.

Client’s Description

referral - tibialis posterior - tpPeople primarily complain of pain along the Achilles and arch of the foot while walking over uneven terrain such as trails or loose gravel. This usually starts with pain and instability when raising up into the toes of that foot. This can dramatically impact the performance athletes that have a lot of twisting on a single foot such as ballet or cross-country. The pain that seems to travel from the Achilles through the heel to the arch is distressing, especially for people who depend on their feet for an active sport. Athletes that have a more stable foot position in their activity, like cycling, often refer to this Achilles referral as “tightness.”

Often, they have already seen an orthopedist or specialist and have had scans to check for tears but have found none. They have theories about tendonitis and micro-tears but have not found answers. When I test the tendon, it is often looser than the other one which does not hurt as the pain is not coming from this tendon but they keep stretching it. People often search for relief with orthotics or special support shoes.

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Self Care

This is the part of my blog where I usually offer some suggestions for home care. Ice plunges are worth trying to relieve the associated joint problems in the tarsals. This muscle, however, is complicated, very deep in the calf and attaches to most of the bones in the arch of the foot. When it gets chronic, it takes time and a good bit of work to get it back up to par. If you think this is your issue,  don’t spend a lot of time on self-care as you may actually make it worse. Go see a professional early in the game. If you aren’t getting results from your orthopedist or podiatrist, see a seasoned bodyworker that specializes in feet or a podiatrist that specializes in rehabilitating athletes.

Therapy Notes

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This muscle  is reported as attaching to mostly the navicular and first cuneiform but attaches to all the attaches to almost every bone in the arch of the foot. Inverts the foot (turns the sole inward) and can become overly tight when the peroneal muscles have become weakened n a lateral ankle sprain. It is easy to spot as the ankle hangs in and inverted position on the table. mobilization of the carpals and fibular joints are needed to restore function to the peroneal muscles.

There are several muscles that overlap the referrals of the tibialis anterior.  I use palpation and ice-and-stretch for assessment.

This muscle can be very difficult to treat with direct massage but is much easier with ice-and-stretch or hot stones. Still, It will not release with lasting results without ankle mobilization.

The carpals and tibiotalar joint must be mobilized for lasting results. Ice plunges are also helpful home care during recovery.

Similar Patterns

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Tony Preston has a practice in Atlanta, Georgia where he sees clients.

He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

Question? Comment? Typo?
The Body Guild.org
(404) 226-1363
tony@thebodyguild.org


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