Issue link: https://www.massageandbodyworkdigital.com/i/72103
MYOFASCIAL TECHNIQUES The retinacula are fibrous bandings within the crural fascia. When restricted, they can irritate bursa (light blue) or limit the adaptability needed for full ankle range. Image courtesy Primal Pictures. Used with permission. For the Crural Fascia/Retinacula Technique, use the tips of your curled fingers, along with just a bit of fingernail to feel for and release restricted areas in the crural fascia. Image courtesy Advanced-Trainings.com. an elastic firmness to their hold on the talus. When this slight elasticity in the connective tissues is lost (through hardening due to injury, overuse, or inefficient biomechanics), the tibia and fibula act more like a clamp than a spring (Image 3, page 111). When particularly fixed, this inelasticity stops the talus before full dorsiflexion is reached, and so limits the range of dorsiflexion. This is often experienced by our clients as a jamming or pinching sensation in the front of the ankle during dorsiflexion. We're referring to this clamping around the talus as a Type 2 dorsiflexion restriction (Type 1 being related to shortness in the tissues of the posterior leg and plantar surface of the foot). We discussed ways to assess these two types of restrictions, and how to work with Type 1 restrictions in the first part of this article ("Myofascial Techniques: Working with Ankle Mobility, Part 1," March/April 2011, page 110). In this second part, we'll look at ways to restore lost dorsiflexion by ensuring adaptability of the tibia and fibula around the wedge of the talus. CRURAL FASCIA/ RETINACULA TECHNIQUE The crural fascia (or fascia cruris, cruris meaning "leg") is a thick membranous wrapping around the lower leg. Like built-in support hose (you didn't know you wore those, did you?), the crural fascia provides the reinforcement, encasing, and undergirding needed by the leg's powerful structures. Releasing this layer helps prepare for the deeper work we'll do with the ankle mortise itself. Within crural fascia are fibrous bands at places of particular strain— these are the retinacula. Deep to the retinacula, cord-like tendons round the corner of the ankle, on their way from their origins in the leg to their attachments in the foot (Image 4). This is a busy place—after all, with the exception of a few thigh muscles that 112 massage & bodywork may/june 2011 just make it past the knee, all lower leg muscles cross the ankle into the foot. With the entire force of standing and locomotion being transmitted across the ankle, the restraining structures here are thick, resilient, and dense. This is all fine and well, except when they do their restraining too well. Too-tight retinacula can irritate the bursa underneath them; they can also limit the adaptability of the ankle by binding the tendons they overlie, or by restricting the necessary spreading of the tibia and fibula around the talus. To ensure adaptability of the crural fascia and the retinacula, we'll use the ends of our curled fingers to feel for and release any restrictions in these outer layers. Using just a bit of your nails, push proximally rather than pull distally, feeling for the fibrous layers of fascia just under the skin (Image 5). Imagine pushing up your client's tight-but-sagging socks. The pressure is firm; your pace is slow and patient. Rather than gliding over the skin, take