Menu
Cart 0

Trigger Point Therapy - Fibularis (Peroneus), Longus, Brevis, Tertius

Posted by Judith Winer on

 

[Latin fibula, pin/buckle; longus, long; brevis, short; tertius, third]

 

Trigger points in the fibularis (peroneus) muscles of the lower leg are a common, but often over-looked, source of ankle pain and weakness. Anyone who suffers from frequent and reoccurring ankle sprains is likely to have trigger points in these muscles. 

FIBULARIS - ANATOMY

The course of the tendon of the insertion of the fibularis longus helps maintain the transverse and lateral longitudinal arches of the foot. A slip of muscle from the fibularis brevis often joins the long extensor tendon of the little toe, whereupon it is known as peroneus digiti minimi. The fibularis tertius is a partially separated lower lateral part of the extensor digitorum longus.

ORIGIN

Longus: upper two-thirds of lateral surface of fibula. Lateral condyle of tibia.
Brevis: lower two-thirds of lateral surface of fibula. Adjacent intermuscular septa.
Tertius: lower third of anterior surface of fibula and interosseous membrane.

INSERTION

Longus: lateral side of medial cuneiform. Base of 1st metatarsal. Brevis: lateral side of base of 5th metatarsal.

Tertius: dorsal surface of base of 5th metatarsal.

ACTION

Longus: everts foot. Assists plantar flexion of ankle joint. Antagonist: tibialis anterior.
Brevis: everts ankle joint.

Tertius: dorsi flexes ankle joint. Everts foot.

NERVE

Fibular (peroneal) nerve, L4, 5, S1.

BASIC FUNCTIONAL MOVEMENT

Examples: walking and running; walking on uneven surfaces.

TRIGGER POINT REFERRED PAIN PATTERNS

Mainly over lateral malleolus, anteriorly and posteriorly in a linear distribution. Laterally along foot, occasionally vague pain in middle third of lateral aspect of lower leg.

 

 

Fibularis - Trigger Point Referred Pain Pattern

 

 

 

Fibularis - Trigger Point Referred Pain Pattern

 

 

INDICATIONS

Pronation of feet, repetitive inversion/eversion injury, tenderness around malleolus, ankle weakness, post-fracture (and casting) rehabilitation, foot problems (e.g. calluses, verrucae, neuromas), osteoarthritis of toes, metatarsalgia, ankle stiffness, lateral compartment syndrome.

CAUSES

Direct trauma, post-fracture, twisted ankle, ill-FItting boots/shoes, poor orthotics, walking on uneven surfaces, splinting (cast), sports (e.g. running, soccer, cycling, climbing, swimming), footwear (high heels), tight socks, prolonged crossed legs, sleeping on stomach with pointed toes.

 

Fibularis - Common Trigger Point Sites

 

 

DIFFERENTIAL DIAGNOSIS

Rupture. Fracture of foot. Fracture of 1st metatarsal (styloid process). Foot problems. Fibular head dysfunction (common peroneal nerve). Toe problems. Ankle problems (arthritis). Gait dysfunction. Compartment syn- dromes (lateral). Osteoarthritis of hip.

CONNECTIONS

TFL, gluteus minimus, extensor digitorum longus/brevis, extensor hallucis brevis.

COMMONLY APPLIED TREATMENT TECHNIQUES

Deep Stroking Massage Yes
Compression  Yes
Muscle Energy  Yes
Positional Release Yes
Spray and Stretch Yes
Dry Needling Yes
Wet Needling Yes

 

SELF HELP

Self-massage techniques can be helpful. Balls and pressure tools may be used, as the muscles are superficial.

GENERAL ADVICE TO CLIENTS

Avoid high-heeled/ at shoes. Regular stretching with hot and/or cold. Strapping/ankle support. Use of heel wedges and/or orthotics. Posture and gait advice. Examine shoes.

  

Find a Trigger Point Professional in your area

More articles about Heel Pain

Nationally Accredited Home-Study Courses

About NAT Certification

 

 

 

 

 

 

 

This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.


Share this post



← Older Post Newer Post →


Leave a comment

Please note, comments must be approved before they are published.

Sale

Unavailable

Sold Out