Patients with lower back pain due to L5 & S1 nerve root irritation often complain of calf cramps, especially at night. The strong calf muscles are responsible for you to be easily able to walk on your toes. These muscles are especially important in the push-off phase of walking on level surfaces as well as on inclines & steps.
To be easily able to test the strength of the calf muscles, the very best way is to have the patient stand on one leg. The patient then lifts the heel off the floor. Normally, there is at least a span of 5″ between the surface of the floor & the under surface of the heel.
When the patient is examined to walk on their toes, one has to assess not just the ability to perform this type of walking but the ability of the patient to raise the heel of the floor by about 4-5″.
Similarly, when the patient is instructed to walk on heels, there should at least be a span of 3-3.5 inches between the floor & the under surface of the big toe joint known as the first metatarsal joint.
The muscles that perform plantar flexion of the foot are:
- medial gastrocnemius (L5, S1 through the tibial nerve)
- lateral gastrocnemius (L5, S1 through the tibial nerve)
- soleus (L5, S1 through the tibial nerve)
- tibialis posterior (L5, S1 through the posterior tibial nerve)
- flexor digitorum longus (L5, S1 through the posterior tibial nerve)
- flexor hallucis longus (L5, S1 through the posterior tibial nerve)
- peroneus longus (L5, S1 through the superficial peroneal nerve)
- peroneus brevis (L5, S1 through the superficial peroneal nerve)
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Jennifer Chu, M.D. emeritus professor of Physical Medicine & Rehabilitation, School of Medicine, University of Pennsylvania, pioneered eToims Twitch Relief Method that utilizes surface electrical stimulation to locate motor points (trigger points). The motor points are then stimulated to induce strong local muscle contractions, termed twitches. This results in reduced muscle pain & discomfort in the areas that were stimulated. The involved pain/discomfort-relieving mechanism is thought to include local muscle exercise & stretch effects.
eToims Soft Tissue Comfort Center? specializes in diagnosis & treatment which ends muscle discomfort & pain.