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The Legs of Fibromyalgia and Myofascial Pain

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By Celeste Cooper

Do your fibro legs deal you fits? Door jams reach out and grab you, leaving mysterious bruises, right? We have come to dub these instances as the fibro effects. But, is there something we can do to minimize the fall out of this trait?

Symptoms 
Do you feel as if you are stepping on pins and needles when getting out of bed and/or experience:

  • Achilles tendon tightness
  • ankle pain and/or weakness
  • buckling knees
  • bunion
  • calf pain
  • cramping of muscles
  • difficulty navigating stairs
  • foot drop
  • foot pain
  • heel pain
  • knee pain
  • leg pain
  • Morton’s foot
  • unexplained neuropathies
  • restless leg syndrome (RLS)
  • shin splint-like pain
  • thigh pain
  • toe pain

Did you know periodic limb movement associated with RLS and fibro share disruption of brain signaling? Did you know myofascial pain from the peripheral nervous system bombards the central nervous system, contributing to wind-up?

Equilibrium Restoration
Many things can contribute to our leg pain, disturbed gait, and other unusual symptoms. Dysfunction of the muscles in the legs affects not only our feet, but our ankles, knees and legs as well. It contributes to hip, buttock, pelvis, and low back pain too. And, there are things we can do to restore function and help our body find balance.

The Leg
Muscles in the upper leg have exceptional work to perform. For instance, the hamstring (a powerhouse muscle group) is responsible for standing and walking. It does a significant amount of 1) muscle work and 2) repetitive action. When these two things are present, so is the risk of myofascial trigger points (TrPs), which are knotted up pieces of muscle fiber in a taut band of muscle that shortens the muscle causing dysfunction and pain.

Our lower leg has eleven muscles, including the foot and ankle that work in tandem to allow for locomotion and balance. Therefore, pain in the feet and ankles may not be coming from TrPs.

In this example, you massage your feet and soak them in Epsom salts, but nothing seems to help. It could be your foot/feet are in the referral pattern of TrPs in other compensating muscles. Until all trigger points are identified and treated, your foot or ankle pain won’t go away.

Joints
Our joints need equalization to operate normally, and the presence of TrPs affects joint function. For instance, TrPs in muscle fibers extending to the knee cause misalignment, making the joint function like a sprung hinge.

*Myofascial pain is not due to inflammation. If inflammation (heat, redness, and swelling) is present, it could be due to another problem that needs immediate attention.

Knowing Your Body
Get to know your body—feel around. Do you notice the telltale signs of a trigger point? In average size muscles, it will feel like a pea. If you press on it, the pain and its pattern are reproduced. Remember: If you find a TrP, treat it, whether it only hurts when you press it or not.

Perpetuating Factors

  • Physical anomalies, i.e. one leg shorter than the other, pelvic tilt, scoliosis, flat foot, high arches, hyper-mobile joints, etc.
  • Poor posture, i.e., hunching, leaning forward, misalignment
  • Sitting or laying without proper support
  • Prolonged sitting or crossing the legs
  • Prolonged contraction of muscles, i.e. bending or squatting
  • Not supporting joints, i.e. hanging your feet over the edge of a lounge chair or sitting in a chair that doesn’t let your feet touch the floor
  • Ill-fitting clothes and shoes
  • Over flexion, i.e. walking in sand or wearing flip-flops
  • Repetitive movement
  • Prolonged immobilization or sustained contraction, i.e. wearing hard-soled shoes or high heels
  • Straining or over stretching leg muscles, i.e. climbing a hill, or sustaining the downward facing dog Yoga position for too long
  • Restriction of circulation, i.e. tight socks
  • Inactivity or over-activity
  • Chilling
  • Poor sleep posture
  • Other related disorders, such as dehydration, vitamin deficiencies, radiculopathy, tendonitis, or other health problems.

Treatment
Treatment includes avoiding perpetuating factors, managing contributing factors, and treating the TrPs with manual intervention.

Once you locate the TrP, apply about 70-80% direct pressure. Locally stretch the fibers affected to isolate the TrP and stabilize it. All trigger points need to be treated, even the ones that aren’t hurting unless you press on them. Drink plenty of water unless you have a condition that prevents it.

Massage therapy, active release therapy, and myofascial release are helpful when provided by a therapist that specializes in the myofascia. Trigger point injections along with self-treatment and guided stretches may be necessary.


About the Author:  Celeste Cooper, RN, is a frequent contributor to ProHealth.  She is an advocate, writer and published author, and a person living with chronic pain. Celeste is lead author of Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain and Broken Body, Wounded Spirit, and Balancing the See Saw of Chronic Pain (a four book series). She spends her time enjoying her family and the rewards she receives from interacting with nature through her writing and photography. You can learn more about Celeste’s writing, advocacy work, helpful tips, and social network connections at CelesteCooper.com.

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3 thoughts on “The Legs of Fibromyalgia and Myofascial Pain”

  1. IanH says:

    One of the signs of FM is “benign pseudohypertrophy” in leg calf muscles. They appear swollen and are definitely enlarged, often by as much as 7cm dia. from pre-morbid illness. This condition is similar to that which occurs in Muscular dystrophy and indeed may be an indication of damage to the muscle tissue.

    This hypertrophy seems to occur more in males with FM than in females with FM. However I cannot confirm this. Does anyone on this forum think that they have benign preudohypertrophy and are you male or female?

  2. Pr15oner says:

    I have symptoms that suggest that the benign condition you mention is a possibility. I have a fibro diagnosis already but the majority of pain is in calves

  3. 3Girls says:

    Female, 63, was diagnosed with FM 2011. I developed prominent anterior lower leg muscle? In both of my legs and yes my calf muscles in the back have always had a nice shape…slightly bigger since sedentary lifestyle has kicked in…lol..pun at myself. But this anterior shin muscle is puzzling to me. My doc unable to explain. Please reply dlfbhunt1@verizon.net. Thanks so much

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