xf-F30jzP66bc - ART of BODYWORK online Tutorials

FOOT PRONATION

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The right of Alastair McLoughlin to be identified as the original Designer, Developer and Author of the Work has been asserted by him in accordance with the Copyright, Design and Patents Act 1998.

All rights reserved. No part of this text may be reproduced, stored in a retrieval system, or transmitted in any form or by any means without the prior written permission of the publisher, nor be otherwise circulated in any form of binding or cover, or reprinted in any physical or electronic manner without the written consent of the author.

The ideas and concepts explored within this text are those of the author. For educational purposes only.

No diagnosis is being offered nor any cure promised by the application of this information.

Alastair McLoughlin cannot be held responsible for any injury arising from the application of this work by the practitioner to any third party however caused.

This work is not a substitute for medical attention. Please seek your physician’s advice if in doubt.

Note: This AoB procedure may also be effective in cases of foot SUPINATION

INDICATIONS FOR USE

The feet are the foundation upon which the human body stands and contacts the earth.

Any abnormal pressures or deviations will transmit unequal forces throughout the kinetic chain.

Therefore any number of bio-mechanical problems may arise from pronation (or supination) of the foot.

These may include but are not limited to:

Foot pain
Ankle problems
Knee pain
Hip pain
Lower back pain
Hallux valgus
Unequal pelvic rotations and instability
Uneven gait
Uneven shoulders
Lumbar, thoracic and cervical spine problems
TMJ and bite problems
Sphenoid restrictions
Headaches

CAUTIONS OR CONTRAINDICATIONS

Please exclude the possibility of any bony fracture due to a recent undiagnosed foot injury that persists.

Refer for medical diagnosis if you are unsure about any undiagnosed condition.

Be aware that the biomechanics of the body can change signiﬁcantly with this AoB work, including the lumbar spine, pelvis and TMJ articulation.

Anyone undergoing signiﬁcant dental or orthodontic work should be made aware that this work can or may change their bite.

Liaise with the clients orthodontist and inform them of the correction you would like to make and the possible implications to the clients dental work.

Assessment:

A visual inspection of the position of the feet when the client is standing - without shoes or socks - will show you any pronation or supination problems.

Whilst the client is standing you can ask them to close their eyes and ask them:

Where exactly in the feet do they feel the pressure: medially, laterally or towards the front or back of the foot?

Is there any difference between the pressure in the two feet?

Is more pressure felt medially on the left foot compared to the right foot, for example?

Position of the patient:

The patient should lay supine on the treatment table.

Locating the precise points for treatment:

This will help you pinpoint the exact location of the two places required to rebalance the foot.

Video sequence (a) traces the location of tibialis anterior - a muscle involved in foot pronation.

Move (i) is located between the tibia and fibula, in the interosseus space, just inferior of the knee joint.

You may feel a slight ‘hot spot’ in the approximate location of the move but further palpation needs to be done to determine the exact location.

Move (ii) is approximately two thirds of the way between the calcaneum and the proximal joint of the great toe - on the plantar aspect of the foot.

This measurement is only an approximation and, once again, you need to palpate the area to determine the exact location.

Remember: Both (i) and (ii) are approximate locations.

Only through palpation will you be able to determine a sensitive or painful place where the move needs to be performed.

It is vital that you locate the precise points of each of these moves.

You must be accurate - within one millimetre - otherwise the work will not be effective.

The patient can help you determine the correct position of each move though their tissue sensitivity.

Occasionally - despite your best effort - some people will have no sensitive points in these areas - even though their feet may be pronated.

Don’t worry - use your best judgement (based upon previous experiences) to locate where YOU determine the best location to make the moves.

Once you have located (i) keep your thumb lightly in that position.

Do not remove your thumb or you will lose that precise place and will have to find it again.

Same instruction for move (ii) - once you have found the correct placement - do not remove your finger.

Simply keep it positioned and ready to make the “move”.

Application of the AoB procedure:

Always perform the AoB movements on both feet.

Note: These ‘moves’ or ‘pressure triggers’ are applied simultaneously.

In the early stages of using this work the client will be able to tell you if you obtained a synchronous pair of ‘moves’ - or if the second move was felt slightly after (or before) the first.

If you don’t achieve a simultaneous pair of moves then re-try and perform a second application.

Apply the moves as shown in the instructional video. Apply the moves to BOTH sides of the body.

Move (i) is located between the tibia and fibula - in the interosseus space just inferior to the knee joint.

Move (ii) is approximately two thirds of the way between the calcaneum and the proximal joint of the great toe - on the plantar aspect of the foot.

Note: Both (i) and (ii) are approximate locations.

Only through palpation will you be able to determine a sensitive or painful place where the move needs to be performed.

Both “moves” are applied simultaneously as shown.

It is important that both moves are applied at precisely the same time. If you’re not sure then your client will be able to tell you.

It may take some practice to get the moves simultaneous - so practice on a pillow or rolled up towel until you perfect the technique.

When the moves are completed pause for between two and five minutes to allow the client to experience any sensations in the lower legs and feet and to assist tissue relaxation around the area.

Sensations such as tingling and warmth of the feet and legs are not unusual.

You may have to wait up to five minutes or longer for these sensations to subside.

Help the client to a seated position:

(a) Pause and check the client experiences no dizziness or light-headedness.

If they are dizzy or light headed then wait for a minute or two to allow that feeling to clear itself.

Only then may the client step down from the couch placing BOTH feet on the floor at the same time to facilitate even weight-bearing.

(b) If the client continues to be dizzy after waiting two minutes then lay them in a foetal position, cover them with a blanket and wait for the dizziness to pass.

Retrun them back to a seated position and check any dizziness has subsided.

Then ask them to stand - placing BOTH feet on the floor at the same time to allow even weight-bearing to occur.

The client may need to sit for a few moments before dressing and leaving your office.

POST TREATMENT CARE

Two scenarios may occur:

There can be an immediate change in the balance and pressure of the foot.
The client may feel a little strange as they are walking around your treatment room, as they experience new foot pressures and placements.
The feeling usually subsides after a few minutes and the treatment is complete.
There may be no apparent changes to the feet - or the client isn’t aware of any changes.
If that is the case, ask the client to sit down for two minutes. After two minutes has elapsed ask them to stand and walk around the room.
They may begin to feel slight changes - but may still be unsure about any significant changes in their feet.
Ask them to sit a few more minutes and then walk around again.
Quite often the reaction (or awareness of change) to treatment isn’t perceived immediately by some.

You may have to repeat the AoB work periodically as part of a monthly ‘tune-up’ - depending on the client and their particular physiology.

The video presentation shows comparative changes in the foot balance from before treatment (lower picture) to after treatment (top picture).

How it works:

It works by activation of the tibialis anterior.

The tibialis anterior originates in the upper two-thirds of the lateral (outside) surface of the tibia.

It descends down and under the medial arch of the foot before inserting into the medial cuneiform and first metatarsal bones of the foot.

It acts to dorsiflex and invert the foot.

Slight deviation of the great toe (Hallux valgus) can improve with this work due to the re-setting of the resting tension of the tibialis anterior, and change in the pressure in the foot upon standing.

Any weakness or reduction in neural pathway connection can result in pronation, due to the lack of tone or support of the foot.

Interestingly the same applies for supination. Excessive stimulation of the tibialis anterior could result in supination.

These moves actually ‘reset’ the resting and active length of the muscle resulting in a more evenly balanced foot position.

They also stimulate proprioceptive responses in the foot.