Feet First

A sail boat in Sardinia (2010)

David and I have had a great weekend and yesterday we went to Villasimius on the southern point of Sardinia. Apart from being very happy with the fact that although the afternoon sun was strong and we didn't get burned, (all thanks to Dermalogica's Solar Defense Range), I also saw a lot of boats bobbing about in the water.

What do boats and feet have in common? Well, I'll tell you.

When I see clients I often get them to stand in-front of a mirror so that we can have a look at their posture and how massage, strengthening and stretching as well as good nutrition can help the body. We call this a 'Postural Assessment', which is followed by basic range of motion tests so that the client and I can record and gauge where we started and where we are headed. It supplies me with a clear marker system to see how the work is progressing. Many therapists work from the head down and others from the feet up. Some use grid systems and plumb lines and others, like myself, don't.

I always start by looking at the feet. I love their beauty as they tell me so much about the person standing in-front of me. I can see how they have started to role medially or laterally, which can put great pressure on the arches, I can see if the tendons are clinging on for dear life and I can also look at the skin to see if pressure points are building up. I can also see if people are rocking forward or backward on their feet; giving too much pressure into the balls of the foot or the heels. I can basically start at the foundations of the body and work up, knowing from where I started I have a trail to follow (Beil, Andrew R., 2010, The Trail Guide To The Body 4th Edition, Books of Discovery).

The best way that I can explain why it is important for you to know is explained by the image of a sail-boat.

A sail boat has a mast that fits atop the boat.

If you look at the image to the left you can see the foot and the lower part of the leg and we are interested in the green bits for today.

The shafts coming down from the top to the foot are the Tibia/Fibular leg bones or the 'Mast' on the boat.

The 'Boat' is formed from the other two bones; the Tallus, which is between the Mast and the Calcaneus, which is the boat's hull.

When I look at your feet in your postural assessment, the Boat on which you walk is very important to me. I like to see how your Mast works relation to the boat and I mark how much the boat's hull is showing behind the mast, giving a clear indication on how the fascia and it's corresponding muscle pockets work for you. When the mast is unstable the boat can veer off track, leading to injuries throughout the rest of the foot, up to the knees and beyond. Indeed, the Spiral Line of fascia 'loops around the body in a helix, joining one side of the skull across the back to the opposite shoulder, and then across the front to the same hip, knee, and foot arch, running up the back of the body to rejoin the fascia on the skull' (T. Myers, 2001, Anatomy Trains, Churchill Livingstone Pulishing, pg 139), clearly showing how important the feet are in relation to the whole well being of the boat's progression through the choppy waters of life.

Lower back pain, planter fascia problems, hip mobility complaints and yes, even head pain can be helped a lot by looking at the feet and relaxing or strengthening the fascia/muscles that support the foot and ankle.

Illustration of the planter fascia left foot.

However, not all body work has to start with sorting out the mast and it's corresponding boat. Personally I like working with my clients! So if they have headaches they want treated directly I am more than happy to work the muscle bags and their trigger points to get the headaches under control before we start looking at working out a way of how to get the mast lined up correctly and easing the tension felt throughout the body. But knowing what is there and how you are standing on your feet can show a huge amount of the body's story.

(A Side Thought
Postural assessment has been argued over for the past few years after Eyal Lederman's paper was published in the well respected Journal of Movement And Body Work in 2011 entitled 'The Fall Of Postural-Structural-Biomechanical Model In Manual And Physical Therapies. Exemplified By Lower Back Pain'. Personally, I find both sides of the argument intellectually thrilling and I am really grateful to Eyal Lederman for getting us to think about why we go through postural assessments, checks and hang on to them so dearly. For my own clinic work, I am happy to stick with them, viewing the postural assessment personal to the client, rather than looking at an ideal posture that I need my client to be forced into.)