Chiropractor Chandler AZ

Carson Robertson
Google Plus

Tibialis Anterior Trigger Points

We often neglect the lower leg when stretching, especially the anterior aspect. The gastrocnemius and soleus muscles sit on the back of the lower leg and garner most of the attention. The fibularis longus, fibularis brevis, and fibularis tertius are on the lateral aspect of the fibula. The posterior tibialis muscle and toe flexors are on the medial aspect of the tibia bone. The tibialis anterior muscle sits on the anterior aspect of the tibia bone. It has a broad origination along the tibia and inserts on the medial aspect of the foot’s medial cuneiform and first metatarsal.

The most recognized injury to the the lower leg is shin splints. Shin splints develop whenever a person overwhelms the soft tissue in the anterior leg, usually with running or jumping activities. However prior to developing these injuries patients will present with trigger points in the lower leg muscles, especially the tibialis anterior.

The tibialis anterior trigger point is located on the proximal end of the muscle and radiates pain down the anterior aspect of the leg and towards the big toe. Because of this pain pattern many people believe that they have developed shin splints but actually they only have a very treatable tibialis trigger point. Older patients are likely to believe they have a low back disc injury or nerve entrapment that is radiating from the knee towards the big toe.

Soft tissue injuries in the lower extremity are often the result of poor walking or gait mechanics. The inefficient walker or runner are pounding the ground and creating spiking forces going through the ankles, legs, knees, quads, and hips. Depending on how the person compensates their movements they can develop achilles tendonitis, plantar fasciitis, IT band Syndrome, or patellar tendonitis.

In the early stages of repetitive stress injuries to the lower leg muscles, soft tissue treatment can very quickly relieve tibialis anterior trigger point symptoms. However if a person continues running and jumping additional lower leg injuries will develop. Treatment is always best in the early stages before more complex and severe soft tissue injuries develop.

tibialis anterior trigger point
Conservative Treatments

Therapeutic treatments for addressing soft tissue injuries involve massage therapy, manual therapy, trigger point therapy, Graston Technique, or Active Release Technique. These treatments increase blood flow, decrease muscle spasms, enhance flexibility, speed healing, and promote proper tissue repair.

When these treatments are incorporated into a treatment plan patients heal faster and are less likely to have long-term pain or soft tissue fibrosis or scar tissue in the injured muscle. These soft tissue treatments are incorporated with therapeutic exercise and flexibility programs.

Medical Treatments

NSAIDs are often prescribed for the initial acute injury stages. In severe cases that involve multiple joint regions, muscle relaxers or oral steroids can be given. Trigger point injections, botox, or steroid injections can be treatment options. Pain management is not usually required unless stronger medications or joint injections are required for treatment.

MRI and X-rays will not usually be ordered to evaluate mild to moderate muscle, tendon, and ligament injuries. Severe cases may utilize advanced imaging to rule out bone fractures, edema, nerve entrapments, tendon or muscle ruptures. NCV testing may be utilized in cases that also involve muscle, sensory, or reflex loss.

Sciatica is the term for radiating pain down the leg. Most commonly it comes from the back and radiates down the leg. Several back injuries and nerve entrapment injuries can cause sciatic pain in the leg. The pain patterns from a lumbar disc, lumbar joint sprain, sacroiliac sprain, or piriformis syndrome produces different patterns of radiating pain than trigger points. Proper identification of the pain pattern, along with reproduction of pain from palpation of the trigger point allows the provider and patient to feel comfortable with the diagnosis.

Likewise many trigger point injuries are associated with poor joint stabilization in the foot, knee, or hip. This leads to poor alignment and excessive forces being placed onto muscles and tendons. Iliotibial band Syndrome is common in runners who develop the injury because of weakness and poor stabilization of the leg and hip muscles. These runners will also have multiple trigger points in the quadriceps, psoas, gastroc, soleus, and gluteus medius.

Your chiropractor, physical therapist, occupational therapist, or physician will evaluate your condition and make a proper diagnosis and treatment recommendations. Ask them any questions you might have about your injury.

In Conclusion

The lower extremity works as a comprehensive unit performing many of the repetitive tasks at home, work, and recreational sports. Injuries to one area of the musculature often indicate that additional damage has been incurred by other muscles.

Many therapeutic exercises can help restore proper strength and endurance to the leg muscles muscles. Isometric exercises are often the initial treatment exercises. Followed by single plane rubber band exercises for hip, knee, and ankle; flexion, extension, adduction, abduction, circumduction, inversion, and eversion. Dynamic exercises involving stability foam, rubber discs, exercise ball, and BOSU balls can be performed on the floor. The more unstable of the surface the more effort and stabilization is required of all the lower extremity muscles.

Vibration plates enhance neuromuscular learning throughout the ankle, knee, foot, hip, and back muscles. Additional strength exercises can be found on the hip, knee, and foot strengthening pages. More information for injuries and treatments for knee pain and foot pain.

Our Chandler Chiropractic & Physical Therapy clinic treats patients with a variety of muscle, tendon, joint, and ligament injuries. The clinic provides treatment for runners, tri-athletes, and weekend warriors in addition to common headache, neck, and back patients traditionally seen in Chiropractic, Physical Therapy, Massage Therapy clinics. We work with all ages and abilities of the residents in Phoenix, Tempe, Gilbert, Mesa, and Chandler AZ.