National Associaltion of Myofascial Trigger Point Therapists - Symptom Checker

Gastrocnemius
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This is the technical name of the muscle being described.  This name may be used to find additional information in any medical resource. Gastrocnemius
A group of muscles generally denotes muscles of the same function and may share a common attachment point. Calf Muscle
Muscle function, in this definition, is what the muscle could do if it was to contract by itself with the body in anatomical position.  This is a general definition of muscle function.  For more information on how muscles work together on the body please refer to a physiology or functional anatomy text.

This muscle will plantar flex the foot (point the toes) and flex the knee.

A description of where a Myofascial Trigger Point may produce pain in the body.  This area is generally located away from the trigger point.

Pain from the gastroc is referred behind the knee as well as the lateral leg below the knee.  Pain may also be felt in the middle of the sole of the foot (instep).

A description of the symptoms a person may experience with trigger points in the muscle being described.

A person with TrPs in the gastroc may complain of non-painful calf cramps due to a TrP in the medial head.  Pain behind the knee is evident when walking over a slanted surface or climbing.

   

 A list of possible diseases that fit the information derived from examination of a patient.

  1. Since pain in this muscle can affect the back of the knee, calf, and into the foot a diagnosis of S1 radiculopathy may be suspected. 
  2. Tennis leg, which is a partial tearing of the medial head of the gastrocnemius, is another possible diagnosis.  Usually pain of this origin is felt suddenly and very intense and will produce swelling in the medial aspect of the midcalf.  A failure to recognize this condition can cause a complicated condition called posterior compartment syndrome.
  3. Phlebitis may be suspected if the pain is constant regardless of muscle use.  Also there may be present a diffuse warmth, redness, swelling, and tenderness of the leg and foot.
  4. A popliteal synovial cyst, also known as a Baker’s cyst, causes a swelling in the posterior (back) knee that is easily palpable when the leg is extended.

A list of activities or positions that may either CAUSE a trigger point to manifest or PROLONG a pain condition respectively.

  1. Activation of TrPs in the gastrocnemius can be from activities such as rock climbing, running uphill, or riding a bicycle with a low seat.
  2. A broken leg in which a person needed a cast will immobilize the foot.  When the cast is removed the now deconditioned and stiff muscle can activate, causing pain/dysfunction when put under load.
  3. Standing in one position while leaning forward for a period of time like washing dishes in a sink that has no toe room
  4. A tight elastic band at the top of long socks that compress the gastrocnemius.  Socks that are too tight will leave an indentation along with a red line.
  5. Hooking the heel on the rung of a high stool allowing the feet to point downward.
  6. Driving long distances while keeping pressure on the accelerator.
  7. Sleeping on the back with tight bed sheets that pull and point the toes away from the body.
  8. Ottomans, recliners, and some dental chairs may compress the gastrocnemius and reduce blood flow in the calf muscles.

A corrective action is usually a modification of daily routine which will reduce stress on the affected muscle(s) in a person with myofascial trigger points.

  1. Placing a pillow or firm support against the feet while lying in bed so that the toes are not pointed forward (dorsiflexed) thus shortening the soleus.
  2. A small pillow under the knees may help relieve pressure that may be caused by occlusion of the popliteal veins.
  3. Avoid high heels and shoes that have soles that do not bend, such as clogs, as these types of shoes cause the toes to point and put strain on the calf muscles respectively.
  4. Use of cruise control on long trips to avoid shortening the soleus will allow for more movement of the leg and foot, thus helping to relieve muscular tension.
  5. Proper stretching of the calf muscles will enhance an athlete’s performance, especially ones that are involved in running sports.  Unfortunately not enough emphasis is placed on these stretches.
 

References : 
Simons DG, Travell JG, Simons LS, Myofascial Pain and Dysfunction: The Trigger Point Manual, vol 1, 2nd Ed. Baltimore: Williams and Wilkins, 1999.

Travell JG, Simons DG, Myofascial Pain and Dysfunction, vol 2. Baltimore: Williams & Wilkins, 1992.


This information is not intended to diagnose, treat, or cure any disease.  A proper diagnosis should be sought from a licensed health care provider.