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Gastrocnemius and Soleus Manual Static Release
Gastrocnemius and Soleus Manual Static Release is a manual therapy technique used to target the muscles of the calf. This release technique involves applying targeted, sustained pressure and release, to the trigger points of the two main calf muscles, the gastrocnemius and soleus. This release is used to lengthen and relax the muscles, relieving pain and restoring range of motion. This technique can be beneficial for individuals experiencing calf tightness, aching, cramping,
Transcript
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This is Brent of the Brookbush Institute,
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...blank
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and we're going over manual release of
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the gastroc and soleus complex. Keep in
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mind this is a video for educational
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purposes, and I'm assuming that if you're
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watching this video to learn this
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technique you are a licensed manual
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practitioner, and you are going to pay
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attention to the laws on scope of
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practice in your state. Sorry personal
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trainers this video doesn't fall within
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your scope. I'm going to have Brian come
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out, he's going to help me demonstrate
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this technique. Now you can assume that
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if I'm going to release the gastroc and
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soleus complex, I have already done a set
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of assessments that had given me an
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indication that he either lacks
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extensibility, over showing signs of over
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activity in his gastroc and soleus
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complex, that could be things like the
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overhead squat assessment where feet,
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flat feet turn out, or an excessive
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forward lean may all indicate over
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activity here. It might have just been
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something as simple as a dorsiflexion
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goniometry. I see a lack of
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dorsiflexion these two muscles could
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restrict that. I could have done my
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gastroc soleus muscle length test and
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that could have given me an indication
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that there was some over activity here.
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Now once we have determined that this is
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an area we want to palpate and look for
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further signs of over activity, it is
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helpful to know your trigger points. All
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right so your common trigger points are
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very much related to motor points, which
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is where we have the neuromuscular
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Junction intervating the muscle, and
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this is often a site of dysfunction
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within these overactive muscles. All
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right so you can see here I've I've gone
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ahead and put circles where the common
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soleus trigger points are, and then X is
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where the common gastroc trigger points
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are. It is helpful for me to kind of know
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round about where those are, but i'm
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going to show you guys how to find them
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even if you didn't have them all
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memorized. What I generally do is I take
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one of the the pads of my thumb, and I
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start kind of strumming perpendicular to
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the fascicles, kind of like I'd be
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rubbing over guitar strings.
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Another little hint here guys is if you
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use your thigh to press into
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dorsiflexion a little bit, that helps put
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some tension, helps lengthen out this
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muscle, it'll help pop those fascicles
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into your finger, so I can see here's a
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tight fascicle. Now what I want to do is I
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want to go proximal and distal to see if
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what's causing the tightness in that
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fascicle, is actually a nodule or a
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specific location of a trigger point, and
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so I can start doing my strumming, kind
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of up and down and seem to be getting
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cold there, warmer, warmer all right, right
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there that's a nice spot. So once i found
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that spot, to help my me pin that spot
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down so that it doesn't end up feel like
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I'm trying to put my finger on a marble
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right, where it just kind of keeps
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popping out, I want to go ahead and put a
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little bit more tension by pressing them
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into dorsiflexion. Actually let me have
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you move down just a little bit Brian,
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Be careful guys as you push
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somebody into dorsiflexion you don't
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push the front of their ankle into the
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end of the table, that's painful. Alright
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so find that little spot again. I'm going
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to make sure I put a little stretch on
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that muscle, that's going to help pull
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everything down, help centralized that
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trigger point, and then I'm actually
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going to use a little distal to proximal
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force with my thumb here, to kind of pin
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it up this way. So rather than trying to
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do this, I'm putting a little stretch and
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pinning up this way, and then to add a
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little bit more pressure i'm actually
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going to go ahead and let this be my
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dummy thumb. So i'm not using this hand
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to apply pressure, i'm going to use this
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hand to apply pressure. The amount of
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pressure i apply is actually going to be
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up to, I wouldn't say the first
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resistance barrier, but the first
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significant increase in resistance from
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this tissue. I think you guys will find
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that as you press into tissue it's
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almost like an exponential curve right,
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you have this nice linear increase in
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how much pressure you get back, and then
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all sudden it's like this really really
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big increase in tension. So I'm going to
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press right
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up into that trough of that curve till I
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got a significant resistance, but not
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past it, and then all I have to do is use
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my body weight, nice straight arms, nice
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good posture, and hold it until that
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point starts to go away; and then if i
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have time, i can start moving through
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some other trigger points that may exist
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in this muscle. Okay so going through
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this whole technique again, i went ahead
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and put just a little bit of pressure
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into Brian's foot here, that's going to
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help dorsiflex his ankle, put a little
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bit of tension into this system, lengthen
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those fibers out so that they're going
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to pop into my fingers a little bit. I
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then run my thumb across the fascicles
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of the gastroc or the soleus, in this
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case alright I'm going to look for the
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most tender fascicles. Once I find those
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tighter denser fascicles, i'm going to
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move proximal and distal and i find like
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that's a pretty good spot right there.
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Once i have a spot i'm going to go ahead
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and kind of go up this way with the
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pressure on the gastroc and soleus, put a
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little bit more pressure into his foot
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so I dorsiflex them a little bit more.
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I'm going to use the opposite hand to
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press right up to that resistance
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barrier, and then I'm going to hold that
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until that goes away. There is one other
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protocol with four six to eight second
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holds, if you guys prefer that protocol
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you can do that too. So I could sit here,
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hold two, three, four, five, six, relax. Go
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back in maybe a little deeper into the
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tissue this time one, two, three, four, five,
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six. If not if i'm going back to just
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that static hold, and it's usually a 20
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to 30 second static hold. After I've done
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that release technique, in Brian's case
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I'd probably go ahead and flip them back
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over do some joint mobilizations. If I
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thought maybe
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is his talus was shifted anteriorly,
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or whatever other joint mobilizations
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that needed to do in his ankle complex,
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and then follow that up with a
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lengthening technique if I thought these
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muscles were short. So I wouldn't use
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release techniques alone, but this would
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certainly be the first step, and be
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helping to regain some ankle mobility
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and calm down any over activity in the
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gastroc and soleus complex. Just to go
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over quickly guys in a more close-up
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view so you can see exactly what it is
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I'm doing, notice i have my thigh, the
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bottom of brian's foot here, so i can
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control dorsiflexion and plantar flexion,
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and the amount of tension in the system.
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I can use this thumb to kind of dig into
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about midway through the gastroc there,
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just unto the first signs of tissue
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resistance, and I can kind of move across
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the fascicles perpendicular to them, and
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kind of strum to find the most dense or
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the highest activity in those fascicles.
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We're going to assume that those
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increased activity in those fascicles is
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a sign of this over activity and
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dysfunction. Once I get there I'm going
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to go ahead and move proximal, distal and
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actually I can feel that there's not as
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much tissue density, not as much give
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back resistance here, as there is here, so
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I know I'm getting closer. And then right
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about here I actually do feel a nice
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tight nodule. Now I kind of mentioned to you
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guys before, it's a little hard to pin
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down if you just kind of go thumb over
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thumb on top. It's also very very painful
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to do it this way, it might help, be a
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little bit more helpful to go a little
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bit more broad with your finger, use this
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as your dummy thumb. So now no more
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pressure in this hand, I'm going to go
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ahead and push into dorsiflexion just a
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little bit, so i feel that a trigger
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point come into my thumb, and then i'm
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going to use my other hand to press
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until i feel that that big increase in
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tissue resistance. As I kind of mentioned
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I think of an exponential curve right,
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and if it's an
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curve that I feel resistance, I want to
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be right in the trough So I'm going to go right here again, and I'm going to go ahead and
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hold that for 30 seconds, or as i
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mentioned earlier in this video we
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could do four, eight second holds. I think
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this feels pretty good though, I should
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get a release here. Brian is starting to
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feel it let go a little bit, yeah usually
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it's a very tender spot at first, and
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then within a few seconds everything
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calms down. So there you guys have it,
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manual release of the gastroc and soleus
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complex. Grab a partner, grab a colleague,
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get to practicing. This is probably not
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something you want to do to the next
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patient that walks in the door if you've
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never done it before. The gastroc and
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soleus do tend to be very tender muscles
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when it comes to compression and manual
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release techniques. I would definitely
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get another manual therapists with
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experience in these techniques if you
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can, getting the feedback from another
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manual therapists is education that
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cannot be replaced. If not if nothing
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else, get a group of you guys together so
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you can start talking about whose
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pressures felt the best, or whose hands
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felt the best, and what you guys are doing
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to help dial this technique in. I hope
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you learned from this video, I hope you
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will integrate this technique into your
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manual practices. I look forward to
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hearing about what type of outcomes you
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