Foot

Lower limb or Foot Pain?

maybe Plantar Fasciitis!

By Cassidy Phillips – Founder of Trigger Point Performance Therapy

Trigger Point Chart

I have personally dealt with aches and pains of the foot especially when I was dealing with the worst of my muscular dysfunctions. I still have foot pains from time to time, and I’m amazed at how foot problems can dreadfully throw off my day. The foot is the first and last body part to touch the ground throughout the day. It supports the body when walking and running. The foot is the foundation for the body’s structural integrity. So, when it comes to addressing the foot and its functionality, should we look only at the foot or should we look directly at the muscles that control how the foot functions?
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Natural range of motion in the foot is a beautiful thing. I think we all take this for granted. As we age, range of motion in the foot is lost and dorsiflection is reduced dramatically. There was a time when we all walked tall and confident only to find ourselves years later shuffling along to get through the work week. We no longer rely on the foot and ankle for movement, but rather concentrate on the knee and hip to propel the body forward.

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Elasticity - the ability for the muscle to lengthen and rebound back to its natural state.

As the biomechanics break down, so does the body’s muscular structure or elasticity. Once this happens it is incredibly important to regain the muscular structure, otherwise the cosmetic makeup may be compromised. If the muscle is stretched past its capacity, it can cause irrevocable damage to the muscle and insertion point.

jump

Your muscles are better off resembling a bungee cord rather than a rope. A bungee cord is pliable, flexible and supple. A rope is rigid. Furthermore, you can’t stretch a knot out of a cord or rope, but you can knead or massage the knot.

stretch_rope

Anatomy of the Bottom of the Foot:
Aches and pains of the foot such as in the heel or in the bottom of the foot can be a very challenging situation. It can stop the best of us from walking, running, or playing sports. Some doctors occasionally suggest putting a cast around the foot.

footpuppet1

 

The muscles actually in the foot, for the most part, are designed to move the toes. They base themselves in the bottom of the foot and they attach somewhere in the toes. There are other muscles that give the foot range of motion. All of these muscles house themselves above the ankle and below the knee. The muscles in the lower leg connect in the bottom of the foot, thereby controlling the foot (like a puppet).
leg_shot

As we talk about foot dysfunction and aches and pains in the bottom of the foot, one term that always pops up is Plantar Fasciitis. I think our society is obsessed with this condition. For purpose of this article, I want you to clear the mental imprint you may have of PF. Let’s define it as general aches and pains of the foot or just look at it as a loss of functionality in the foot.

This article is not addressing PF per se, but is addressing the muscles that attach in the the bottom of the foot that can cause all kind of problems for the foot’s functionality. To define it:

Plantar – pertaining to the bottom of the foot,(wikionary.org)

Fasciitis – inflammation of the fascia

Fascia adj. fascial (from latin: a band) – is the soft tissue component of the connective tissue system that permeates the human body. It interpenetrates and surrounds muscles, bones, organs, nerves, blood vessels and other structures. Wikipedia.org

So, if you put these two words together you may have plantar fasciitis anywhere in the bottom of the foot where you feel aches and pains.

Myofacsial Release is a form of massage to aid in fascial disfunctions

Myofascial Release MassageMyofascial release refers to the manual massage technique for stretching the fascia and releasing bonds between fascia, integument, and muscles with the goal of eliminating pain, increasing range of motion and equilibrioception. Myofascial release usually involves applying shear compression or tension in various directions, or by skin rolling. – wikapedia.com

The question is WHERE does this Myofascial Release massage need to occur?

Take a look at this. You have a muscle called the posterior tibialis. It bases itself between the tibia and fibia and starts just below the knee and just above the ankle.
anatomy

The posterior tibialis bases itself in the bottom of the foot, specifically in the arch. When you take a look at this picture, it’s interesting that the muscle in the center back area of the lower leg connects directly in the arch of the foot. Wow, this is simple anatomy!

If you massage this area so that you can strengthen the muscles to allow the tendons to do their job efficiently, then maybe the functionality of the foot will come back and the aches and pains will be minimized.

There are really three (3) main muscles that contribute to aches and pains within the bottom of the foot, or at least for principle’s sake, force the foot to lose its ability to function properly and as a result cause discomfort. The first being the posterior tibialis which we have discussed. Second, there is the soleus

foot

….which is just above the posterior tibialis.

achilles

Lastly, there is thegastrocnemius or calf, which of course is layered on top of the soleus.

There are other muscles within the lower leg that connect in the bottom of the foot and I’ll address those later. For now, these 3 muscles will give you the greatest rate of return. The question is…what areas can you massage, strengthen and tone to get the maximum amount of flexibility and range of motion? To help answer this, grab the back of your leg and squeeze firmly.

caren_calf

After you have a good grip on the muscle group, rotate your foot in a circle. You may find that it is difficult to rotate due to the calf area being over worked and tight, therefore pulling on the insertion points that connect in the bottom of the foot. (Please notice how the thumb is placed on inside of the soleus muscle, not on the bone. The forefingers are on the outside of the soleus.)

carin_foot

Now, apply pressure with the opposite hand where you would normally feel discomfort on the bottom of the foot. Just by doing this simple test you may feel a change in sensation on the bottom of the foot. This is a great experiment to see if the muscles within the calf region are in fact tight and pulling from their insertion points.

So what’s the point?
All the muscles in the calf region connect in the bottom of the foot. Once they get over worked and under paid, they will pull from their insertion and origin points. This not only causes loss of flexibility in the foot and ankle, but also creates aches and pains within the bottom of the foot.

Take a look at the image below. See how the tendons are supporting the ankle then attaching in the bottom of the foot. Remember, all of these tendons are parented by the muscles they are associated with. The muscles are much bigger than the tendons, so you can imagine the damage a muscle can do to a tendon if it is not taken care of.

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It only makes sense that in order to free your foot from the inability to function properly and the discomfort associated with the muscles pulling from the insertion points in the bottom of the foot, then you must go after the puppet master. If you don’t have optimal flexibility in the foot and ankle, then you need to strengthen, tone, and massage the muscles that are telling the foot and ankle what to do.

Follow me here for a minute…due to dehydration, repetitive motion, and poor biomechanics while moving, sitting or even sleeping, muscles can stick together. Once again, the posterior tibialis muscle is located in the back of the leg layered beneath the soleus and gastroc (calf).

lowerleg-back

If all of the muscles within this region were to stick together, the insertion points in the bottom of the foot would not have a chance to function properly.

The Bottom Line:

You have to treat the muscles that control the foot to regain range of motion in the foot. As it pertains to foot aches and pains, by creating elasticity (with massage or Myofascial release) within the muscles that connect in the arch of the foot you are going to allow the muscles to rebound to their natural state. This reduces the amount of tension on the bottom of the foot, specifically in the arch of the foot.

Other Dysfunctions:

I want to talk about a few more foot dysfunctions because in reality there are additional muscles below the knee and above the ankle that influence the bottom, side, and even top of the foot. I believe that once one muscle becomes dysfunctional others will follow.

I’ll start with the muscles that base themselves to the left and right of the posterior tibialis, flexor haligus and digitus.

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What you need to know about this pair of flexors in the back of the leg is that they both attach in the front, bottom side of the toes.

foot_shot

The significance is that when one or both of these flexor muscles lose their range of motion and elasticity, the region in the front of the foot and toes become challenged. Also, once these muscles start to adhere to other muscles that surround them, there is a similar situation as with the posterior tibialis. There is too much muscle for the insertion point which can cause or exacerbate situations such pulling the toes into one another. Myofacial Release or massage on the bottom of the foot would be helpful in this situation, while obviously massaging, strengthening, and toning the muscles of the lower leg.

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Exercises: Examples of massages for the areas discussed above

TP Footballer & Baller Block Soleus Exercise

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TP Double Ball Calf Exercise

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TP Single Ball Calf Exercise

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Video Exercises: Video examples of massages for the areas discussed above

TP Footballer & Baller Block

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TP Double Ball Video

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