Achilles heal…
Ankles: I know the myriad origins and insertions of the muscles surrounding this joint. The delicate web of bones that create a smooth functioning foot. How the nervous system relays messages all the way down there, so far from brain and spine. The miraculous mini-motions of balance an ankle offers us in weight bearing. Ankles…one of the few body parts never to give me challenge. Until now. Best way to learn.
Not that I haven’t treated many ankles. A patient might have a current ankle problem but, as people dig back in their history, reports of early ankle sprain are so very common. Years later, unresolved instability created by an ankle sprain can lead to problems in knee, hip, back.
So this is my ankle story. Though trauma can create sudden onset of ankle pain, this is a tale to remind us that these problems can arise very insidiously. Aches and pains can brew on the back burner for a long time before manifesting as painful body parts. “It came out of nowhere” is generally not the case.
I’ve been aware of my own left calf tightness for a long time. So unusual tension in my left hip and hamstring came as no surprise. This was what I like to call “under the radar” tension. The kind you don’t feel just going about your day. This tight sensation was noticeable during my regular practice of fascia release. I know what normal is, so something new is generally obvious.
An uninterrupted line of tension stringing from low back to left hip to hamstring to calf had me target sciatic nerve—-rolling and releasing that line of tissue then gently flossing the nerve. (Scroll down to video page bottom if flossing intrigues you) This treatment helped but increasing trouble developed when I began hard hiking for twelve days as we traveled through the Southwest.
I was stressing this sad ankle daily and began to have constant calf pain with walking. Noticeable limping drew me in deeper. I was caring for fascia and nervous system but I got more curious about the muscles and tendons. When I dug around my fingers found specific bands of Achilles tendon, peroneus, gastroc-soleus, extensor longus that were very gnarly. Gnarly---that’s my word for tightly restricted, bound up, unhappy!
Once I started to specifically release these players, things began to ease up. I still needed fascia release and nerve floss but I added specific muscle/tendon stretching, so different than dynamic on-off flossing.
Last but not least, I had to deal with some loss in strength. A tight muscle is a weak muscle. Automatically. It was obviously different lowering and raising my heel on the right compared to the left. Strengthening always has to be carefully and mindfully titrated in. I started to work with the weakness a few days ago. In walking I can totally feel how long term weakness in my right core--- psoas of course---was a contributing factor. I can consciously call psoas in while weight bearing if I want less pain.
So what is this ankle thing? Sprain? Sciatica? Tendon tear? Do we need a diagnosis in order to treat something? Usually not. A physical therapist treats signs and symptoms, we don’t treat the diagnosis. In fact, waiting for a diagnosis can waste precious time. If pain doesn’t respond to healing techniques and the magic tincture of time and rest, a diagnosis may be helpful. I imagine I’ll be tenderly with this for a couple more weeks before it slips under the radar again.
Healing body parts always has me following the same triumvirate:
Loose---release tight fascia and muscle first.
Long---tend to mobilizing nervous system and re-gaining flexibility.
Strong---build strength back and insure that power is core connected.
Got something bugging you? You don’t have to figure this out alone. As long as you’re willing to come down to your mat twenty minutes daily for a spell, I love partnering with you on this journey. Before you decide to commit, let’s talk about it first.
❤️Bella