Issue link: https://www.massageandbodyworkdigital.com/i/72093
ESSENTIAL SKILLS Therapy. Once the pain has subsided, a gradual return to activity is recommended while wearing shoes with good support. Myofascial Therapy The fascia of the foot is inextricably connected to the muscles, the tendons, and the ligaments throughout the foot and ankle. If you are trained in myofascial work, begin by working the fascia on the dorsal foot up to the knee, then work the fascia on the plantar surface of the foot up the calf. There may be major or minor fascial components, depending on the nature of the injury. Friction Therapy Beginning at the distal end of the muscle, apply a friction motion pressing laterally while frictioning in an anterior to posterior direction (Image 2). Move to different segments of the muscle as it attaches to the metatarsal bone wherever you have found tenderness with mild pressure. Be sure to work on both sides of the muscle where it attaches to the metatarsal bones between each of the toes that are affected. Exercise Therapy Once there is no pain during walking, exercises for the feet and toes can begin. You will need a few simple supplies, including a small towel approximately 24 by 15 inches, and 1-, 2-, and 3-pound weights. Place the towel on a wood or tile floor so that the long end is facing away from you and place a 1-pound weight at the far end of the towel. Now place your heels on the ground and your toes on the near edge of the towel. Using only the toes, gradually 2 pull the towel toward you one pull at a time. (You might want to dampen the towel to make this a bit easier at first.) When the towel can be easily pulled in all the way, place a 2-pound weight near the end and repeat, working your way up to 4 or 5 pounds. Then place the towel sideways in front of you and place the weight at one end. Now, with one foot, move the towel by inverting the foot with the heel on the ground and the forefoot on the towel. Then reverse the direction and evert the foot. In ABMP's Online Education Center offers online seminars taught by some of the most recognized names in the field. Participate in live webinars at ABMP.com, where you can also view dozens of archived sessions. Webinars are free to members; CE credit is also available. these two exercises, you are combining the muscles that control the toes with the muscles of the lower leg. SUMMARY Injuries to the interosseous muscles of the forefoot are fairly common and make walking painful. Recovery of full function is possible with accurate assessment, skillfully applied treatment, and exercise therapy. Editor's note: Massage & Bodywork is dedicated to educating readers within the scope of practice for massage therapy. Essential Skills is based on author Ben E. Benjamin's years of experience and education. The column is meant to add to readers' knowledge, not to dictate their treatment protocols. Ben E. Benjamin, PhD, holds a doctorate in education and sports medicine, and is founder of the Muscular Therapy Institute. Benjamin has been in private practice for more than 45 years and has taught extensively across the country on topics including orthopedic massage, Active Isolated Stretching and Strengthening, and ethics. He is the author of Listen to Your Pain (Penguin, 2007), Are You Tense? (Pantheon, 1978), and Conversation Transformation (McGraw- Hill, 2012), and coauthor of The Ethics of Touch (Sohnen-Moe Associates, 2003). Presently, he is offering continuing education for massage therapists around the world via webinars. He can be contacted at ben@benbenjamin.com. Celebrate ABMP's 25th anniversary and you may win a refund on your membership. ABMP.com. 111