I made this trigger point map to get right to the point (pun!) by providing some direction with self myofascial release (SMR). It shows all of the hot spots of the lower leg along with their referred pain patterns on one image.
A separate trigger point map of the hip and thigh is here.
Why We Need Mobile Ankles
If the ankles can’t move, the body has to find other ways to move – by producing extra movement in areas that are designed for stability, like the knees and lower back.
Signs of Immobile Ankles
- Trouble getting below parallel in a squat
- Heels lifting when squatting
- Lower back or hamstring discomfort when squatting or deadlifting
- Awkward bottom position when catching a clean
Common Lower Leg Trigger Points in Lifters
This study identified an immediate significant improvement in ankle ROM after a single trigger point release of the soleus. The tibialis anterior and peroneus tertius can also affect ankle ROM.
Another spot worthy of mention is the peroneus longus point, which is the uppermost point on the map. You might find this point getting cranky when the hip stabilizers aren’t kicking in the way they should.
What are Trigger Points and Referred Pain Patterns?
A trigger point is a hyperirritable spot in a taut band of muscle tissue that hurts when you press on it.
Referred pain is felt as a deep, oppressive ache, and is referred away from the trigger point as shown in the diagram above.
Why Should We Release Trigger Points?
The science on trigger points is a bit murky – but if it feels good and helps you move better, that might be all the evidence that you need.
Though we don’t fully understand why it works, SMR has been reported to improve circulation, promote muscle relaxation, loosen scar tissue, stretch tight muscles and fascia, enhance mood, and relieve muscle spasms. It does not have an effect on force output, as some have been concerned about with static stretching.
For those who like data, here is a meta-analysis that concluded that pre-rolling is an effective strategy for short- term improvements in flexibility without decreasing muscle performance:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465761/#!po=70.0000
Some lifting-related troubles that could arise from harboring trigger points could include limited ROM, muscle guarding, shifting, as well as weakness relating to any of these issues. Here is a study that found muscle strength to be significantly lower in subjects who have trigger points in comparison to healthy subjects:
https://www.ncbi.nlm.nih.gov/pubmed/22142714
Additionally, trigger points can make you feel pretty stiff and uncomfortable. Trying to work with a muscle that has trigger points can feel like pulling on a knotted rope.
How to Release
- You can use a tool like a lacrosse ball, a beastie ball, or a foam roller to spare your hands from tiring. Otherwise, just jab a thumb in there.
- Press on the spot and hold for at least 30 seconds, but no longer than 90 seconds. You can either apply steady pressure, or perform deep strokes.
- On a pain level of 1-10, shoot for a 5-7.
- Release when you feel the pain subsiding, and don’t overwork the spot. It is better to hit the spot over multiple sessions than it is to annihilate it in one shot.
- Follow the releases with ankle mobilizations, then put the legs right to work.
When to Release
Soft tissue work can temporarily increase range of motion in the short term, making the warm-up an ideal time to incorporate it. (An added benefit of performing soft tissue work prior to lifting is that it gets you rolling around on the ground, which is a great way to start a session.)
An efficient warm-up that can be completed in 10 minutes (or less) could look like this:
1. Soft Tissue Work
2. Mobilization
3. Activation
4. Strength Training
Post-training is also a great time for SMR. Or, just release whenever you see fit.
Do I Have to Release?
If you don’t have trigger points or find that SMR isn’t helpful, you don’t have to do it. SMR is optional.
If you do it and find that it helps, then keep it up.
Making the Improvements Stick
As awesome as trigger point release is, it might not be a singular solution.
If a muscle is unusually tight or keeps getting trigger points, it can be a sign that something is not functioning quite as it should.
For example, individuals with joint hypermobility might find that their bodies set up restrictive trigger points in an effort to stabilize a joint. Other theories on the possible causes of persistent tightness include improper loading/programming, movement issues, or stress.
It does feel good to just lie there after a release, but results might be more likely to stick when soft tissue work is used in conjunction with other techniques that incorporate stabilization and strengthening.
Conclusion
SMR is quick, simple, effective, and easy to perform on yourself. Even with the help of regular massage therapy appointments, it is a good idea to have the ability to perform some soft tissue maintenance on your own.
If you want to go deeper (another pun!), the Trigger Point Workbook is an amazing resource.