Activation of TrPs

Question 1

FLEXOR HALLUCIS BREVIS

Answer 1

Same as other deep and superficial foot muscles. Generally restriction of movement.
Other traumas to these deep intrinsic foot muscles, such as bruising, banging, stubbing toes, and falling, can also acti- vate TrPs in them.

Question 2

QUADRATUS PLANTAE

Answer 2

An asymmetrical gait, Morton foot structure, excessive pronation or supination when walking, Ill-fitting shoes

Question 3

Quadratus Lumborum

Answer 3

repeatedly bending over, especially to one side. Coughing often (cold). Anything causing the pelvis to be raised on one side.

Question 4

Flexor Hallucis Longus

Answer 4

Mechanical abuse from unaccustomed walking or running. Faulty biomechanics of ankle.

Question 5

Lumbar Paraspinals – Iliocostalis Lumborum and Lx and Sx Multifidus

Answer 5

Iliocostalis Lumborum – Lifting heavy objects using your back, unaccustomed digging/physical labour, scoliosis, sustained postures, hypo/hyperlordodic curvature, bending and twisting motions when these muscles are already fatigued or cold
Multifidus – Spondylolithesis, unaccustomed physical labour, sustained postures, bending and twisting motions when these muscles are already fatigued or cold

Question 6

ABDUCTOR HALLICIS

Answer 6

Uncorrected hyperpronation, hyper/hypomobility of the joints of the foot, inflexible shoes, and walking or running on uneven terrain may all perpetuate TrP activation in the intrinsic muscles of the foot

Question 7

Gluteus Maximus

Answer 7

-Stress through overload.
-Trauma to the muscle resulting from the impact of a fall.
-Prolonged walking in a forward leaning position.
-An injection into the muscle.
Excessive lordosis.
- Excessive lordosis

Question 8

Gluteus Medius

Answer 8

• Overuse injuries
• Sudden overload
• Chronic overload due to pronged flexion of the hip, leg length discrepancies, sacro-iliac dysfunction, sitting with your legs crossed

Question 9

Gluteus Minimus

Answer 9

• Falls
• Prolonged sitting
• Prolonged standing or walking.
• Limping because of a foot or knee injury will put pressure on this muscle and cause trigger points

Question 10

Piriformis

Answer 10

• Quick changes of direction in sports activity such as tennis, handball, soccer, football basketball, volleyball etc.
• Sitting often and for long periods.
• Acute overload as when catching oneself from a fall.
• Holding the thigh flexed in abduction for long periods as when driving a car.
• Local compression- sitting on an uncomfortable chair or wallet. `

Question 11

Iliopsoas

Answer 11

Prolonged sitting, long distance cycling and running, postural abnormalities

Question 12

Tensor Fascia Latae

Answer 12

Too much walking running or climbing can overload this muscle and this is especially so, if the ground is uneven.
Sleeping with the knees up may also cause TrPs as the muscle is under constant stretch.
Unstable ankles or worn-out shoes.
Walking with heavy loads or being overweight.
Morton’s foot structure

Question 13

Sartorius

Answer 13

Seldom appearing as a single muscle syndrome, they are usually activated as secondary to other muscles in the functional unit and therefore brought on as a combination of the aggravating factors to the surrounding musculature.

Question 14

Rectus Femoris

Answer 14

• A fall, or trauma that suddenly overloads a lengthening contraction
• Sitting for long periods of time with a weight on the lap
• Recovery from hip fracture or surgery
• Overload caused by abnormal hip joint mechanics
• Intramuscular injection (diabetes)
• Overload due to excessively contracted hamstring group

Question 15

Vastus Lateralis

Answer 15

• Sudden overload through a misstep or fall
• Sustained overload due to extensively tightened hamstrings
• Trigger points in associated muscles
• Trauma
• Immobilisation

Question 16

Vastus Medialis

Answer 16

Excessive pronation of the feet. 
Morton’s foot
Possible toeing out when walking
Activities such as jogging and skiing 
Prolonged kneeling.

Question 17

Biceps Femoris

Answer 17

Activation can occur from acute or repetitive overload or from the chronic trauma of under-thigh compression by an ill-fitting chair.

Question 18

Semitendinosus

Answer 18

Acute or repetitive overload
Chronic trauma of underthigh compression by an ill-fitting chair.
Short-stature patients with hamstring TrPs who sit in the customary chairs
Patients of average stature who sit in long-legged chairs with too high a seat

Question 19

Semimembranosus

Answer 19

Acute or repetitive overload
Chronic trauma of underthigh compression by an ill-fitting chair.
Short-stature patients with hamstring TrPs who sit in the customary chairs
Patients of average stature who sit in long-legged chairs with too high a seat

Question 20

Adductor Longus & Brevis

Answer 20

Climbing too many stairs too often
Making quick turns when skiing
Gripping the sides of a horse when riding
A sudden movement which spreads the legs as in a fall

Question 21

Adductor Magnus

Answer 21

Climbing too many stairs too often, gripping the sides of a horse when ridding, making quick turns when skiing. A sudden movement which spreads the legs.

Question 22

Pectineus

Answer 22

Climbing too many stairs too often, gripping the sides of a horse when ridding, making quick turns when skiing. A sudden movement which spreads the legs, as in a fall, or sitting crossed-legged for long periods.

Question 23

Gracilis

Answer 23

None

Question 24

Gastrocnemius

Answer 24

Activation of these TPs are usually the result of physical overload and mal-positioning of the foot such as in climbing steep slopes, jogging uphill, riding a bicycle with too low a seat, or the foot being plantar-flexed for too long.

Question 25

Soleus

Answer 25

This can be caused by overload of the soleus when the individual walks in shoes smooth shoes on a slippery surface, or walking on soft sand, or on a slanted surface.
Jogging or running can also responsible as is the sudden overload from slipping or almost falling.
Leaving the muscle in a shortened position by wearing high heels can produce soleus contracture.
Contracture can also be caused aggravated by circulation impairment by leg rest.

Question 26

Peroneus Longus

Answer 26

Walking, running or climbing to excess.
Eversion injury
Wearing high heeled shoes (this throws the weight of the body forward and the peroneal muscles must stay contracted to maintain balance).
Sitting with crossed legs can put pressure on the peroneal nerves, which can lead to numbness and muscle weakness.
Squatting for long periods compresses nerves and blood vessels in addition to putting strain on a number of muscles.

Question 27

Peroneus Brevis

Answer 27

Walking, running or climbing to excess.
Eversion injury
Wearing high heeled shoes (this throws the weight of the body forward and the peroneal muscles must stay contracted to maintain balance.
Sitting with crossed legs can put pressure on the peroneal nerves, which can lead to numbness and muscle weakness.
Squatting for long periods compresses nerves and blood vessels in addition to putting strain on a number of muscles.

Question 28

Tibialis Anterior

Answer 28

Strenuous running, walking or climbing 
Changing running or walking style 
Walking on rough ground.
Driving for long periods with the foot on the accelerator.
Pedaling a bicycle
Climbing long flights of stairs 
Inactivity if the leg has been in a cast

Question 29

Extensor Hallucis Longus

Answer 29

A radiculopathy of L4-L5 may cause trigger points in the long extensors of the toes
This muscle can be overloaded through strenuous running, walking or climbing.