Wednesday, September 19, 2012

Achilles Tendinitis Pain? Trigger Point Therapy Helps!

Previously I covered trigger pointing for plantar fasciitis and inner heel pain. Since then, I received a few questions about trigger pointing for pain in various parts of the body. (Thanks for all your questions!) One of the enquiries was how to trigger point achilles pain. This is pain in the back of the ankle/s.
Credit: 'The Trigger Point Therapy Workbook'

Target trigger point #1: Soleus
I would first target the soleus trigger point (see pic to the right). Use your thumb to feel along the soleus muscle, until you find the trigger point. It will feel like a solid roundish mass. It will HURT when you press on it. This HURT almost always seems way out of proportion to the pressure you apply to it.

Use the opposite knee to rub out the trigger point firmly. This means, for a trigger point in your right soleus, rub the right soleus on your left knee. Thumbs work fine too.

Or you can get someone who enjoys hurting you to rub on that trigger point with their thumbs.

It's more fun that way :p



Target trigger point #2: Tibialis Posterior
Next, feel along the tibialis posterior muscle for a trigger point (see pic to the right). This muscle is quite deep - under the soleus and gastrocnemius. You will find the trigger point along the vertical line between the two 'heads' of the gastrocnemius. That's kind of the depression in the middle of the calf.

The trigger point will feel like a solid roundish mass. It won't hurt when you press on it....

I'm lying - of course it will hurt.

How much Hurt?
Rub out these trigger points 6-12 times, every hour. It should be enough pressure to be a 'good' hurt. Expect to feel immediately relief from your achilles pain. And for stubborn trigger points, it could take up to two weeks to completely resolve. Keep at it!

Let me know if these worked for you and if you managed to find those trigger points! And keep those questions coming!

Next post: Trigger Pointing for Knee Pain, even 'arthrtiic' knees

20 comments:

  1. I wish you were around to "TLC" my heels!

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    1. Sue, I would have loved to 'put on the hurt' on your heels - it's amazing how the pain just goes away with trigger point therapy. You can definitely apply the treatment yourself too. Would love to know how it works for you. :)

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  2. Thanks Grace for the sharing . I had bump into your blog . Both of my heel tendinitis are amazingly subsided alot . No longer felt the pain after waking up in the moning . I can run again .The tendon around is still a bit tight but not pain . Your blog is simply a blessing .

    Yong Kheng

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    1. Thanks so much for your comment and I am so glad your tendinitis pain is nearly gone! This is yet another confirmation that trigger point therapy works! Keep running!!

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  3. HI Grace, this information has made a big difference for me, although I don't know if it's the solution. I had and still have pain in the back of my heels (mostly right). My right heel is almost always sore in the mornings. I wake up with pain, and when I start walking I must walk gently because it feels like my right Achilles is going to rip off the back of my heel if I put enough pressure on it. if I race I need to wake up very early to warm up the Achilles and the heel. since applying your steps (almost 2 weeks) I have noticed less pain in the mornings, but if I run I have my usual pain as the duration increases (10 - 30km) right at the back of the heel where Achilles joins. I have done trigger point release in the evenings before bed too but in the mornings my heel is still sore and tight. I also don't find any hard trigger points (solid roundish mass) anywhere. I never found them to begin with but I did have severely painful muscles (more in right than left)in those areas which I firmly massage with a plastic hand roller, and they are not sore anymore. Was your experience that your Achilles pain when away right away or was it been delayed by training and loading the Achilles.

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    1. Thanks for your comment and glad my blog post helped alleviate some of your Achilles pain. As to your question, if you have successfully deactivated those trigger points for your Achilles tendinitis, you should be able to continue running without fear of loading the Achilles - in my experience, rest doesn't help but movement and repeated frequent trigger pointing does. During my long runs, if I feel pain starting to come one, I would stretch out the calf muscles and hit the trigger points as often as needed. However unless you can locate those trigger points I'm not sure how much that's going to help. From what you describe I'm pretty sure it's trigger points that's contributing to your pain, and your religiously foam rolling the muscles are incidentally getting at least the soleus trigger point deactivated. The other trigger point is much deeper though so you're probably not reaching it. I have a couple other suggestions for you - sleep with your toes dorsi flexed not pointed, stretch throughout the day, hot soak helps me more than ice baths. If you want help locating your trigger points let's do a Skype or something. Easier to show you that way. :)

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  4. Thanks for pushing me to keep on trying. I wasn't sure what my muscle should feel like, so what I assumed to be a thick long sinuous muscle was actually a trigger point in the upper calf, below the back of the knee, towards the peroneal. It's not gone yet. I can only make small dents in it, but after 3 days of constantly working on it I have finally woken up without heel pain today. I am so relieved. The key is to know what the difference is between muscle and tendon and a trigger point in a muscle. Charl

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    1. Charl, thanks for the awesome update! Made my day knowing that you managed to locate that hard-to-find trigger point and have been successful in banishing that horrible Achilles tendinitis pain. I'll have to update my post and add a remark there that not all trigger points are round mass-like things. Some are like spaghetti noodle shapes and now that I think of it can feel like a tendon or be tricky to tell apart from muscle to those of us who are new at it. The trigger point book does cover a bit of that. Happy running!!!

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  5. Just want to express my gratitude for all your posts on trigger points. They gave me relief immediately after months of pain and cluelessness. It was pretty tricky finding the points my fingers but I got them with one end of a fat pen. Why did you stop writing after 2013?? Would you know where I can get the Trigger Point book locally?

    Shirene

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    1. Shirene, thanks for your comment and so glad to hear you got immediate relief from your pain by using simple trigger pointing! I haven't posted much else after 2013 because baby was born and I have been nicely occupied since then, but I have continued to massage and do trigger point all this while. The Trigger point book is probably not available locally - you could try ordering on Amazon and have it shipped to you, otherwise if you like I can order it and get it sent over to you - just cover the shipping charges. It's $10 used on Amazon. Let me know!

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  6. Just want to express my gratitude for all your posts on trigger points. They gave me immediate relief after months of pain and cluelessness. It was tricky finding the points but I got them with the one end of a fat pen. Why did you stop writing after 2013?? Would you know where I can get the book locally?

    Shirene

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    1. Hi Shirene, thanks for your comment and so glad the trigger point therapy worked for you immediately! You're right the points are tricky to find but once you know what they feel like, it gets a lot easier after that. I had a baby in 2013 and haven't had much opportunity to blog since then. Definitely get your hands on the book if you can - Amazon ships internationally, and a few other sites also. If you need help, I can also ship you a copy from the US. Let me know!

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  7. Hi Grace
    A 15 month painful Achilies of mine atlast gave a instant 40% pain relief on the day one. I hope my recovery will be in one or two weeks. Let God bless you for your service to the society.
    Painless
    Devaraju

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    1. Thanks Raj for leaving your comment and I am very happy for you that your Achilles pain was helped so much by the trigger point therapy! I hope you get a full recovery and remain pain free!

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  8. I've had Planters fasciitis for about 5 years. I've tried everything under the sun but this is the first time I've heard about trigger point therapy and it was very interesting, thank you. I've been performing it on my calves for about 3 days now. I was hoping for instant relief but the pain in my feet seems to be getting worse. I'm hoping it's one of those things that gets worse before it gets better and that it will get better. is this normal in your experience and do you have any suggestions for me? Thanks in advance.

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    1. Hi Becki, you should be experiencing relief and the pain in your feet shouldn't be getting worse. What do the trigger points in your calves feel like (shape, size) and is the pain disproportionate to the pressure applied? How did you locate the trigger points?

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  9. thank you for your response, sorry it took me so long to get back to you. I do the massage on my legs rubbing my calves with my thumb pressing to find the knot. The knot feels hard and moves around When I massage it. It is about the size of one of those big gumballs you get in the gumball machines, smaller than a golf ball but bigger than a marble. it feels it feels good when I massaging it and it feels like it's breaking up the tension but later and the day when I walk my feet feel usually worse. Do you think I should stop?

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    1. It should be intensely painful when you are rubbing out a trigger point - what do you mean when you say it feels good? Does it feel good immediately after?

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  10. It feels good to massage my legs, when I get to the knot it does hurt and I keep pressing on the ball until it stops hurting or I feel it leave my body. My feet don't feel much better though and then next day my foot pain feels worse. That's why I was wondering if I should stop doing trigger point or if sometimes it gets worse before it gets better.

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    1. Thanks for clarifying - i have some questions - when you sleep at night are your toes pointed (like a ballerina) or flexed towards your shins? If you are a tummy sleeper that can aggravate plantar fasciitis. You'll need to rub that trigger point six times only, every hour. And do the barefoot drills and calf stretches (described in my other blog post). Let me know how it goes!

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