Understanding Trigger Points: Painful, Unstable Ankle

Client’s Description

People often come in complaining that they have twisted their ankle and wonder if it is sprained. They associate it to stepping off a curb where the ball of the foot hits the curb and the outside edge of the foot twists down. Others come in complaining that the ankle feels weak and painful. When asked about the pain, they usually trace around the back of their ankle.

When there is an actual strain/sprain, there is usually swelling and some blood pooling along the edge of the foot. It looks like a weird bruise along the outside edge of the foot. There is often a bruise just above the ankle as well. Google “twisted ankle bruise” and you’ll see that a lot of people want to put a pic of this on the web and they all look pretty similar. Your neuromuscular therapist will refer you to appropriate medical help if they suspect a sprained ankle.

Even though your ankle may not be sprained, this weakness can easily lead to an ankle sprain. Get it taken care of before it becomes worse. Left unchecked, this muscle will tighten on the peroneal nerve causing foot drop. You’d first notice it as stubbing your toe on the carpet regularly but it can become a very serious problem.

The injury usually occurs when people step off the curb so that the outside of the foot twists down unexpectedly. I don’t treat enough clumsy runway models to get many cases of this from falling off spiky high heels but that didn’t stop me from finding this great pic. You know, I just wanted you to get a visual of how the ankle twists.  Maybe my clients have too much dignity to admit that they did it this way. Nah, they’d be so proud of the runway thing. I digress.

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Self Care

Avoid crossing your legs in a figure 4. This can press on the peroneal muscles. Continued crossing to the point that the foot falls asleep regularly can cause nerve damage.

Long periods in bed with the ankle straightened can contribute to this problem as well. Sleep on your side with the ankle bent or use a foot board.

While this is a problem, stick to shoes with good lateral support. Once this is a problem, it is aggravated by the wrong shoes. It is usually one of two problems. The first is an unstable shoe the stresses peroneus longus as it tries to stabilize the lateral foot. The second is when the lip on the opening of the shoe rides up and rubs into the peroneal tendons on the ankle as would happen with ankle boots. Sometimes, a strap that fits uncomfortably across the instep can aggravate this problem, although those straps usually produce problems in the muscle within the foot.

Ice plunges are a great help for compressing out waste, tightening ligaments and generally stabilizing this ankle. Don’t use Ice And Stretch on this problem.

Check with a trigger point specialist who can take care of the underlying problems. There are problems in nearby joints that perpetuate this as well as other elements of Organized Pain.

Therapy Notes

oit-peroneus-longusAs you can see from this picture, peroneus longus traps a number of bones between its origin on the fibular head and its insertion on the first metatarsal. Each of those joints should be checked for their mobility. The fibula/tibia joint and tibia/talar joint are particularly critical to the release of this trigger point.

Ice plunges can be instrumental in repairing damaged tissue and stabilizing the ankle after the joints and trigger points are treated.

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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