Massage & Bodywork

March/April 2013

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5 4 The skeletal divisions of the foot: the medial arch and the lateral arch (purple). Image courtesy Primal Pictures. Used by permission. barefoot for longer than they have been running with shoes, our bodies do better when the feet are not overcushioned or immobilized. I'll describe two techniques from Advanced-Trainings. com's Advanced Myofascial Techniques seminar and DVD series that can help anyone's feet regain a higher degree of natural mobility and adaptability, whether they run barefoot or not. Are Flat Feet Bad Feet? Looking at the issue of arch height, a quick overview of arch anatomy is in order. Skeletally, the foot bones function as sets of longitudinal rays, each comprised of a toe, its metatarsal, and an associated tarsal bone. These foot rays are further grouped into two structural divisions: the medial and lateral arches (Image 4). The bones of the medial arch include the phalanges of toes one, two, and three; their metatarsals; plus the cuneiforms, navicular, and talus. The lateral arch is made up of toe rays four and five, which share the cuboid as their associated tarsal. The cuboid in turn articulates with the calcaneus (the heel bone) via a unique locking joint, which adds stability. The connective tissues, muscles, tendons, and ligaments of the foot and lower leg contribute either spring or fixity to the arches, depending on the tissues' own elasticity and resilience. Conventionally, low arches or "flat feet" have been thought to be problematic, though some proponents of barefoot running question this assumption. While overpronation (Image 5) has clearly been linked to foot, ankle, and leg problems, the relationship of arch height to pronation and overall foot health is not as clear. The generally accepted view links low arches with overpronation of the calcaneus. Because the talus (medial arch) rests on top of the calcaneus (lateral arch), pronation or eversion of the calcaneus and lateral arch is conventionally thought to dump the talus medially, lowering the medial arch and giving rise to flat feet. However, there is credible research Overpronation of the calcaneus can cause problems, but may be linked to high arches, not low arches, as conventionally assumed. Image courtesy Léo Washburn. Used by permission. that contradicts this view, correlating pronation with higher arches rather than lower ones, 2 and multiple studies suggest that barefoot running can reduce overpronation.3 There is also evidence that shoe use accentuates foot narrowing and arch height. One study (comparing indigenous nonshoe users with habitual shoe-wearers) correlated shoe use with higher arches and narrowed feet, and with less-even weight distribution in the sole when compared to non-shoe users.4 Other studies question the reliability and usefulness of arch-height measurements in general.5 Where does this leave us? Rather than assuming problems based solely on arch height, we can take the pragmatic approach of assessing and releasing articular immobility and connectivetissue restrictions wherever we find them, working toward the structural differentiation that brings adaptability. In addition to more balanced foot mobility, it is also important to include symptom improvement (less pain in the feet or elsewhere) and our clients' subjective experience (do the feet simply feel better?) as indicators of success. Using adaptability, symptom improvement, and subjective experience as our criteria is often more effective, and probably more universally relevant, than looking for change in foot shape or arch height alone. Anterior/Posterior Arch Mobility Technique The metatarsals are lined up side by side in the midfoot, much like sardines in a can. This sideby-side arrangement helps the metatarsals resist excessive lateral movement, while allowing them to spring up and down in the sagittal plane. The controlled dorsal/plantar mobility of the metatarsus allows the connective tissues of the www.abmp.com. See what benefits await you. 115

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