Massage & Bodywork

November | December 2014

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98 m a s s a g e & b o d y w o r k n o v e m b e r / d e c e m b e r 2 0 1 4 Our feet contain a series of longitudinal and transverse arches that function as spring mechanisms, essential to the musculoskeletal health of the feet and the entire body. The medial arch, with its thick plantar ligaments and muscular tendons crossing the arch of the instep, has been compared to the architecture of tie-rod and truss roof beams (Image 1). The ligaments and tendons stretch under load, then rebound like springs, contributing elastic energy to gait. The flexibility of the arches can be observed in how the instep pronates and slightly flattens when a person balances on one foot. Many people mistake this flattening effect for a dysfunctional condition and then try to hold up their arches. Chronic holding up is not recommended because it leads to adaptive shortening, joint rigidity, and myofascial pain. In the arches, it also pulls the joints into a close-packed, supinated position, which restricts range of motion. The best way to develop the arches is with active movement that engages intrinsic and extrinsic muscles (those contained entirely within the foot, and those that originate or insert elsewhere) to pull the bones into place and lift the arches. For example, a person can practice consciously pushing off with the toes on each step during a long walk. This will strengthen intrinsic muscles in the foot, improve joint mobility, and tune up the spring mechanism. Although feet are incredibly sturdy, they are prone to progressive musculoskeletal dysfunction from poor alignment that twists the foot and restricts range of motion. Some massage clients, particularly seniors, suffer from chronic myofascial foot pain associated with hyperpronation, or "fallen arches." Hyperpronation can be rigid and permanent; this occurs when supporting tissues have been ruptured or are too flexible, in which case the medial arch only flattens when weight-bearing. NEUTRAL POSITION Restoring normal flexibility to rigid arches requires an understanding of the neutral position of major joints in each part of the foot. To assess the neutral position of ankle joints, look at how the feet align in a standing posture. In joint neutral, the Achilles tendons are relatively vertical; the talus and calcaneus align the subtalar joint in a position between inversion and eversion. Joint neutral can be assessed in the midfoot by the shape of the arches. Taut ligaments and tendons provide tensional support like a string on a bow: they bend the arches and hold the bones in place with compressive forces. Each arch has a keystone, which is the block braced in the middle (Image 2). The navicular is the keystone of the medial arch, so it sinks under load and recoils as weight is lifted off the foot. technique THE SCIENCE OF MOVEMENT Tie-Rod Navicular (keystone of arch) Anterior strut Posterior strut 1 Cu LC IC MeC 5 4 3 2 1 2 A B Spring in the Arches Active Movement Leads To Proper Alignment By Mary Ann Foster Medial arch Transverse arches: A-Across midfoot, B-Across forefoot. Intermediate cuneiform and 2nd metatarsal (keystone of arches)

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