Conditions
When one leg feels shorter than the other
Sunday May 09, 2010
A
lot of people come to me saying that one of their legs is shorter
than the other. This condition makes them feel misaligned and off
balance. Movement feels strained and “not right” to them. Often,
their pelvis feels “twisted.”
Many opinions exist about why the legs have different lengths. There are also many ways to measure a leg and the bones in it. And there are yet more ways how healers, allopathic or alternative, treat this condition. Some practitioners recommend an orthodic (insert) in the shoe on the shorter side, others focus on adjusting the pelvis and spine to help the person be and feel more aligned.
My approach from the Rolfing world is focused on looking for tightnesses in the hip on the shorter side. Often, I find tightness that might have been a result of trauma or compensation for an injury on the same or even on the other side. Sometimes, things tighten diagonally.
With these clients, I test the hips first by comparing the hips’ ability to lengthen by gently pulling on them in various angles. The client can usually feel where the sides differ and what is trying to stretch and lengthen but can’t. I follow their perceptions and open the hip by lengthening the muscles and fascia where they feel it. Very often, they remark afterwards: “It feels like my shorter leg is longer than the other!”
Beside the hip, I have also discovered that the femur plays a large role in how much movement there is in the leg. If the soft tissue is tight around the femur, the femur cannot glide and rotate properly as we walk, run, stand or sit. The femur becomes entrapped by the soft tissue in the thigh and the range of movement of the shorter leg is diminished. That tends to reinforce the tightnesses that are already there and also the pattern of the legs and feet either to point out (externally rotate) or point in (pigeon-toed).
Sometimes, the longer leg can be the problem. Especially with people with osteoarthritis in one of the hips, the movement is altered by the pain in the hip and the person has a limp. It is often the longer leg that doesn’t glide in the hip joint itself that can be the culprit.
In the conclusion, the difference in the leg lengths is a serious issue. Alignment of the body cannot be established properly unless the legs bear weight similarly . I am not obsessed with symmetry; I look for functionality. Do the legs provide the support necessary for the spine to point up? Is weight distributed similarly on the left and right sides? Is there a glide in the body movement as the person walks? These are the things I look for.
Many opinions exist about why the legs have different lengths. There are also many ways to measure a leg and the bones in it. And there are yet more ways how healers, allopathic or alternative, treat this condition. Some practitioners recommend an orthodic (insert) in the shoe on the shorter side, others focus on adjusting the pelvis and spine to help the person be and feel more aligned.
My approach from the Rolfing world is focused on looking for tightnesses in the hip on the shorter side. Often, I find tightness that might have been a result of trauma or compensation for an injury on the same or even on the other side. Sometimes, things tighten diagonally.
With these clients, I test the hips first by comparing the hips’ ability to lengthen by gently pulling on them in various angles. The client can usually feel where the sides differ and what is trying to stretch and lengthen but can’t. I follow their perceptions and open the hip by lengthening the muscles and fascia where they feel it. Very often, they remark afterwards: “It feels like my shorter leg is longer than the other!”
Beside the hip, I have also discovered that the femur plays a large role in how much movement there is in the leg. If the soft tissue is tight around the femur, the femur cannot glide and rotate properly as we walk, run, stand or sit. The femur becomes entrapped by the soft tissue in the thigh and the range of movement of the shorter leg is diminished. That tends to reinforce the tightnesses that are already there and also the pattern of the legs and feet either to point out (externally rotate) or point in (pigeon-toed).
Sometimes, the longer leg can be the problem. Especially with people with osteoarthritis in one of the hips, the movement is altered by the pain in the hip and the person has a limp. It is often the longer leg that doesn’t glide in the hip joint itself that can be the culprit.
In the conclusion, the difference in the leg lengths is a serious issue. Alignment of the body cannot be established properly unless the legs bear weight similarly . I am not obsessed with symmetry; I look for functionality. Do the legs provide the support necessary for the spine to point up? Is weight distributed similarly on the left and right sides? Is there a glide in the body movement as the person walks? These are the things I look for.
Interosseous Membrane
Sunday Apr 04, 2010
Lately,
I’ve been working with a lot of people who experience tightness in
the calves, knee weakness and ankle problems. All of these issues
can be related to the interosseous membrane.
What is the interosseous membrane? It is a membrane made of dense connective tissue that holds the two bones of the lower leg together. The tibia and fibula are designed to move apart every time we bend the ankle. This way, more space is created for the blood to flow and to pump it up to the heart.
Probably partly because of genetics, some of us have tighter calves than others. Another factor can also be a lot of running activity and the resulting shin splints. In addition, some people have enormous sensitivity in their lower legs where they barely let me touch them in the first sessions (but as I work with the calves and they loosen up, they also become less sensitive to the touch).
When I work with these clients, I help open up the space between the tibia and the fibula. I can access it from either the shin side or the back side. I often have the client slowly move the ankle between the flexion and relaxation positions to encourage the sensation of the bones widening and as if the muscles move like pulleys – some lengthen and some shorten.
What is the interosseous membrane? It is a membrane made of dense connective tissue that holds the two bones of the lower leg together. The tibia and fibula are designed to move apart every time we bend the ankle. This way, more space is created for the blood to flow and to pump it up to the heart.
Probably partly because of genetics, some of us have tighter calves than others. Another factor can also be a lot of running activity and the resulting shin splints. In addition, some people have enormous sensitivity in their lower legs where they barely let me touch them in the first sessions (but as I work with the calves and they loosen up, they also become less sensitive to the touch).
When I work with these clients, I help open up the space between the tibia and the fibula. I can access it from either the shin side or the back side. I often have the client slowly move the ankle between the flexion and relaxation positions to encourage the sensation of the bones widening and as if the muscles move like pulleys – some lengthen and some shorten.
Rib Misalignment Disguised as a Shoulder Pain
Tuesday Feb 16, 2010
Lately,
I have been working with a lot of people with shoulder pain.
Usually, symptoms include pain under the shoulder blade and
tightness of the nape and neck. Some variations include also the
shoulder joint itself but that is most often someone who has had a
specific injury to the shoulder. I find that women, more than men,
seem to “carry the world on their shoulders.”
Because of our structure, the ribcage is the largest entity of the body. It’s made of many bones but all the bones are embedded in soft tissue. The soft tissue determines where and how each rib relates to other ribs and vertebrae. If one rib is changed, the rest of the ribcage is also affected. The soft tissue is what stabilizes the ribs in position. Go and have some ribs at Rudy’s in Albuquerque (my favorite!). You’ll see the huge amount of meat that comes between them!
Most common issues with the ribs are reinforced by our posture. When we “slouch,” some ribs are shifted. If we stay in that position for hours, those ribs have a limited movement with each breath. They either feel like they are submerged under another rib (usually under the breast), or they feel flared out (usually the few lowest ribs in the abdominal area). Because of the entrapment in the front, these patterns create a strained effect on the back of the ribcage.
When an injury happens, let’s say in a car accident with a seat belt on, the ribcage is changed dramatically. The trauma and the pain causes the system to protect itself. People are often very sensitive to touch for the first couple of months after the accident while scar tissue forms. After that and in the following years, the body establishes a new homeostasis and a way to keep things “together.” This results in more tightness around the injured ribs.
With each client, I find the ribs that are involved. Those usually feel tight and sore and there is less space between them. I find those places and help them open. I also work with the relationship of the rib to its corresponding vertebra. It seems almost magical: when some of the involved ribs separate, the tightness in the shoulders resolves. It’s pretty cool.
Because of my own struggle with posture, I look for rib misalignment with everyone who reports his or her shoulders coming forward and who has tightness in the nape and shoulders. Sadly to say, it is most of us. I included.
Because of our structure, the ribcage is the largest entity of the body. It’s made of many bones but all the bones are embedded in soft tissue. The soft tissue determines where and how each rib relates to other ribs and vertebrae. If one rib is changed, the rest of the ribcage is also affected. The soft tissue is what stabilizes the ribs in position. Go and have some ribs at Rudy’s in Albuquerque (my favorite!). You’ll see the huge amount of meat that comes between them!
Most common issues with the ribs are reinforced by our posture. When we “slouch,” some ribs are shifted. If we stay in that position for hours, those ribs have a limited movement with each breath. They either feel like they are submerged under another rib (usually under the breast), or they feel flared out (usually the few lowest ribs in the abdominal area). Because of the entrapment in the front, these patterns create a strained effect on the back of the ribcage.
When an injury happens, let’s say in a car accident with a seat belt on, the ribcage is changed dramatically. The trauma and the pain causes the system to protect itself. People are often very sensitive to touch for the first couple of months after the accident while scar tissue forms. After that and in the following years, the body establishes a new homeostasis and a way to keep things “together.” This results in more tightness around the injured ribs.
With each client, I find the ribs that are involved. Those usually feel tight and sore and there is less space between them. I find those places and help them open. I also work with the relationship of the rib to its corresponding vertebra. It seems almost magical: when some of the involved ribs separate, the tightness in the shoulders resolves. It’s pretty cool.
Because of my own struggle with posture, I look for rib misalignment with everyone who reports his or her shoulders coming forward and who has tightness in the nape and shoulders. Sadly to say, it is most of us. I included.
Feet and Foundation
Saturday Jan 09, 2010
Working
with the feet is all about the foundation. Finding the support of
the earth underneath can help the rest of the body “stack up.” It
is a state of resting into gravity when one can just be.
This is possible when we trust our feet and legs to carry and support us. The feet and legs are connected to the point where whatever issue is in the foot is also in the lower and/or upper leg and vice versa. They go hand in hand because tendons in the foot originate as muscles in the lower leg.
Most of us experience some kind of ankle or foot issue in our youth as we climb trees or hike on uneven surfaces or stab a toe. Some of us were not allowed to run around bare-foot, some of us wore shoes that were at times too small and some of us wear high heels and inserts. Some people have a genetic propensity towards high or low arches. Environmental factors such as the gait of the parents matters as the child learns to walk and naturally emulates the people around.
The Foot
All of these factors influence the four arches in the foot. There is the medial arch (in the middle of the foot) balanced by the lateral arch (on the outside of the foot), and there are two transverse arches across the metatarsal bones and the cuneiforms. Naturally, they all have the ability to spring up and down as we walk, giving us a sense of propelling forward without too much effort. It has been observed that people who walk bare-foot as children tend to have the most balanced arches.
During walking, there are two stages of the foot participation: landing and push-off stage.
LandingAs we contact the ground with the foot, there is a sense of landing. When all of the arches are allowed to land and touch the surface, all 26 bones of the foot move. This is very profound because all of the bones form many joints with each other. All of these joints are synovial which means that they have fluid that lubricates and cushions the joints during motion. When the joint stops moving due to an injury or tightness of the surrounding soft tissue, the production of the synovial fluid decreases and the joint becomes compressed. As a result, the joint has less space and the cartillage is replaced by scar tissue that can lead to arthritis.
Push-OffThis stage involves pushing off while bending all the toes in the foot. A lot of people walk without using their toes at all. This can be a result of wearing hard-soled shoes or having no heel strap. Whenever I buy shoes, these two criteria are essential – soft and bending soles, and a heel strap. The former allows for bending the toes and the latter allowes the whole foot to lengthen and relax without the insecurity of having the shoe fall off (which creates tension in the plantar fascia).
The Lower LegAs I mentioned before, the foot issues reflect in the lower legs and vice versa. The muscles of the lower leg become the tendons in the foot. They act as pullies around the inner and outer ankle bones (maleoli). They attach to the bones of the foot to create the four arches. Often, muscles in the calves get “glued” together and lose their function of differentiated movement. These adhesions are the fascial sheaths that don’t permit the muscles’ independent movement and it ultimately results in imbalance in the arches in the foot.
As the lower legs and feet become more balanced, they provide more stability and mobility for the rest of the body. Finding a good foundation results in ability to feel aligned. The lower back and abdomen can stay soft yet supported. In this state, the body can rest into itself. Yeah!
This is possible when we trust our feet and legs to carry and support us. The feet and legs are connected to the point where whatever issue is in the foot is also in the lower and/or upper leg and vice versa. They go hand in hand because tendons in the foot originate as muscles in the lower leg.
Most of us experience some kind of ankle or foot issue in our youth as we climb trees or hike on uneven surfaces or stab a toe. Some of us were not allowed to run around bare-foot, some of us wore shoes that were at times too small and some of us wear high heels and inserts. Some people have a genetic propensity towards high or low arches. Environmental factors such as the gait of the parents matters as the child learns to walk and naturally emulates the people around.
The Foot
All of these factors influence the four arches in the foot. There is the medial arch (in the middle of the foot) balanced by the lateral arch (on the outside of the foot), and there are two transverse arches across the metatarsal bones and the cuneiforms. Naturally, they all have the ability to spring up and down as we walk, giving us a sense of propelling forward without too much effort. It has been observed that people who walk bare-foot as children tend to have the most balanced arches.
During walking, there are two stages of the foot participation: landing and push-off stage.
LandingAs we contact the ground with the foot, there is a sense of landing. When all of the arches are allowed to land and touch the surface, all 26 bones of the foot move. This is very profound because all of the bones form many joints with each other. All of these joints are synovial which means that they have fluid that lubricates and cushions the joints during motion. When the joint stops moving due to an injury or tightness of the surrounding soft tissue, the production of the synovial fluid decreases and the joint becomes compressed. As a result, the joint has less space and the cartillage is replaced by scar tissue that can lead to arthritis.
Push-OffThis stage involves pushing off while bending all the toes in the foot. A lot of people walk without using their toes at all. This can be a result of wearing hard-soled shoes or having no heel strap. Whenever I buy shoes, these two criteria are essential – soft and bending soles, and a heel strap. The former allows for bending the toes and the latter allowes the whole foot to lengthen and relax without the insecurity of having the shoe fall off (which creates tension in the plantar fascia).
The Lower LegAs I mentioned before, the foot issues reflect in the lower legs and vice versa. The muscles of the lower leg become the tendons in the foot. They act as pullies around the inner and outer ankle bones (maleoli). They attach to the bones of the foot to create the four arches. Often, muscles in the calves get “glued” together and lose their function of differentiated movement. These adhesions are the fascial sheaths that don’t permit the muscles’ independent movement and it ultimately results in imbalance in the arches in the foot.
As the lower legs and feet become more balanced, they provide more stability and mobility for the rest of the body. Finding a good foundation results in ability to feel aligned. The lower back and abdomen can stay soft yet supported. In this state, the body can rest into itself. Yeah!
Sciatica
Tuesday Nov 10, 2009
Sciatica
is probably the second most common problem that people come to me
for. It is a sensation that may include one or several of these
areas: low back, hip, thigh, calf and even foot. Most people
experience the sensations more on one side.
There are two kinds of sciatica issues: the ones that are stemming from the spine mis-alignment and second that are more about the sciatic nerve impinged by the soft tissue in the piriformis area or in the thigh.
The sciatic nerve is a thick bundle of nerves that travel the whole length of the leg. It starts as a bundle of nerves coming out of the L5, S1 and S2 vertebrae. Sometimes, the L5 is rotated on the sacrum or the sacrum may be rotated itself. This may cause impingement of the sciatic nerve. The nerve can be irritated or inflamed, causing nerve sensations or numbness to the leg. This tends to be a more complicated pattern because it involves the spine in addition to the soft tissue tightness.
The second kind of sciatic nerve issues are people with chronic tightness in the leg and hip. The soft tissue becomes hard and at some point doesn’t allow the femur to glide while moving or even when sitting. The sensations are usually in the hip and on the back side of the leg. From anatomy stand point, the piriformis muscle of the hip is interesting because in small percentage of the population, the sciatic nerve actually goes through the piriformis. When the piriformis becomes tight, it can trigger the sciatic nerve sensations.
In both patterns, I work with the hip, ie. gluteal muscles, piriformis and the connective tissue on the back side of the leg. Usually, this gives a person relief to move or rest the leg while the femur is free enough to find comfortable position in which it is not “pulled on.” If the sciatic pain doesn’t go completely away, I continue pursuing the spine and how it relates to the sacrum, pelvis and the legs. We work the soft tissue that could be pulling on any of these structures. These may be the psoas or the adductors and many other structures.
For some people, the sciatica can dissipate in their first Rolfing session. For others, it may take longer. Usually, the less amount of time a person has had it, the bigger chance is in resolving it fast. Don’t wait until it becomes a larger pattern.
There are two kinds of sciatica issues: the ones that are stemming from the spine mis-alignment and second that are more about the sciatic nerve impinged by the soft tissue in the piriformis area or in the thigh.
The sciatic nerve is a thick bundle of nerves that travel the whole length of the leg. It starts as a bundle of nerves coming out of the L5, S1 and S2 vertebrae. Sometimes, the L5 is rotated on the sacrum or the sacrum may be rotated itself. This may cause impingement of the sciatic nerve. The nerve can be irritated or inflamed, causing nerve sensations or numbness to the leg. This tends to be a more complicated pattern because it involves the spine in addition to the soft tissue tightness.
The second kind of sciatic nerve issues are people with chronic tightness in the leg and hip. The soft tissue becomes hard and at some point doesn’t allow the femur to glide while moving or even when sitting. The sensations are usually in the hip and on the back side of the leg. From anatomy stand point, the piriformis muscle of the hip is interesting because in small percentage of the population, the sciatic nerve actually goes through the piriformis. When the piriformis becomes tight, it can trigger the sciatic nerve sensations.
In both patterns, I work with the hip, ie. gluteal muscles, piriformis and the connective tissue on the back side of the leg. Usually, this gives a person relief to move or rest the leg while the femur is free enough to find comfortable position in which it is not “pulled on.” If the sciatic pain doesn’t go completely away, I continue pursuing the spine and how it relates to the sacrum, pelvis and the legs. We work the soft tissue that could be pulling on any of these structures. These may be the psoas or the adductors and many other structures.
For some people, the sciatica can dissipate in their first Rolfing session. For others, it may take longer. Usually, the less amount of time a person has had it, the bigger chance is in resolving it fast. Don’t wait until it becomes a larger pattern.