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MYOFASCIAL TECHNIQUES The Interosseous Membrane Technique: After preparing the outer layers of the lower leg, use the knuckles of a soft fist to encourage the fibula to release laterally, giving more room for the talus. Use your client's active dorsiflexion to bring the widest part of the talus between the tibia and fibula, augmenting the release. Images courtesy Advanced-Trainings.com. part of the talar wedge can assist your widening of the tibial/fibular space. Your pressure is quite full, but still comfortable for your client. The very strong interosseous structures respond slowly, so be sure to wait long enough to feel the subtle release and widening of the fibula away from the tibia. It can be helpful to imagine unrolling the two bones of the lower leg like the two parts of a scroll. There is, in fact, a small amount of external fibular rotation with dorsiflexion,3 and adding this dimension to your lower leg work can increase its effectiveness. Once you've felt the fibula respond, shift your knuckles to a new place, repeating this technique along the entire length of the fibula, particularly at the distal end where the tibiofibular ligaments are located. After working just one leg in this way, you might ask your client to stand and walk a few steps, comparing the left and right legs. Often the difference in mobility and stability will be profound. (Then, be sure to work the second leg as well!) TOO LOOSE OR TOO TIGHT? Our overall intention with these techniques is to improve any dorsiflexion restrictions by ensuring that the fibula and tibia can widen slightly around the wedge-shaped talus, particularly in full dorsiflexion. But what about ankles that already seem too mobile, such as in overpronation patterns, or unstable ankles that twist easily? While both pronation and ankle sprains can theoretically cause laxity in the talar mortise, in practice, both sprains and pronation are often associated with limited dorsiflexion at the talar/tibial joint. In the Dorsiflexion Test, you'll see people using a combination of foot pronation, eversion, and external tibial rotation when talar dorsiflexion is limited. Similarly, losing the front/back adaptability that dorsiflexion provides can increase lateral forces on the ankle, leading to easier ankle turning and rolling. There are exceptional cases where there is clearly too much laxity between the tibia and fibula, often as the result of congenital conditions or from an unhealed injury. These clients can benefit from a referral to an orthopedist or rehabilitation specialist. Empirically, we've found that in even these cases, and certainly in the majority of people, whenever a limitation in dorsiflexion is improved, clients experience improvement in balance, stability, and less tendency toward overpronation, even when there is also an apparent side-to-side hypermobility. Trainings.com faculty, which offers distance learning and in-person Advanced Myofascial Techniques seminars throughout the United States and abroad. He is also a Certified Advanced Rolfer and teaches for the Rolf Institute of Structural Integration. Contact him via info@advanced-trainings.com and Advanced-Trainings.com's Facebook page. NOTES 1. For word buffs, a plafond is an ornately decorated ceiling. It originates from the French plat "flat," plus fond "bottom, base." Accordingly, the tibial plafond could be thought of as both an ornate, wedge-shaped ceiling for the talus, and a base for the tibia above it. 2. In contrast to an adaptable landing with the midfoot, a thumping heel strike is harder and less accommodating, due in part to the wider part of the talus being wedged between the malleoli of the tibia and fibula. The timing of the knee's extension in the gait cycle plays a large roll in determining which part of the foot contacts the ground first. 3. J. Forst et al., "Effect of Upper Tibial Osteotomy on Fibula Movement and Ankle Joint Motion," Archives of Orthopaedic and Trauma Surgery 112, no. 5: 239–42. earn CE hours at your convenience: abmp's online education center, www.abmp.com 115 Til Luchau is a member of the Advanced-