184441381-WEBOne session of myofascial trigger-point therapy on latent trigger points in the triceps surae resulted in a significant and clinically meaningful increase in ankle range of motion among a group of recreational runners with restricted active ankle joint dorsiflexion and latent myofascial trigger points, according to recent research.

The study, “The immediate effect of triceps surae myofascial trigger point therapy on restricted active ankle joint dorsiflexion in recreational runners: A crossover randomised controlled trial,” involved 22 recreational runners—11 men and 11 women—ranging in age from 18 to 50 years. The mean age of these subjects was approximately 25 years.

In order to participate in the study, subjects had to run at least twice a week and present a unilateral restriction of active ankle dorsiflexion—less than 10 degrees—in either or both knee flexion, or soleus, and knee extension, or gastrocnemius. Subjects also had to have at least one latent myofascial trigger point within the soleus or gastrocnemius muscles.

After meeting these inclusion criteria, subjects were randomly assigned to either the intervention group or control group first. All participants then switched group assignments one week later, so that the subjects could serve as their own controls within the study.

For the intervention session, a researcher first assessed baseline active ankle range of motion. This was followed by 10 minutes of myofascial trigger-point therapy and then a 10-second passive stretch in knee flexion and knee extension. At the end of the intervention session, each subject’s active ankle range of motion was once again assessed.

As for the myofascial trigger-point therapy, this involved the slow application of increasing thumb pressure on any latent trigger points within the gastrocnemius and soleus. Prior to the intervention, these trigger points had been identified and marked with an X on the subject’s skin. During the myofascial trigger-point therapy, each participant was prone with the leg in full extension.

Employing the barrier release concept, the therapist applied increasing pressure until the first instance of tissue resistance, or barrier. Once the barrier was reached, the pressure was maintained until the therapist felt a release in muscle tension beneath the palpating thumb. After the release, one 10-second passive stretch in both knee flexion and extension was performed. The entire process was repeated, within a 10-minute time period, until all identified myofascial trigger points had been deactivated.

When assigned to the control group, participants did not receive any intervention or placebo intervention. Instead, researchers assessed their baseline active ankle range of motion, and then guided subjects to a 10-minute supervised rest period, followed by another assessment of active ankle range of motion.

Results of the research showed an increase in mean ankle range of motion of 4 degrees in the soleus and 3 degrees in the gastrocnemius after the subjects received myofascial trigger-point therapy, whereas the control group showed no such improvement.

“The results of this study demonstrate a statistically significant change in ankle dorsiflexion [range of motion] immediately post [myofascial trigger-point] therapy to the triceps surae of recreational runners,” state the study’s authors.


Authors: Rob Grieve, Amy Cranston, Andrew Henderson, Rachel John, George Malone and Christopher Mayall.

Sources: Department of Allied Health Professionals, Faculty of Health and Life Sciences, Glenside Campus, University of the West of England, Blackberry Hill, Bristol, United Kingdom. Originally published in 2013 in the Journal of Bodywork & Movement Therapies.