AHSE Logo

The official organization for Hanna Somatics information, resources, continuing education, practitioner support, and community.

Finding My Left Foot: Mobilizing the Feet and Healing Foot Sprains - By Susan Koenig

 

Illustrations:

1.  Plantarflexion - pointing the foot away from the kneecap.
     Dorsiflexion - bringing the foot toward the kneecap.

 

2.  Inversion - turning the sole of the foot inward, toward the mindline.
     Eversion - turning the sole of the foot outward, away from the midline.

3.  The retinacula (the plural for retinaculum) are like straps around the ankle joint. They tend to slip distally (toward the toes). Pushing them upwards, as shown in the video (at bottom of this page), is both comforting and helpful for foot motility.

 

 

4.  The figure on the left shows the gastrocnemius muscle with its 2 heads and the long achilles tendon attaching to the heel. It's a 2-joint muscle, crossing the ankle and the knee. It plantarflexes the ankle joint and is most powerful with the knee straight (extended).

     The figure on the right is the soleus muscle. It is deep to (underneath) the gastrocnemius muscle, and is a 1-joint muscle, attaching to the heel bone and below the knee at the fibula and tibia. It plantarflexes the ankle joint with the knee bent (flexed).

 

5.  This pic shows the front of the foreleg. The anterior tibialis (in green) dorsiflexes the ankle - brings the foot toward the kneecap. The extensor digitorum longus extends (raises) the 4 toes and the extensor halusis longus extends (raises) the big toe. Both of the muscles work with the anterior tibilalis to dorsiflex the ankls.

6.  This pic shows a skin rolling technique on the scapula (shoulder blade). This is the technique I used on the top of my foot and on all parts of my foreleg that I could reach. To do this technique, you use your finger and thumb to lift and separate the skin from the underlying tissue. As you apply this technique you'll notice restrictions which you try and loosen and work through by lifting the skin and moving it in different directions. Skin rolling reduces superficial myofasical adhesions.

[All pics are from Google Images.]
______________________________________________________________________________________

[Reprinted with permission from "Somatics For You" Newletter #21 - Oct. 2, 2018]

      A couple of weeks ago, I sprained my left foot; not a horrible sprain, but a sprain nonetheless. X-rays showed no broken bones. I was fitted with an extremely comfortable wrap and a boot. The boot I never used; just too klutzy amid a confusion of straps and painful to get into. Fortunately, I had a couple of walking sticks and they worked just fine. The scariest part of the accident was the sound I heard coming from my foot, as I mis-stepped on the last step of a staircase. I fell over onto my left side and knew enough to just lie there. I felt the shock through my whole body and while a thousand "Oh no's!" went through my mind, another part of me said, "The healing starts now."

      I rested 24 hours, then things got much better. I knew I was lucky. Three weeks later, I still had a hobble, and very tentatively took my dog for slow, very short walks. Full, functional recovery was in my sights.

      What did I do to help myself? Of course, I started using somatic movement right away. This I'll say more about shortly. A big thank you goes to my husband Paul, for his care and concern. Also, a huge thank you to Monica Roseberry who led me in a "tapping session". Briefly, a tapping session is about setting a goal, and then using various acupressure points which you tap as you repeat your goal. The process is quite a bit more involved. Monica is incredibly skilled and experienced, and has developed her own format.

      Somatically, the main ingredients I used were: rest, calming thoughts, and focused breathing, tapping, somatic movements and some manual (massage) fascial techniques. The best part of the day was lying on the floor and doing the basic Cat Routine as developed by Thomas Hanna. (Somatics by Thomas Hanna, p.99) This has been my daily practice, my form of meditation, for the last 28 years. It allows me to shine a light, as if from a lighthouse, on my inner world, both mind and body. Sometimes I lose myself in the sensations from the movements, or marvel at the flow and rhythms of rocking my pelvis this way and that, or give appreciation for the relief from pain and discomfort I might be experiencing.

      Somatic movements are helping me find my left foot again. Right after the injury, I just wanted to keep it as still as possible because stillness didn't hurt. I'd look at both feet and they felt so different from one another. My right foot was just my regular right foot. But my left foot represented so much more to me aside from the physical part of the injury. The emotional aspect of this injury contained hidden, unconscious truths I did not want to confront, but then decided I needed to confront. I worked on the emotional and psychological aspects with Monica Roseberry and her tapping technique. The result has been a renewed sense of energy and motivation for my own somatic work. Thus, I am back creating a new issue of my newsletter (after almost a year's gap), completing several videos I had started, and gestating some new ideas for the future.

      Below are a number of videos centered around mobilizing the feet, including rehabilitating foot sprains. Each video, except the last, starts with simple movements and then integrates the movements into larger regions of the body or even the whole body.

 

 >> The body is incredibly interconnected and smaller regions need to be integrated into larger functional patterns which mimic real life. “The hip bone is connected to the thigh bone.” Our feet are related to our head, and our spine, and our shoulders, and our being in both straightforward anatomical/physiological ways and in the more elusive, metaphorical psycho-social-environmental, and I would add, spiritual realms. We learn to walk, and then hopefully we learn to stand up for ourselves.

      The movements in the videos start more simply and then evolve into combinations of movements creating a more sophisticated integration of feet with body. Bringing presence and mindfulness to the process is key: using minimal force, moving slowly, paying attention to the sensations of the movements; paying attention to the your first person experience and trusting what feels helpful and what does not. This last quality is what many of us leave out and yet it is often the key in helping us discriminate between movements that help or those that prolong our healing. Of course, I am using self-pandicular movements in these videos. In pandiculation, the main clinical technique in Hanna Somatic Education, you are using the motor parts of the brain, especially the motor-sensory cortex, to voluntarily contract a group of muscles, and then slowly and with control, voluntarily release out of the contraction to rest and relaxation. Pandiculation can feel like magic and often releases tight, contracted muscles in a very short period of time.

      What is new to me in my healing process with my foot sprain is a greater understanding of how I can apply fascial tissue techniques along with somatic movement. By and large, fascial tissue is our fibrous body-wide web consisting of fibrous and elastic tissues embedded in a matrix. It is everywhere and has different  names such as tendons, ligaments, joint capsules, aponeuroses, muscle septa, and more. Muscles are embedded in pockets in the fascia. Everything—muscle fibers, blood vessels, bones, nerves, organs, and more—is wrapped in some form of fascial tissue. In the last video, you’ll see a demonstration of how I use massage techniques, including skin rolling, to help bring comfort, pain relief, and mobility back to my left foot.

      Fascia plays several important roles in the functional organization of muscles and our body as a whole. Different fascial tissues emphasize different roles. Some are better at muscle force transmission, some are better at transmitting proprioceptive information (sensory information about gravity and where our limits are in space)—gut and organ fascial sensory receptors transmit interoceptive information informing us about our sense of self; and research now is showing that fascia contains many nociceptive nerve endings (pain receptors, sympathetic innervation), and much, much more.

      I’ve been watching various YouTube videos about fascia. Therefore, in the last video, I not only show a few things such as wraps, creams, and shoes that helped me in the earlier phases of my healing, but also I’ve included a demonstration of my interpretation of how to apply manual/massage techniques to some of the fascial tissues of my left foot and foreleg.

      One of my clients, a woman in her seventies, who fell off a ladder and injured her shoulder, asked me if she would heal perfectly. I told her that in my opinion, “perfection” was not the goal. The goal was functional healing; healing that would allow her to do what she wanted to do in her life, unimpeded, even if her shoulder didn’t end up healing perfectly. This took a great deal of weight off her shoulders, no pun intended (but I like it). So many things happen to us in life, including injuries. Setting a goal of functional healing is so much more doable than some ideal of perfection.

_____________________________________________________________________________________

Integrating Foot and Ankle Movements into Full Body Movements

Video 1 of 3: Ankle Movements of Dorsi and Plantarflexion (5:34): https://youtu.be/NGT52_6KDHg

Video 2 of 3: Ankle Movements with Spine and Shoulders (3:48):  https://youtu.be/v3vh5wPHU3Y

Video 3 of 3: Ankle, Spine, and Shoulder Movements in Prone (12:05): https://youtu.be/vCzTqvZk1lU

_____________________________________________________________________________________

Foot Rotation - Inversion, Eversion with Integration into Full Body Movement (9:03): https://youtu.be/929MAkYP62U

Foot and Foreleg Movements from Sitting (13:11): https://youtu.be/Wgt13fgt-Qc

Fascial Techniques for Feet and Forelegs (14:13): https://youtu.be/UnsHU9wEdHQ

_____________________________________________________________________________________

Note: The best videos that I've found on fascia are, in my opinion, from Dr. Schleip, who has digested the latest research, including research by Luigi Stecco (Italy) Atlas of Physiology of Muscular Fascia. The following are a couple of YouTube references of talks featuring Dr. Schleip.

1.  Fascinating Fascia: Latest News (lecture by Robert Schleip to European Rolfers). Published on April 29, 2017 (48:47):  https://youtu.be/HolcYlwWITs

2.  Robert Schleip 'Fascia as Internal Sensor'. Published January 31, 2017 (33:31):  https://youtu.be/4FQaL8beUiA    [Lecture presentation from Dr. Schleip via live video streaming within the conference on 'An Integrative Approach or Medically Unexplainable Physical Symptoms (MUPS)' of the Dutch Osteopathic Association (NVU) on September 17-18, 2016.]