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Trigger Point Therapy - Treating Soleus

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Treating the Gastro-Soleus Complex - Stuart Hinds

 

 

From a dynamic postural viewpoint, the soleus prevents the body falling forward at the ankle joint during standing

In gait, the muscle eccentrically decelerates subtalar joint pronation and internal rotation of the lower leg at heel-strike. It also decelerates dorsi flexion of the foot.

Spasm or myofascial trigger points in the soleus can be the origin of achilles pain, tight hamstrings, lower back pain, night cramp, and even headaches.

The soleus typically refers pain into the posterior aspect and plantar surface of the heel and to the distal end of the Achilles tendon.

A rare myofascial trigger point spreads pain to the ipsilateral sacroiliac joint, and can also refer pain to the jaw in extreme cases.

Anatomy

Part of the triceps surae. The soleus is so called because its shape resembles a fish. The calcaneal tendon of the soleus and gastrocnemius is the thickest and strongest tendon in the body.

Origin

Posterior surfaces of head of bula and upper third of body of bula. Soleal line and middle third of medial border of tibia. Tendinous arch between tibia and bula.

Insertion

With tendon of gastrocnemius into posterior surface of calcaneus.

  

 

Soleus Trigger Points

Soleus  - Common Trigger Point Sites

 

Action

Plantar flexes ankle joint. Frequently in contraction during standing, to prevent body falling forward at ankle joint, i.e. to offset line of pull through body’s center of gravity, thus helping to maintain upright posture. Antagonist: tibialis anterior.

Nerve

Tibial nerve, L5, S1, 2. BASIC FUNCTIONAL

Movement

Example: standing on tiptoes.

 

 

Soleus Trigger Points

Soleus Trigger Points - Common Referred Pain Patterns

 

 

 

Trigger point referred pain patterns

Pain in distal Achilles tendon and heel to posterior half of foot. Calf pain from knee to just above Achilles tendon origin. 4–5 cm zone of pain in ipsilateral sacroiliac region (rare).

Indications

Calf/heel/posterior knee pain, chronic/long-term use of high-heeled shoes, planter fasciitis, chronic calf shortening, calf pain walking stairs, low back pain, leg cramps.

Causes

Post-fracture splinting, poor orthotics, prolonged driving, sports (e.g. running, soccer, cycling, climbing, skiing, rowing machine), footwear (high heels), PSLE, occupational standing, direct blow/ trauma, pressure on calf.

Differential Diagnosis

Achilles tendonitis. Compartment syndrome. Vascular disease.
Heel spur. Fasciitis. Subtalar
joint problems. Venous pump mechanisms. Tendon rupture. Baker’s cyst. Shin splints. Stress fracture. Leg length discrepancy.

Connections

Popliteus, gastrocnemius, tibialis posterior, quadratus plantae (of foot), abductor hallucis (of foot), piriformis, occasionally to jaw.

 

 

Self help for Soleus Trigger Points

Soleus Trigger Points can be self treated but the muscle is deep and pressure tools should not be used without instruction from a professional. 

 

 

Soleus Trigger Points - Stretching

Stretching can be useful and there are many simple stretching exercises for the soleus that anyone can perform at home without special equipment

 

 

 

Self Help

Self-massage techniques can be helpful; you can even use the opposite knee. Balls and pressure tools may be used but not by the novice, as the muscle is deep and there are many superficial and deep veins in the area.

Stretching is excellent for disabling trigger points in the calf muscles. Use of foam rollers can be effective.

General Advice

Change footwear. Change and vary running techniques/running surface. Change/avoid high-heeled shoes. Regular stretching. Leg rests at home and at work. Use of cold. Massage after sports, with warm up before and cool down after. Posture.

 

 

Links

Find a Trigger Point Professional in your area

Treating Gastrocnemius

Dry Needling for Trigger Points

NAT Professional Courses

Certify as a Trigger Point Therapist

Membership Plans

 

About NAT Courses

As a manual therapist or exercise professional, there is only one way to expand your business - education!

Learning more skills increases the services that you offer and provides more opportunity for specialization.

Every NAT course is designed to build on what you already know, to empower you to treat more clients and grow your practice, with a minimal investment in time and money.

Help Desk

  

About Niel Asher Education

Niel Asher Education is a leading provider of distance learning and continued education courses.

Established in the United Kingdom in 1999, we provide course and distance learning material for therapists and other healthcare professionals in over 40 countries.

Our courses are accredited by over 90 professional associations and national accreditation institutions including the National Academy of Sports Medicine (NASM) and National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). Full details of all international course accreditations can be found on our website.  

Printed course materials and other products offered on our websites are despatched worldwide from our 3 locations in the UK (London), USA (Pennsylvania) and Australia (Melbourne).

More About Us

 

NAMTPT AWARD

We are honored to have received the 2017 "Excellence in Education" Award from the National Association of Myofascial Trigger Point Therapists.

Since 1999 Niel Asher Education has won numerous awards for education and in particular for education and services provided in the field of trigger point therapy.

Read Full Article 

 

Award Winning Instructors

Niel Asher Healthcare course instructors have won a host of prestigious awards including 2 lifetime achievement honorees - Stuart Hinds, Lifetime Achievement Honoree, AAMT, 2015, and Dr. Jonathan Kuttner, MD, Lifetime Achievement Honoree, NAMTPT, 2014.

Meet the Instructors

 

Accreditation

If you are a qualified/licensed manual therapist or exercise/fitness professional you can expand your credentials with NAT certification.

In addition to national accreditation for continued education, each course that we offer includes "NAT Learning Credits". By taking and completing courses you can accumulate NAT credits to qualify for NAT certification.

There are currently 3 levels of NAT certification. Certifying NAT is a valuable way to show your clients that you take continued education seriously, and to promote your skills and qualifications.

Most of our courses are accredited for CE/CPD/CPE. A full list of CE accreditations can be found by clicking on the link below. 

About NAT Certification

 

Niel Asher Technique

Since 1999 the Niel Asher Technique for treating trigger points has been adopted by over 100,000 therapists worldwide, and has been applied to the treatment of a number of common musculoskeletal injuries.

The Niel Asher Technique for treating frozen shoulder was first introduced and published in 1997 and has been widely adopted by therapists and exercise professionals working within elite sports and athletics.

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International Students

Most of our courses are available as either "Printed" or 'Download" editions, wherever you live. Internet connection is required to access online and downloadable material.

When you purchase a download edition, you receive immediate lifetime access to all course material. Course texts can be downloaded and printed if required. 

When you purchase a "Printed" edition, you will also receive free access to the download edition.

We ship Worldwide from locations in the USA, UK, and Australia. Most items are despatched within 24 hours and shipping is FREE for all orders over US$50.

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Where to Start?

We offer a range of over 50 courses, presented by some of the worlds leading manual therapists. All courses are reviewed annually, and new courses are regularly added.

Our courses are modular, and designed to build on what you already know. For more information, please visit our "Where to Start?" page.

Start Here

 

 

Trigger Point Therapy CE Course

Trigger Point Therapy Master Course

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Online Education Award

 

 

www.therapyfinder.com

 

 

 

 

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