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Peroneal Muscles – Massage Therapy Notes

Therapist Notes include:
Anatomy review,
Syndromes and Conditions,
Assessment notes,
Treatment Preparation,
NMT protocols and more…


Peroneal muscles are responsive to craniostructural work, pelvic work, and local joint work. In addition, the proper preparation makes the trigger points in the peroneal muscles very responsive to direct work if it is still needed.

Musculoskeletal Anatomy

About these Illustrations…

This post on anatomy contains the standard information about origin, insertion, function, and innervation. It also includes information on functional considerations and anomalies. This is also the place to find all posts related to this muscle.


Peroneal muscles are indicated in several ways:

  • Instability in the low leg when standing on one foot
  • Weakness and pain in the lateral ankle when walking on uneven ground
  • Collapse of the foot nmedially
  • Lateral ankle sprain

Integrative Treatment Sequencing


Lateral Strain Patterns

A lateral strain pattern of the cranium directly governs the stability of the lateral low leg muscles. In The Typical Pattern, the left lateral strain pattern weakens the right peroneal muscles. Structural release consistently provides lasting results when using the right lateral strain technique. Resolve the functional patterns after this structural release to avoid iatrogenic discomfort.

Valgus Thrust

The valgus thrust of the ankle often creates a weakness in the tibialis anterior. In turn, the peroneal muscles can become unstable. In addition, the squamosal suture of the temporal bone governs the valgus thrust of the ankle.

Upper Cervical

The atlas and the SBS tend to be anterior on the right and rotated to the left when the peroneus longus has trigger points. Typically, it is more effective to focus on the related craniostructural and pelvic patterns.

If you’re not inclined to do craniostructural techniques, establish joint play in the atlas before addressing the pelvis.

You can find details in this post.

Pelvic Balancing

Peroneus longus patterns are directly governed by the shearing of the ilium on the sacrum. As a result, the pelvis tends to be posterior on the side with peroneal trigger points.

Lift the os coxae anteriorly to free the sacroiliac joint.

You can find more details in this post.

Release of the fibular head for peroneal trigger points

Local Joints

Fibular head mobilization consistently releases this trigger point.

Palpate for the tender, swollen tissue at the base of the first metatarsal. Evert the foot while lifting the fibular head anterior and inferior. In 30-90 seconds, the swollen tissue at the base of the first metatarsal will soften. At that point, review the peroneal trigger point. The entire muscle will improve in tone and strength.

NMT Protocol for Lateral Low Leg

Detailed Trigger Point Work

This protocol from The Workbook of Classical Neuromuscular Therapy is a more detailed treatment of the attachments and belly of the lateral low leg muscles.

If you’ve done any of the steps before this, the releases are easy and lasting. If you haven’t done those releases, At least go back and release the fibular head. It will be so much easier for you and your clients.

You can find the detailed steps in this post.

Self-Care Follow-up

This post includes activities to change, stretches, icing, and yoga tips. It is an excellent resource for clients.

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Tony Preston has a practice in Atlanta, Georgia, where he sees clients. He has written materials and instructed classes since the mid-90s. This includes anatomy, trigger points, cranial, and neuromuscular.

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*This site is undergoing significant changes. We are reformatting and expanding the posts to make them easier to read. The result will also be more accessible and include more patterns with better self-care. Meanwhile, there may be formatting, content presentation, and readability inconsistencies. Until we get older posts updated, please excuse our mess.

2 thoughts on “Peroneal Muscles – Massage Therapy Notes”

  1. Pingback: Lateral Low Leg - Neuromuscular Protocol - Integrative Works

  2. Pingback: Painful, Unstable Ankle - Integrative Works

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