Peroneus Tertius

Pointer Plus The Pointer Plus is an easy to use trigger point (TP) locator which incorporates a push button stimulation feature to immediately treat Trigger point pain.

The Peroneus Tertius is an anterior muscle of the leg.

Anatomical Attachments:

• Origin: Attaches to the distal 1/3 of the anterior surface of the fibula, from the distal part of the interosseous membrane.
• Insertion: Attaches to the dorsal base of the 5th metatarsal bone.

Action: Dorsiflexes and everts the foot.

Synergist: Peroneus brevis and longus, Extensor digitorum longus.

Antagonist: Plantar flexion by Soleus.

Nerve Supply: Deep peroneal nerve (L5 and S1).

Nerve Entrapment: Entraps the peroneal nerve.

Vascular supply: Anterior tibial artery.

• Primary: The pain refers over the ankle with a spillover to the heel.
• Satellite or associated triggers: Extensor digitorum longus, Anterior Gluteus Minimus.

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Trigger Point Signs and Symptoms: Weakness of the ankles prone to strain, pain and soreness posterior and superior to the lateral malleolus, foot drop if the deep peroneal nerve is entrapped, prone to ankle fractures.

Trigger Point Activating and Perpetuating Factors: Prolonged immobilization of the ankle, spraining the ankle.

Differential Diagnosis: Peroneal Nerve Entrapment Syndromes, (Segmental, Subluxation, Somatic dysfunction) L5 S1 or S2 radiculopathy or neuropathy, Diabetic neuropathy, Morton foot structure, Lateral Compartment Syndrome, Muscular Dystrophy, Charcot’s arthropathy, Ankle Sprain/Strain Syndrome, Reflex sympathetic dystrophy (Complex regional pain syndrome), Systemic lupus erythematosus, Osteoarthritis, Rheumatoid Arthritis, Gout, Bursitis, Plantar fasciitis, Achilles tendon rupture or tear, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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