Issue link: https://www.massageandbodyworkdigital.com/i/135515
4 Til Luchau has two upcoming ABMP.com webinars: • uly 31. "Emotions: Are They Contagious? Boundaries, Empathy, and Body-Mind." J • August 28. "Chronic Pain: Body-Mind Considerations for Hands-On Work." the conventional application of rest, ice, compression, and elevation), recovery times can be significantly shorter.3 A full discussion of ankle injuries' many aspects is beyond the scope of this article. Whether damaged ligaments and tissues recover quickly or slowly, once the acute phase has passed, they can be left thickened, adhered, and scarred, leading to less fibular adaptability and continuing ankle limitation, pain, and irritation. It is here that we'll focus. I'll describe two techniques (from Advanced-Trainings. com's Advanced Myofascial Techniques seminar, webinar, and DVD series) that can be helpful in keeping the fibula mobile and in recovering lost fibular adaptability, whether from injury, habitual movement patterns, or activity. To understand fibula motions, we need to review the shape of the talus, the top bone in the foot. The superior articular surface of the talus, where it lies within the forklike mortise formed by the tibia and fibula, is wider anteriorly than posteriorly. As this wider part of the wedge-shaped talus rolls between the tibia and fibula in dorsiflexion, these two bones spread apart (Image 4). Normally, lateral translation is 3–5 millimeters, limited by the stretch of the interosseous and tibiofibular ligaments, which give this joint its spring. (This is also the mechanism that explains why squeezing the lateral and medial malleoli together on a cadaver reportedly results in foot plantarflexion, which postural tone presumably prevents in living bodies.) 4 In addition to lateral translation and posterior glide, the fibula also rotates slightly with ankle flexion (Image 4).5 This small but significant fibular rotation is considered an essential part of normal ankle function, as it helps the talus remain in close contact with the ankle mortise throughout its dorsiflexion/ plantarflexion range. This close but pliable contact is crucial for even load distribution and balanced stability/adaptability in standing and gait.6 Said another way, unimpaired fibula translation and rotation helps protect the ankle bones' thin layer of articular cartilage from undue stress and degeneration.7 Ideas for freeing the talus by working with the retinacula and interosseous membrane were covered in "Working With Ankle Mobility, Part 2" (Massage & Bodywork, May/ June 2011, page 110). Here are two techniques to further your work with these vital structures. Distal Tibiofibular Joint Technique At their lower end, the fibula and tibia join at the distal tibiofibular joint (also known as the tibiofibular syndesmosis). This stiff articulation is bound together by tough, pearly ligaments in front (the anterior tibiofibular ligament, Image 4), in back (the posterior tibiofibular ligament, not pictured), and between the bones (the interosseous ligament, Image 4). As discussed earlier, a small amount of springy adaptability here is important for balanced function of the ankle, especially for full dorsiflexion, so this technique is useful whenever ankle dorsiflexion is limited. ABMPtv.com "Working with the Fibula" Watch Til Luchau's technique videos and read his past Myofascial Techniques articles in Massage & Bodywork's digital edition. The link is available at www.massageandbodywork. com, at ABMP.com, and on Advanced-Trainings. com's Facebook page. 4 In ankle dorsiflexion (blue arrow), the fibula normally rotates (yellow arrow), glides posteriorly (green arrow), and spreads laterally away from the tibia (pink arrow). When these small motions are restricted, ankle motion and adaptability is impaired. The anterior tibiofibular ligament and interosseous membrane are also shown. Image courtesy Primal Pictures. Used by permission. www.abmp.com. See what benefits await you. 115