Trigger Point Therapy - Heel Pain and Night Cramp

Treatment Techniques for Gastrocnemius and Soleus Trigger Points 

60% of adults will suffer from night cramp at some point

Cramp is an involuntary spasm of the muscle caused when an already shortened muscle shortens further. It is a very painful condition and very common. The calf is the area most affected, but foot cramps are also fairly common.

The majority of cramps occur at night

Known as nocturnal cramps, these are remarkably common, with 60% of the adult population reporting suffering from this at some point. Most sufferers will wake as a result of the cramp, leading to fatigue for them and, usually, anyone they are sharing a bed with.

Cramp is usually short-lived, anything from 30 seconds to 10 minutes, but the muscle may be painful for 24 hours after the initial cramp subsides.

Age Related

The propensity to suffer from cramp seems to increase with age, with around a third of the over-60 population and half of the over-80 population reporting regular leg cramps. Pregnant women, children, athletes, and those with physical jobs are also more at risk than the rest of the population.

Trigger Points in the soleus are often associated with heel pain and night cramp 

The soleus is the plantar flexor muscle of the ankle.  It is located on the back of the lower leg and originates at the posterior (rear) aspect of the fibular head and the medial border of the tibial shaft. It is capable of exerting powerful forces onto the ankle joint.

The soleus muscle forms the Achilles tendon when it inserts into the gastrocnemius aponeurosis. The tibial nerves S1 and S2 innervate it; arterial sources include the sural, peronial, and posterior tibial arteries.

As well as helping to maintain posture by preventing the body from falling forward, the soleus muscle is primarily used for pushing off the ground while walking. The soleus is vital to everyday activities such as dancing, running, and walking, and may be exercised through calf raises while standing up or sitting down.

Treating Soleus - Exercise Caution!

The soleus is also part of the skeletal-muscle pump, which is a collection of muscles that help the heart circulate blood. Veins within the muscles become compressed and decompressed as the muscles surrounding them contract and relax. This aids in venous return of blood to the heart. Therapists need to remember this and exercise appropriate caution when treating this muscle.

Stretching the soleus to help dissipate trigger points

Trigger Point Therapy - Soleus

Trigger points in the soleus develop for a whole host of reasons including prolonged wearing of high heels, post-fracture splinting, poor orthotics, driving, popular sports (e.g. running, soccer, cycling, climbing, skiing, rowing machine), occupational standing, or a direct blow/ trauma, to the calf.

When trigger points have developed, we often see the following referred pain patterns: Pain in distal achilles tendon and heel to posterior half of foot. Calf pain from knee to just above achilles tendon origin. 4–5 cm zone of pain in ipsilateral sacroiliac region (rare).

Trigger Points in Soleus - Night Cramp

Trigger points are often directly associated with night cramp. Treating these (often overlooked) trigger points can be marvelously effective in providing relief.