Massage & Bodywork

MARCH | APRIL 2023

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as the foot moves into dorsifl exion (scan the "Active Engagement Stripping: Tibialis Posterior" QR code). 4. Sweeping Cross-Fiber and Broadening Strokes: Triceps Surae Group The gastrocnemius and soleus muscles are collectively referred to as the triceps surae group. Use a sweeping motion of the thumb or surface of the palm to apply long, broad, cross-fi ber strokes. Pressure levels can be varied depending on the severity of the condition and the client's pain (Image 2). 5. Positional Release Applications: Foot/Ankle Complex Positional release is a technique that works primarily at the neurological level. Placing tissues in a position that decreases adverse input from nociceptors helps decrease pain. Results are usually most effective when the target tissue is brought into a shortened position. However, with nerve conditions, this may not be the case. Since no specifi c position guarantees pain relief for every client, fi nding the best position is often a trial-and-error process. Find a position that decreases discomfort the most. Sometimes it helps to press on tender areas first and then ask the client which position decreases pain more. Hold the position for 30–60 seconds, then slowly move the foot into a neutral position. This strategy can often reduce pain in a severe condition. 6. Myofascial/DNM Strategies Myofascial therapy and dermoneuromodulation (DNM) are benefi cial with neural sensitization and severe conditions. In this technique, a superfi cial force is applied to the skin that gently pulls it over the underlying fascia and connective tissues. Try pulling the skin in different directions to fi nd the position that decreases most pain; hold that position for 30 seconds or so. 7. Metatarsal Spreading This technique addresses a variety of pain complaints in the foot that affect the short intrinsic muscles between the metatarsal bones. It also reduces nerve entrapment between the heads of the metatarsals in Morton's neuroma. Grasp the forefoot with both hands while the thumbs are on the plantar surface of the foot. Use the thumbs to produce a sweeping motion back and forth that encourages spreading and broadening of the metatarsals (Image 3, page 25). 8. Metatarsal Mobilization Metatarsal mobilization treats nerve compression in Morton's neuroma, but also has applications for other foot pain complaints. Grasp the forefoot with both hands, as in metatarsal spreading. Begin by holding the last four metatarsals with one hand and the fi rst metatarsal with the other. Shift the metatarsals in relation to each other back and forth. Then move to the next metatarsal, so the one hand grasps three metatarsals and the other hand grasps two. Repeat the mobilization technique, shifting the metatarsals back and forth. Repeat the procedure 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 21 2 VIDEO: "ACTIVE ENGAGEMENT STRIPPING: TIBIALIS POSTERIOR" 1. Open your camera 2. Scan the code 3. Tap on notification 4. Watch!

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