Self Muscle Massage pt 8- Shin/Outer Ankle

Posted on

This is part eight in our Self Muscle Massage Series. In the first part of the series we introduced and discussed the three release techniques that will be used below. If you would like to review them, click here. If you would like to see any other part of the series, click here.

In this installment of the series, we’ll be talking about the front and outside of the lower leg. This area includes your shin, the top of your foot and the outside of your ankle up to your knee. It is home to the anterior tibialis (AT), extensor digitorum (ED), and the peroneal muscles. It is also a very common area for overuse injuries in the form of tendonitis, muscle strains/sprains and spasms, the most popular of which is “shin splints”.

Potential Causes of Injury

In normal gait, these muscles are responsible for lowering the foot all the way to the ground. The front muscles or dorsiflexors (their primary function is to pull the toes and ankle up) slowly lower the foot to the ground from heel to toe. The outer muscles (their primary function is to evert the foot or tilt the foot out to the side away from the body) slowly lower the foot to the ground from the outside of the heel, over the arch and onto the big toe. As you move through push off, these muscles rely on elastic recoil to pull the toes and ankle up for clearance through the swing phase. This reduces a large amount of the stress on these muscles and allows them to use their full strength for shock absorption at heel strike. However, if push off is decreased in any way (over pronation, high arches, tight calves for example), these muscles must then work overtime to not only pull the toes/ankle up so that you don’t trip over them and but also to slowly lower the foot to the ground upon heel strike. Over time, the muscles will become overworked and can break down.

Anatomy:

Landmarks

There are three landmarks used to navigate the muscles in the shin area and outer part of the lower leg. Remember, there are two bones in the lower leg that run parallel to each other from the knee to the ankle. The inner most and larger bone is the tibia and the smaller, outer bone is the fibula.shinbonyland
#1 The fibular head- The fibula head is actually located slightly below the knee. To find it, while sitting with your knee bent, wrap your hand around the upper part of your calf so that the space between your thumb and index finger are directly behind the knee and your fingers are wrapped around towards the front of your knee. The fibular head will be the large, bony bump under your index finger.fibhead1 fibhead2

#2 The lateral malleolus (outer ankle bone)- The lateral malleolus is the lower end of the fibula bone and makes up the outer portion of the ankle joint (the tibia makes up the other half and makes up the medial malleolus). Very easy landmark to find. As you move up the lower leg from the ankle to the knee towards the fibular head, this line will be your outer border. As you work on the muscles in this region if you find yourself behind the fibula, you’re working on the muscles in the back of your leg and need to come forward towards the shin.

#3 The Tibia- The tibia is your large lower leg bone. It joins with the femur to create the knee joint and runs down the leg to make up the inner portion of the ankle joint. Use the tibia as your inner border when working on this region. Always stay to the outside  of it when working on these muscles.

Muscles:

When working on the muscles in this area, think of them in three strips. You have one strip directly off the tibia, a strip next to it, and then an outer strip that starts on the fibular head.

shinmuscle1

#1 Anterior Tibialis (AT) The first muscle in the lower leg and the easiest to find is the anterior tibialis or AT. It starts just below the knee on the tibia, runs down the front of the leg and then wraps across to the inside of the ankle. It is responsible for pulling the ankle up (dorsiflexion) and in (inversion). It is also the most common location for “shin splints”.

#2 Extensor Digitorum Longus (EDL)- The second muscle in the lower leg lies between the AT and the fibular head. It starts on the upper tibia, runs down the front of the leg and then splits into four tendons (one to each of your smaller toes). It is responsible for pulling your toes and ankle up (toe extension and dorsiflexion).

#3 Extensor Hallicus Longus (EHL)- This muscle lies deep to the AT and EDL muscles on the front of the lower leg. It starts on the tibia, runs down the front of the leg and then becomes a tendon to the big toe. It is responsible for extending the big toe and dorsiflexing the foot. While the larger muscle may be hidden, the lower tendon is visible and can be traced up to where it meets the other muscles.

#4 Peroneals (Longus and Brevis)-shinmuscle2

I’m going to bunch these two muscles together since they are both responsible for the same motion and follow the same pathway; the brevis is just shorter. Both muscles are responsible for everting the foot (tilting the foot out away from the body; just the foot moves, not the entire leg). The long muscle runs from the fibular head, down the outside of the leg, behind the lateral malleolus and wraps under the foot just before heel. The short muscle starts midway down the fibula and follows the same path.

Soft Tissue Release Techniques

What you’ll need: foam roller and tennis ball

The techniques:

1) Lengthen/elongate the muscle with the foam roller.

2) Cross friction (works perpendicular to the muscle fibers) with the tennis ball.

3) Sustained pressure or trigger point release with the tennis ball.

Key Area’s to Work On:shinkeyarea

#1 The first key area to target when working on this area of the lower leg is at or just below the fibular head. This area is also where the IT Band comes in from the outer thigh as well as where the gastroc and soleus muscles come in from the calf. Be sure to foam roll this area first as a warm up. Start on the side of the leg and then rotate forward to get just in front of it and backwards to get just behind it. This will help loosen up the intersection areas for the different muscle groups coming together. Cross friction and sustained pressure also work very well at this area.

#2 The second key area to target is the muscle bellies of these muscles. A “muscle belly” refers to the thickest part of the muscle and is a common area for tension, as well as, muscle knots/spasms. Start by warming up the area with the foam roller and look for tender sports or knots. Then get to work with the tennis ball. Start with cross friction and then sink deeper with sustained pressure/trigger point release.

#3 The third key area to target is the front of the ankle where the tendons all come together. Draw a line between the top of the two ankle bones and the bottom, and you’ll be on the right spot. If you pull your toes/ankle up you should be able to see a thick band pop up. This contains the AT, EHL, and EDL tendons. The tennis ball will work best in this area with the cross friction technique. see the video below for more specifics.

#4 The last key area (not pictured above) is in regards to any pain/tenderness you may be having along the top of your foot. When working on the tendons here it is best to use your thumb for the cross friction technique. Start light and work deeper as the tenderness allows. Remember- cross friction moves perpendicular to the direction of the tendon.

Video

Here is a video demonstrating the soft tissue release techniques for this area.

References

1) Hammer, Warren. (2007). Functional Soft-Tissue Examination and Treatment by Manual Methods, 3rd edition. Jones and Bartlett Publishers, Inc, Sudbury, MA.

2) Moore, Keith and Dalley, Arthur. (1999). Clinically Oriented Anatomy, 4th edition. Lippincott Williams and Wilkins, Baltimore, MD.

Leave a Reply

Your email address will not be published. Required fields are marked *