Muscle News Vol I.31:  Gastrocnemius
 
Knock Out Plantar Fasciitis Pain with this 
Home Run Tip!
In the distant past ... long before you knew anything about trigger point therapy ... long before you understood the principle of referred pain ... before you ever witnessed joint pain melt away by pressing on taut bands of muscle tissue ... you were like everybody else. 

When you had pain in your knee, you thought it meant there was a problem in your knee.  Pain in your wrist meant there was a problem in your wrist.  Pain in your back was a problem ... in your back.  And many good doctors and practitioners agreed with you.

Now look how far you've come!  Now, when we mention this month's subject of Plantar Fasciitis, a painful condition in the bottom of the foot, you're already asking the 3 BIG Q'S:

1.)  What muscle causes referred pain in the bottom of my foot?
2.)  Where is this muscle's location?
3.)  How can I get my hands on it to relieve any myofascial trigger points it might be harboring?

These are the very questions Muscle News answers each month to empower you to be in charge of your musculoskeletal health. 

The topic of this month, Plantar Fasciitis is a big deal.  According to a Medscape overview, around 10% of the United States population experiences heel pain resulting in 1 million visits per year to medical professionals due to Plantar Fasciitis.  Treatments cost us between $192 and $376 million dollars annually, consisting of injections, surgeries, steroids and physical therapy, with an average recovery time of 6 weeks.  Recurrence of the condition is not uncommon. 

With these stats in mind, let's take a look at what others still might be overlooking ... the fact that pain ("-itis") in the bottom of the foot ("plantar") might be caused or contributed to by trigger points in a distant muscle.

In this case, based on decades of MTPT research, the muscle most likely to be at fault is the Gastrocnemius.

The Gastrocnemius is a thick muscle in your calf that is separated into 2 heads, the Medial Gastroc (inside calf) and the Lateral Gastroc (outer calf).  Here is the referred pain pattern in the image to the left:

As you can see, a trigger point in the Medial Gastroc (indicated by the 'X') directly causes referred pain right over the bottom of the foot, exactly where most Plantar Fasciitis pain is experienced. 

Even in cases where a heel spur is present in this area, the pain that patients complain of is often relieved or reduced just by resolving trigger points in the Gastrocnemius. 

For these and other great reasons, let's look at how to evaluate and perform self-care for the Gastrocnemius.  We've provided some nice videos to help in the sections below:

*The information in this article is not intended to diagnose or treat any medical condition and does not substitute for a thorough evaluation by a medical professional.  Please consult your physician to determine whether these self-care tips are appropriate for you.
Quick Self-Tests to Tell if You have Trigger Points in Your Gastrocnemius:

TEST:  Straight Leg Dorsiflexion Test
 
    

The test in this video demonstrates how much your ankle and foot should be able to dorsiflex.  Sitting with your legs straight, use a strap or jump rope to gently pull the foot back toward the knee, as shown.  30-45 degrees of dorsiflexion is a Passing result.  Less than 30-45 degrees is a Not Passing result, indicating the likelihood of trigger points in the Gastrocnemius and risk of Plantar Fasciitis pain and other injury.
 

Simple Self-Care Remedies

Here are simple self-care tips for relieving myofascial pain and dysfunction in your Gastrocnemius:


Step 1:  Warming Up with Moist Heat

To relax and warm up the fibers of the Gastrocnemius, soak the calf in a warm bath or place the calf on moist heat such as a Fomentek bag for 10-15 minutes, as shown in the video below:

 

    

   

Step 2:  Compression

The following video demonstrates how to use your self-care tool to resolve trigger points all along the Medial Gastroc.  As always when you find a tender spot, press in to tolerance and hold for 10 seconds while completing at least two full breaths in and out.  Then continue searching for more tender spots until the entire muscle is covered.  

 

RECALL THAT THE TRIGGER POINT MOST LIKELY TO REFER PAIN TO THE PLANTAR FOOT IS NEAR THE UPPER PORTION OF THE MEDIAL GASTROC JUST BELOW THE KNEE (marked by the "X" in the referred pain diagram).     

    


For added effectiveness, please combine stretching and movement with your compression, as shown in this video below.  While holding the compression point, move the ankle through its entire range of motion.

   


Step 3:  Stretching

Perform the following stretch in the video below 2-3 times per day on both sides, holding a comfortable stretch for 20-30 seconds.    

    


We hope you enjoy the addition of these videos to this issue of Muscle News - We welcome your feedback!
  
  
Sincerely,
  
Your Friends at The Pressure Positive Co.
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Link Highlights:

NAMTPT LOGO National Association  of Myofascial Trigger Point Therapists

________________
 
Trigger Point Therapy for Low Back Pain: A Self-Treatment Workbook 

by Mary Biancalana MS CMTPT LMT (Author), Sharon Sauer CMTPT LMT (Author), Bernard Filner MD (Foreword)

Learn the secrets to lasting pain relief: finding and deactivating trigger points, the underlying cause of most low back pain. Trigger points are sensitive tight spots in taut bands of muscle tissue. Treating trigger points that refer pain to the low back and buttock areas, rather than addressing only the specific sites of your pain, is the best way to comprehensively treat occasional or chronic discomfort and prevent it from coming back.

Packed with illustrated treatment techniques, Trigger Point Therapy for Low Back Pain offers effective strategies beginners can practice at home and detailed hands-on protocols health care practitioners can use while working with patients. Find out which of eleven muscles could be causing back pain, then learn specific trigger point treatments and correct underlying perpetuating factors to immediately relieve soreness and tension in these muscles. If you're ready to try a targeted approach to eliminating back pain, this manual will provide you with all the information you need to get started and end low back discomfort once and for all.


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Our goal is to help people manage muscle discomfort by providing useful, safe, simple, and inexpensive massage tools to help facilitate trigger point and myofascial release.

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