Massage & Bodywork

May/June 2009

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pathology perspectives BY RUTH WERNER ON YOUR FEET! MORTON'S NEUROMA This issue of Massage & Bodywork is dedicated to practitioner safety. From a pathology perspective, practitioner safety creates an opening for a number of different discussions. Our profession has several occupational hazards, and we invest significant time and energy during our education to minimize these risks. We learn important hygienic practices for our clients' protection, but also to keep ourselves safe from the threat of infectious diseases spread through skin-to-skin contact. We learn good body mechanics to preserve the life expectancy of our hands and our backs. But one under- addressed group of hazards is common to massage therapists and anyone else who spends much of their work day standing: foot problems. In the realm of bodywork practitioner safety, foot pain may seem like a minor issue, but it can certainly degrade the quality of life for the person who has it. At the risk of overstating the obvious, feet comprise the surface area through which we respond and adapt to gravity. As we well know, any misalignment or imbalance of forces in the feet can have system-wide implications: one foot hitting the ground wrong can torque a knee, twist a hip, subluxate a sacroiliac joint, and eventually cause headaches as those directional forces reverberate. More locally, if a foot malfunctions because of some internal misalignment, compensation patterns can increase the risk for other foot problems. In this way, a bunion can lead to ligament instability; plantar fasciitis can contribute to metatarsal pain; jammed arches can contribute to hammertoe; and any dysfunction can contribute to the development of this article's topic, Morton's neuroma. Imagine the sensation of having a marble lodged in the ball of your foot, or a bolt of electrical pain that shoots into your toes with every step: that is the sensation of Morton's neuroma. ANATOMY REVIEW To understand this problem well, and to strategize how to prevent it or use massage to address it, we need to take a brief look at some relevant aspects of foot anatomy. The metatarsals make up the long part of the foot and are visit to access your digital magazine 111

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