Chiropractor Chandler AZ

Carson Robertson
Google Plus

Posterior Tibialis Trigger Points and Shin Splints

The tibia is one of the lower leg bones that absorbs tremendous amount of stress when we walk and run. The fibula sits on the lateral or outside of the lower leg. There are several muscles below the knee that help absorb tremendous amounts of stress and strain from every step we take. The tibialis anterior is on the front of the lower leg while the fibularis longus, fibularis brevis, and fibularis tertius are on the outside of the lower leg. The gastrocnemius and soleus muscles are in the back of the leg. The posterior tibialis muscle is on the medial aspect of the lower leg along with the toe flexor muscles.

The posterior tibialis muscle is commonly injured in runners who overpronate their feet. Both walkers and runners increase stress loads on this muscle when the foot arch collapses, or overpronate. This position requires the lower leg muscles to work harder to absorb the pounding effects from walking. Eventually poor foot mechanics will produce posterior tibialis syndrome.

Shin splints and achilles tendonitis are other injuries associated with dysfunction in the lower leg in walkers and runners. The excessive stress damages the muscles and tendons.

Palpation of the posterior tibialis trigger point radiates pain down the lower leg towards the ankle. Often times it can be very sharp and intense. Most people never touch or rub their lower leg behind the tibia bone and do not realize how tender this area has become.

Palpation and reproduction of the lower leg trigger point is clinically important for ruling out additional leg injuries such as stress fractures.

tibialis posterior 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.