Lower Leg Pain? These Muscles Could Be To Blame

Maybe it’s been nagging you for months, or perhaps it just started this morning. Whatever the case, lower leg pain can be frustrating and disruptive, making you wonder: What’s wrong? While conditions like tendinopathy or acute injuries are common culprits, there’s another often-overlooked factor that could be causing or contributing to your discomfort—trigger points in overused muscles.

Much of the information in this article is inspired by Myofascial Pain and Dysfunction: The Trigger Point Therapy Manual by Dr. Janet G. Travell and Dr. David G. Simons. This comprehensive two-volume set revolutionized my approach to massage, helping me provide lasting relief to my clients. If you're looking for a more accessible, hands-on resource, I highly recommend The Trigger Point Therapy Workbook by Clair Davies, NCTMB, which breaks down the concepts into an easy-to-follow, self-treatment guide.

When a muscle is overused—held in a tight or constricted state for too long—it becomes fatigued and tense, much like you might feel after a stressful, overbooked week. Over time, the muscle can lock into this tight position, forming painful knots known as trigger points. These knots don’t just cause localized pain; they can pull on surrounding muscles, restrict movement, and even contribute to wrist dysfunction.

In this article, we’ll explore the key muscles that may be behind your lower leg pain and what you can do to relieve it.

Muscles That Can Create Pain In The Lower Leg

Now that we've explored how muscles can contribute to or even cause pain in the lower leg, let's take a closer look at the specific muscles that may be responsible. While there's much more to say about each one, I've highlighted the key points that you should know. If any of these symptoms sound familiar, be sure to check out the section below on what you can do to find relief.

1. Gluteus Minimus

This muscle attaches to the lower half of the hip bone and the top of the femur. Its function is to support the pelvis during walking.

Symptoms It Can Cause:

• Pain in the back or side of the thigh and lower leg

• Limping

How It Can Be Overused:

• Sitting on a fat wallet

• Prolonged sitting or standing

• Carrying your weight on one leg

• Extensive walking or running

2. Extensor Digitorum Longus and Extensor Hallucis Longus

These muscles lie beneath the tibialis anterior at the shin. The Flexor Digitorum Longus attaches to the top of the tibia and extends to the bones of the four smaller toes, while the Extensor Hallucis Longus originates at the midpoint of the fibula and extends to the bones of the big toe. Together, they help raise the front of the foot. The Flexor Digitorum Longus assists in turning the foot outward, while the Extensor Hallucis Longus helps to turn the foot inward.

Symptoms They Can Cause:

• Difficulty raising the foot

• Weakness in the front of the leg

• Pain in the top of the foot

How They Can Be Overused:

• Sudden overload from stubbing toes or kicking a ball

• Overwork in operating the gas and break peddles

• Wearing high heels

• Long flights of stairs

3. Calf Muscles

The two main muscles of the calf are the gastrocnemius and the soleus. Together, they generate the primary force needed for lifting the body to stand and for propelling it forward while walking or running.

Symptoms They Can Cause:

• Night cramps in the calves

• Pain in the calves

• Pain in the back of the knee

How They Can Be Overused:

• Climbing, walking uphill, or bike riding

• Leaning forward while standing for extended periods of time

• Sitting in a chair that puts pressure on the back of the legs

• Poor shoes

• Aerobic dancing

4. Tibialis Posterior

This muscle lies beneath the calf muscles, positioned between the tibia and fibula bones. It attaches to the bones, and its tendon extends downward, wrapping around the inner side of the heel and connecting to several bones in the middle of the foot's arch. Its primary function is to flex the foot downward and ensure proper weight distribution along the outer edge of the foot.

Symptoms It Can Cause:

• Pain in the Achilles tendon

• Pain in the calf and heel

How It Can Be Overused:

• Walking or running on rough, uneven ground

• Poor shoes

How Do We Fix Triggered Muscles?

The good news is that triggered muscles can often be relatively quick and easy to "un-trigger." However, if you continue the activity that caused the issue in the first place, the muscle will likely become triggered again. Consider how you can modify or mediate these triggers—for example, running on smoother surfaces or less extensively. For activities that cannot be changed, consistently applying the following two steps can help keep your pain significantly reduced.

Step 1: Relax the Muscle

The first step in releasing a triggered muscle is to relax it. Whether through foam rolling your legs, self-massage with tennis balls or your hands, or seeking the help of a professional massage therapist, massage is the most effective way to ease muscle tension and restore movement. If you're interested in learning more about self-massage, I highly recommend The Trigger Point Therapy Workbook by Clair Davies, NCTMB.

Step 2: Strengthen and Stabilize

Relaxing the muscle alone is not enough. The reason it became overworked in the first place is often due to weakness/instability—either in the muscle itself or in surrounding muscles that failed to provide adequate support. Developing a targeted corrective exercise routine to strengthen and stabilize your hips, knees, and ankles is essential for long-term relief. These exercises don’t require a gym and usually take just a few minutes each day, but the benefits will be well worth the effort!

If you are currently dealing with pain in your lower legs, schedule a consult with me today to see how we can work together to help you feel and move better!

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