Massage & Bodywork

MAY | JUNE 2021

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L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 41 Passive Stretching of Flexor Retinaculum Positioning: client supine. 1. Gently grasp and support the client's leg above the ankle. 2. Firmly pin the flexor tendons with your fingers or thumb proximal to the tarsal tunnel. 3. Passively evert the foot to elongate and free the fibers of the flexor retinaculum and flexor tendons within the tarsal tunnel. 4. Repeat as you pin the flexor tendons in various directions. restricted by both extrinsic and intrinsic factors. Extrinsic factors (restricting forces from outside the tunnel) include improperly fitted shoes, generalized edema from trauma or chronic conditions, posttraumatic or postsurgical scarring, and postural or anatomical abnormalities such as pes planus. Intrinsic factors (restricting forces within the tunnel) include tendinopathy, tenosynovitis, osteophytes, soft-tissue fibrosis, and space-occupying etiologies like ganglion cysts, varicose veins, lipomas, or tumors. All these factors can create compression of the posterior tibial nerve, medial plantar nerve, or lateral plantar nerve within the tarsal tunnel. Nerve compression within the tarsal tunnel is referred to as tarsal tunnel syndrome or posterior tibial neuralgia and presents as burning pain or numbness in the associated area that occurs spontaneously or with movement and/or weakness or atrophy in the associated muscles. As is the case with carpal tunnel syndrome, nerve Palpating the Tarsal Tunnel Positioning: client supine. 1. Stand or sit at the foot of the table, and gently grasp the client's heel with your non-palpating hand. 2. Use the thumb of your palpating hand to locate the medial malleolus. 3. Slide your thumb to the posterior and inferior edge of the malleolus. 4. Continue moving posteriorly and inferiorly into the trough at the medial calcaneus. dysfunction is often progressive and can become permanent if left untreated. It can be more challenging to treat the tarsal tunnel as it is an integral part of the weight- bearing architecture of the lower extremity and significantly less common than carpal tunnel syndrome. A comprehensive assessment of both extrinsic and intrinsic factors is required in order to determine proper treatment. Christy Cael is a licensed massage therapist and certified strength and conditioning specialist. Her private practice focuses on injury treatment, biomechanical analysis, craniosacral therapy, and massage for clients with neurological issues. She is the author of Functional Anatomy: Musculoskeletal Anatomy, Kinesiology, and Palpation for Manual Therapists (New York: Jones & Bartlett Learning, 2010;¦jblearning.com). Contact her at christy_cael@hotmail.com.

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