Massage & Bodywork

MARCH | APRIL 2016

Issue link: https://www.massageandbodyworkdigital.com/i/640605

Contents of this Issue

Navigation

Page 103 of 133

being significantly increased as you use these or other treatments. Because compression of the nerve can occur between soft tissues (the deep fascia of the abductor hallucis muscle and the quadratus plantae muscle), massage could be helpful in reducing any compressive forces on the nerve. Soft-tissue treatment may also be beneficial in reducing nerve irritability by reducing tensile forces pulling on the nerve. In many cases, nerve pain is increased because of tensile or compressive forces on the nerve. These forces may be relatively small but still produce detrimental results. Moving soft tissues in a direction that relieves stress on the nerve is often very helpful and allows the brain to reset its perceived noxious input from pain receptors, further decreasing pain. Knowing your anatomy is critical in order to find the appropriate direction to move the foot, which can also vary to some degree from person to person. The massage therapist can do this by moving the foot in particular directions that relieve the tension. The first way to do this is to move the foot into inversion. Effectiveness in this treatment will be known when the direction of movement is one that relieves tensile loading on the nerve and reduces pain. Experiment with your client on what position feels best. SCIENCE OF NERVES C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 101 The second way to relieve nerve tension is accomplished by grasping the heel and hind foot and gently pulling it in a medial direction (Image 7). Ask the client if the position or movement reduces any of the foot pain. The ADM muscle, or arch of the foot, may be painful with palpation. It may be helpful to press on one of these sore areas as you perform the heel/foot movements. Look for reduced pain when this technique is applied. Once you find a position that decreases pain, hold it for about two minutes and then very slowly and gradually let it go. After releasing the hold, perform gentle and easy passive movements with the foot to help encourage a freedom of movement and to reestablish new, reduced levels of neural reporting. The more frequently this technique is applied, the more beneficial it will be, so it is helpful to teach the client how to do this at home. Compliance is key to successful treatment. It is likely you will continue to encounter clients who complain of plantar foot pain. If traditional strategies are unsuccessful, it is a good idea to consider other possibilities, such as ICN compression. Many people have to live with this significant pain for a long time without anyone considering other possibilities that might be the cause. If you are that one health-care professional who looks out of the box to help clients find relief, you will be forever appreciated, as this condition can be disabling if left unchecked. Notes 1. D. Butler, Mobilisation of the Nervous System (London: Churchill Livingstone, 1991). 2. U. Chundru et al., "Plantar Fasciitis and Calcaneal Spur Formation are Associated with Abductor Digiti Minimi Atrophy on MRI of the Foot," Skeletal Radiology 37, no. 6 (2008): 505–10; M. Pecina, A. Markiewitz, and J. Krmpotic-Nemanic, Tunnel Syndromes: Peripheral Nerve Compression Syndromes (Boca Raton: CRC Press, 2001). 3. B. Dirim, D. Resnick, and N. K. Ozenler, "Bilateral Baxter's Neuropathy Secondary to Plantar Fasciitis," Medical Science Monitor 16, no. 4 (2010): CS50–CS53. 4. Chundru, "Plantar Fasciitis and Calcaneal Spur Formation are Associated with Abductor Digiti Minimi Atrophy on MRI of the Foot." 5. Dirim, "Bilateral Baxter's Neuropathy Secondary to Plantar Fasciitis." Whitney Lowe is the developer and instructor of one of the profession's most popular orthopedic massage training programs. His texts and programs have been used by professionals and schools for almost 30 years. Learn more at www.academyofclinicalmassage.com. 6 7 Testing the strength of the flexor digitorum brevis can indicate ICN compression. Relieve nerve tension by twisting the hindfoot and heel into a position that slackens the nerve.

Articles in this issue

Links on this page

Archives of this issue

view archives of Massage & Bodywork - MARCH | APRIL 2016