A joint is a space. As simple as this sounds its often overlooked. Japp Van der Wal MD, Ph.D said it best no bones connect, there is a disconnect via connective tissue, joints are NOT hinges. So, first and foremost joints/spaces NEED to move. So whats optimal? When moving, a gradual build up of tension on the open angle of the joint. Less than optimal? According to the work of professor Freddy Kaltenborn, if movement produces a pinch, pain, impingement on the closing angle of the joint, its an indicator that the deep connective tissue (CT) is overly densified and/or fibrotic. Yes, its changeable tissue. Here is a quick look at a pretension (slant board) with local tension (band) aimed at mobilizing the deep CT of the foot/ankle. Have client dorsiflex to the degree they can without overly compressing (no pinching), usually because of the band, they get deeper into range then the assessment displayed. They should experience a strong tension posteriorly! This is very intense yet needed, due to the strength of the collagenous architecture. Outside support is usually needed so balance is maintained. Always follow up mobilizations with appropriate strength exercises! As always, this example is to spawn thought on YOUR end. Be creatively-specific to your clients needs. Enjoy!
Posted on: Wed, 19 Nov 2014 22:17:34 +0000