6.6 EXTENSOR DIGITORUM LONGUS AND EXTENSOR HALLUCIS LONGUS
6.6 EXTENSOR DIGITORUM LONGUS AND EXTENSOR HALLUCIS LONGUS
Figure 9. Pain pattern referred from TrPs at commonly observed locations in extensor digitorum longus and extensor hallucis longus (Travell & Simons, 1992).
Symptoms• Night cramps are common in the presence of active TrPs in the long extensors.
• Pain tends to be dull and bearable .
• Muscle weakness (especially in extensor digitorum longus), can lead to mild foot drop.
• TrP mediated compression of the deep peroneal nerve can lead to complete foot drop, weakness in anterior compartment musculature and paraesthesia.
Trigger Point Examination
• The most effective method of palpating a TrP in extensor digitorum or extensor hallucis longus is to use the flat palpation method.
• Palpation of active TrP's in either muscle will usually elicit local tenderness and referred pain but rarely will it produce a local twitch response.
Associated Trigger Points
• Usually appear secondary to TrPs in tibialis anterior.
• If peroneus tertius is affected, chances are that extensor digitorum also harbours TrPs.
• Are also associated with TrPs in the peroneus longus and brevis as they all perform a similar function.
Differential Diagnoses
• MPS of peroneus longus, brevis and tertius, extensor digitorum brevis, tibialis anterior and extensor hallucis brevis.
