Treating Tibialis Anterior Trigger Points - Dr. Jonathan Kuttner
The tibialis anterior trigger point typically causes pain in the front of the shin, ankle and on the big toe.
The pain in the big toe can often be mistaken for gout, and the metabolic condition that causes gout may also irritate the trigger points in the lower leg muscles.
In most cases however, these trigger points are related to sports/overuse issues, and are often present in long distance drivers.
Tibialis Anterior - Common Trigger Point Site
[Latin tibia, pipe or ute/shinbone; anterior, before]
Lateral condyle of tibia. Upper half of lateral surface of tibia. Interosseous membrane.
Medial and plantar surface of medial cuneiform bone. Base of 1st metatarsal.
Deep peroneal nerve, L4, 5, S1.
BASIC FUNCTIONAL MOVEMENT
Example: walking and running (helps prevent foot from slapping onto ground after heel strikes; lifts foot clear of ground as leg swings forward).
Tibialis Anterior - Typical Referred Pattern
TRIGGER POINT REFERRED PAIN PATTERNS
Anteromedial vague pain along shin, with zone of pain 3–5 cm in ankle joint (anterior), culminating in great-toe pain (whole toe).
Ankle pain/tenderness, pain in great toe, shin splints (anterior tibial compartment syndrome), foot dragging, ankle weakness (children), gout toe, turf toe, falls, balance issues.
Direct trauma, twisted ankle, ill-fitting boots/shoes, poor orthotics, walking on uneven surfaces, stubbing great toe, overload (e.g. walking, car pedals).
Lumbar discopathy. Arthritic toes. Anterior tibial compartment syndrome. Shin splints (anterior). Varicose veins. Gout.
Extensor hallucis longus, peroneus tertius, extensor hallucis brevis, extensor digitorum brevis/longus, flexor hallucis longus, 1st dorsal interosseous.
Self Help - Pressure tools can be useful but be aware of varicose veins
GENERAL ADVICE TO PATIENTS
Self-massage techniques can be helpful. Be careful if there are varicose veins. Balls, hooks, and pressure tools can generally be used, as the muscle is fairly superficial.
Avoid long car journeys and use of pedals. Regularly change running surface/ shoes. Avoid walking (prolonged) on sloping surfaces.
Have stretch program (heat/warmth/cold). Adjust car seat. Use wedge under heel of foot for car pedal.
Recommended Starter Packs:
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.
- Trigger Point Therapy - Looking for Holding Patterns
Understanding Trigger Points and Holding Patterns Trigger Point Workbooks Trigger Points and their role...
- Trigger Point Therapy - Self Help Tips for Sciatica
Sciatica and Trigger Points - Overview for Therapists and Patients Sciatica most often occurs when the sciatic ...
- Trigger Point Therapy - Treating the Trapezius
Treating Trigger Points - Trapezius The left and right trapezius viewed as a whole create a trapezium ...
- Trigger Point Therapy - Postural and Phasic Muscles
Postural Muscles and Trigger Points - Dr. Jonathan Kuttner M.D. Postural and Phasic Muscles It's often accepted ...
- Trigger Point Therapy - Treating Achilles Tendinitis
Simeon Asher demonstrates a trigger point treatment protocol for achilles tendinitis Achilles Tendinitis is often a...
- Trigger Point Therapy - Treating Gluteus Medius
Stuart Hinds presents a technique for using tape to provide an off-loading effect when treating trigger points in...
- Trigger Point Therapy - Where to Start?
About NAT Home-Study Courses NAT courses are designed to provide continued education for qualified manual thera...
- Trigger Point Therapy - CRPS1
Michael Coffee LMT presenting his techniques for the treatment of CRPS at the 33rd Annual NAMTPT Conference, Chicago,...
- Trigger Point Therapy - Treating Pectoralis Major
Pectoralis Major Trigger Points - Dr. Jonathan Kuttner M.D. Most therapists could keep themselves busy full t...
- My Journey with NAT - Michael Coffee
Michael Coffee, Massage Therapist, NAT, Nationally Certified with NCBTMB - Michael seen here presenting his trigg...
Share this post