The peroneus longus, brevis and tertius are three muscles located at your ankle. They can cause pain in this area, as well as in the foot.
Especially if they are tense or carry trigger points.
However, you can free these muscles from tensions and trigger points with a self-massage.
On this page, you will learn how to do this. You will also learn …
Read on and free yourself of your pain!
Tensions in these muscles usually lead to sensitivity of pressure and pain in the muscles.
Trigger points cause the same ailments, but they can also transmit the pain to other areas.
Below you will find the exact pain zones for each of the three muscles.
Trigger points in the peroneus longus can cause pain in the lateral area of the calf which radiates downwards.
Trigger points in the peroneus brevis can result in pain in the inferior part of the lateral lower leg. It usually radiates downwards and can cause the following ailments:
Pain caused by trigger points in the peroneus tertius usually extends from the anterior ankle to the back of the foot.
In addition, the pain can radiate to the lateral side of the heel.
Trigger points in the peroneus often lead to a weakness of these muscles.
Weakness, in turn, can cause instability in your ankle joints, increasing the risk to twist the ankle.
These three muscles lie on the lateral side of the lower leg, as well as on its front, passing down to the foot.
The peroneus longus and brevis lie on the lateral side, whereas the peroneus tertius is located at the front of the lower leg.
In the following sections, I describe the location of these muscles in more detail.
The peroneus longus is attached to the lateral compartment of the lower leg (more precisely: fibula), just below the knee.
Its head runs down the entire side of the lower leg, goes around your ankle, runs towards the lateral portion of your foot and then continues under the foot to its medial side.
The peroneus brevis lies below the longus and is covered by it for the most part. It arises from the lower two-thirds of the lateral surface of the fibula, runs downward and snakes its way around the ankle.
However, it does not pass below your foot, but attaches to its lateral side.
The peroneus tertius also arises from the fibula, but lies further forward. It runs toward the lateral side of the foot, just like the peroneus brevis.
These muscles provide stabilization and movement control, instead of literally moving a joint.
This stabilization work is carried out as long as the foot touches the ground and the ankle joint needs to be stabilized.
As soon as the foot leaves the ground, the muscles are able to move the ankle joint.
Trigger points are activated by many different factors.
In this case, injuries come first, followed by immobilization and “unfavorable” habits such as wearing high-heeled shoes.
In the following, I will explain some of these points in more detail.
In the case of a supination trauma, colloquially also known as a sprained or twisted ankle, the lateral ligaments of the ankle are injured.
These injuries range from overstretching to total ruptures.
Concerning the peroneus longus and brevis, the severity of the injury plays a subordinate role. They are always stretched to the extreme in a supination trauma, and this happens very easily.
These sudden stretches of the muscles often lead to the activation of trigger points.
But this is only the acute, immediate mechanism.
If you twist your ankle and injure yourself in the process, your peronei will always contract reflexively in order to protect the injured ligaments from more stretching.
Remember the function of these three muscles. They move the lateral edge of the foot upwards outwards, i.e. in the opposite direction of the “twist”.
This “reflex contraction” of the musculature is also called protective tension.
If this tension lasts for a long time, it can also overload the muscles and lead to activation of trigger points.
If a muscle is held in one position for a longer period of time, this leads to reduced blood circulation, increased muscle tension and, in the end, to trigger points.
In addition, the maximum resilience of a muscle decreases rapidly during immobilization, and weak muscles are much more susceptible to trigger points than “well-trained” ones.
In point 4.1, we talked about “trauma caused by a twist”. If such an injury is very severe, the ankle joint is immobilized for a few weeks, for example with an aircast splint.
This splint severely restricts the mobility of the ankle joint in supination and pronation and thus protects the injured ligament structures.
However, this also decreases the strain on the peronei, which means that they become drastically weaker and are poorly supplied with blood. What is more, they wouldn’t be used any more in their entire functions. This provides a perfect precondition for the activation of trigger points.
This also shows the importance of adapted strengthening exercises and loosening after the injury is completely healed.
If you cross your legs while sitting, the peroneus longus is trapped between the crossed leg and the knee.
This compression can overload the muscle and create trigger points.
The same applies to high stockings, which have a very firm elastic tension. These also compress the muscle and can lead to problems.
Wearing high heels puts your ankle in an unstable position. Now remember that the peronei primarily perform stabilization work in the ankle joint.
High heels can overload these muscles, especially if you wear them very often or for long periods of time.
This chapter may be harder for many of you to understand, but it is very important for those who walk a lot and are bothered by ankle, foot or heel pain.
So, let’s deal with functional anatomy …
Your tibialis anterior is the antagonist of your peroneus longus and brevis. It rises the back of the foot. This function is very important to ensure a controlled rolling movement during jogging.
This muscle is particularly strained when running downhill. You have certainly experienced this burning sensation in the area of your tibia when running downhill. That’s your overloaded tibialis anterior.
Many joggers overload this muscle when …
This overload is reflected in an increased muscle tension, and possibly in trigger points.
Increased muscle tension naturally results in the peroneus longus and brevis having to work harder to fulfil their function, because they work against it.
This heavy work can overload them and lead to trigger points.
Palpation of these muscles works best during contraction.
In the following, I will show you how you can feel each of these three muscles.
First palpate the head of the fibula, i.e. the origin of the muscle.
Note: The muscle head of the longus only reaches as far as about the middle of the lower leg.
Then it merges into the long tendon of the muscle. If you feel a contraction of the lower leg during this movement, it is the peroneus brevis or the tendon of the longus, which moves under your fingers.
The peroneus brevis is a little more difficult to feel, because it is covered by the longus. But with some patience and practice you will succeed.
If not, this is no problem, because you can massage the muscle without feeling it. You just need to know where to massage.
The peroneus tertius is relatively easy to palpate. Before you feel the muscle, however, you must first feel your malleolar fork.
To feel the muscle, proceed as follows:
Many techniques, positions and devices are available for the self-massage of this muscle.
On this page, I will show you how to massage these muscles with your hands. As techniques, I apply the precise massage strokes as well as the pressure-motion technique.