Peroneus Longus, Peroneus Brevis, Peroneus Tertius, Trigger Points
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The peroneus longus, brevis and tertius muscles are located on the outer side of your leg between the knee and your anklebone. These three muscles attach along your fibula, the thin bone on the outside of your lower leg. The bottom of the fibula is actually your anklebone you see sticking out. The peroneus muscles often cause the pain associated with a sprained ankle.
If your sprained ankle resulted in little or no swelling, or if you still have pain a long time after your injury you should definitely be suspicious of the peroneus muscles. Now, don’t get too angry at these muscles, the trigger points they create are protective response. Sprained ankles often occur when you roll your ankle outward.
This extreme jarring and stretch of the peroneus muscles causes a contraction to prevent a bone break or tear. Unfortunately the pain and stiffness of these trigger points can long outlast the original injury. If this the weakness caused by these trigger points goes untreated re-injury is almost certain.
This time however the injury can be worse, potentially causing tears and breaks. The constant tension could also lead to growing pressure resulting in lateral compartment syndrome, which can cause permanent nerve damage and require surgery.
The red region indicates the likely pain pattern location you will experience from these muscles. The green circles are the trigger point location . This is where you need to massage in order to relieve the pain. Check out the trigger point page for details regarding treatment tips and techniques.
The peroneus longus is longest and largest of the three muscles and also causes the most pain and stiffness. This is the first of the group to check. Attached to the upper two thirds of the fibula serious tension or trauma on this muscle can cause stress fractures or breaks to the fibula bone. From the top of the fibula the muscle runs down the side of the leg, around the back of the anklebone and wraps all the way under your foot to the first metatarsel.
The metatarsels are the bones in your foot between the toes and your ankle. The first metatarsel is connected to your big toe and 2,3,4,5 connect to their respective toes.
The peroneus longus muscle is used to point your foot and turn the bottom of your foot outward. This motion is repeated constantly while walking and because the muscle must contract and slowly release it is really working twice for each step. This heavy workload means that the peroneus longus muscle should be one of the first muscles you check to maintain healthy feet.
This muscle creates similar pain patterns as the peroneus longus but often refers pain further along the side of your foot. The muscle attaches to the base of the fifth metatarsal, the bump in front of your heel on the outside of your foot.
This muscle is more difficult to locate and one in twelve people don’t even have one. Also interesting, one in seven people have a fourth peroneus muscle. The bottom of this muscle attaches to the 4th and 5th metatarsals.
Conditions and Differential Diagnoses
Pain from peroneus longus trigger points is often felt on the outside of the ankle. Less common pain locations are the outer leg and the outside of the foot. The peroneus brevis muscle also refers pain to the outside of the ankle but further down the side of the foot as well.
The peroneus tertius refers pain to the front of your anklebone and the outside of the heel. Another way to distinguish this referred pain from damage from a sprain is to check the ankle. Referred pain will be less severe and less sharp then pain from damaged tissue. Ankle weakness and difficulty in raising your foot is likely a result of these trigger points.
Numbness in the leg ankle and top of your foot can result from nerve compression. This numbness is similar to that of spine problems like a ruptured disk. Treating your leg muscle could save you from being diagnosed with a more serious spine issue.
By rotating your foot outward then pointing your toes you can see the contraction below the side of your knee. This is the peroneus longus muscle. The peroneus brevis muscle is found by feeling the contraction from lifting the pinkie toe side of your foot.
You can find your peroneus tertius muscle by lifting the same part of your foot and checking for the contraction just above and in front of your anklebone.
Elevating your leg on a stool or bed can make these muscles more accessible. Using the Theracane Massager or a hand tool you can make short slow strokes to treat and deactivate the trigger points.
You can also try laying on your side and using a ball to massage the muscle against the ground. Similar tools and techniques can be used to treat all three muscles. Find the tender points and tight knots and work on it regularly until the pain is gone.
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