Healthcare and Medicine Reference
In-Depth Information
pauses for absorption, are often more effective.
While restrictions most often occur in the flexion-
extension pattern, waves involving lateral flexion or
rotation can be helpful also*.
This simple movement has been beautifully elaborated
by Continuum, which can be explored via www.
continuummovement.com, or www.
continuummontage. com.
• Neck: The suboccipital area at the top of the neck is
an area that often holds excess tension and
immobility. The importance of the rectus and
obliquus capitis muscles, which mediate between
eye movements and spinal movements, to the
general mobility of the SBL can hardly be
overstated. These muscles create the beginnings of
hyperextension and rotation, and occipital
protraction (an anterior shift of the head on the
neck). They are stretched by upper cervical flexion,
rotation, and sliding the occiput posterior on the
condyles of the atlas.
To induce movement in this area requires some
concentration to focus the movement at the top of
the neck, since similar movements can be produced
in the lower cervicals by the expresses that overlie
these essential, ancient, and tiny locals. Lying
supine, and keeping attention at the top of the
cervicals under the skull, slide the back of your
head up away from the body, but without lifting it
off the surface you are lying on. Maintaining this
position of upper cervical flexion and length, move
slowly into rotation, again focusing on the upper
cervicals.
The 'Awareness Through Movement' lessons of
Moshe Feldenkrais, which separate eye movements
from neck and body movements, are unequaled in
their ability to clarify and differentiate these
muscles and this area. 5
Specific areas
• Plantar: Taking the SBL from the bottom, tense
plantar fascia will limit foot and toe mobility as
well as limit movement in the SBL as a whole. A
simple but effective technique calls for having your
client stand barefoot and do a forward bend with
straight knees, just to see how it feels. Then have
the client (standing again) place a tennis ball under
her foot. Now have her give weight into various
parts of the plantar surface from the front of the
heel out to the ball of the foot, looking for places
that hurt or feel tight. She should give enough
weight to reach that point between pleasure and
pain, and should sustain the pressure on each point
for at least 20 seconds. The whole exercise should
take a few minutes.
Remove the ball and have her lean forward again,
and call her attention to the difference in feeling
between the two sides of the SBL. Often the
comparison is quite dramatic. Have her do the
other foot, of course, and check if the forward bend
is once again even, though more mobile. A more
advanced, limber, or masochistic client can graduate
to a golf ball.
Any movement that requires dorsiflexion will
stretch the plantar-calf section of the SBL. A simple
but effective stretch for the plantar fascia and its
connection around to the Achilles is to kneel with
the feet dorsiflexed and the toes hyperextended
under you, and then sit on (or toward, for the stiffer
among us) your heels. For the more limber, 'walk'
the knees back toward the toes to increase the
stretch.
• Calf: Leaning forward and resting your forearms on
a wall, the lower leg section of the SBL can be
stretched by putting one foot back and resting into
the heel. If the heel reaches the floor easily, flex the
knee forward toward the wall to increase the stretch
on the soleus.
• Hamstrings: Any of the forward bends described
above will help lengthen the hamstring group.
Swing the upper body left and right during these
bends to ensure that the entire muscle group, not
just one line through it, gets activated and
stretched.
• Spine: Inducing wave motions throughout the SBL,
especially in the erector spinae and surrounding
tissues, is very good for loosening and waking up
the SBL. Have your client lie prone, or in any
comfortable lying position. Ask the client to tighten
the belly muscles, so a wave of flexion goes through
the low back and pelvis. Encourage this wave of
motion to spread progressively out across the entire
back or even down the legs. Watch the motion, and
observe where there are 'dead' spots - places where
the motion is stifled and does not pass through.
Place your hand on the dead spot and encourage
the client to bring motion to that area. Clients will
frequently try ever-larger efforts to force the motion
through the dead spot, but smaller motions, with
Palpation guide for the SBL
Beginning again from the distal end of the SBL, the first
station is at the underside of the tips of the toes, which
we cannot feel very well through the pads, but we can
find the tendons of the short toe flexors under the thinner-
skinned proximal part of the toes. The plantar fascia
really begins at the ball of the foot station, narrowing as
it passes back toward the front of the heel, where it is less
than an inch (2 cm) wide. Pulling the toes up into exten-
sion brings the plantar fascia into sharp relief, where its
edges can be easily felt. The lateral band is hard to feel
directly through the thick overlying padding, but can be
inferred by putting your finger or knuckle into the line
that runs between the outer edge of the heel to the 5th
metatarsal base, a clearly palpable knob of bone halfway
between the heel and the little toe (Figs 3.6 and 3.7, p. 76).
The lateral band, and the accompanying abductor digiti
minimi can be found between the base of the 5th meta-
tarsal and the outer edge of the calcaneus.
The track runs around and through the heel, which
is hard to feel through the tough padding on the bottom,
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