How can foot pain be connected to the ribcage?
I am currently treating a keen runner in his 40’s who has come in with planta fasciitis. Now, you may think, how on earth can the ribcage be involved with this problem?
Assessment:
When I assessed this man, I noticed that he did have an increased tightness in his calf region but he had already been through an extensive course of physiotherapy using electrotherapy, generic stretches, massage and strengthening in the area with the only outcome being a worsening problem.
So, I need to look elsewhere for the causes of his problem. As usual, I ALWAYS assess the ribcage. I want to see how the person is breathing, can they fill the ribs? What position is the spine and sternum in? Does anything look tight there?
Tensions in the oblique area will affect breathing pattern and the ability for the ribcage to rotate optimally. This will, in turn, affect both the shoulder and the leg during walking / running. Should the ribcage and/or any of its many muscles be moving and working in a non-optimal way, this will have a knock on effect on the biomechanics potentially throughout the entire body.
Identifying the problem:
With my example, he had very tight abdominals, particularly on one side holding him in a relatively flexed and rotated trunk position. This meant he struggled to access his posterior chain muscles in the trunk (back extensors) and needed to try to compensate for this further down the chain.
In this case he was overusing the foot and toe flexors to get an adequate push off whilst walking and running. Sooner or later, the overworking muscle gets so tired it can tear or become inflamed and require help. Cue client into clinic!
The spinal extensors that attach onto the ribs will find it harder to work if the trunk is flexed. The extension muscles need to work harmoniously in a pattern for best performance.Understanding optimal spine and ribcage mechanics and the myofascial connections makes helping these clients a lot easier. You can apply this knowledge to Pilates, Yoga, Functional training and other bodywork disciplines.
More information:
If you would like to deepen your understanding of the ribcage, check out the second workshop in the Spine and Trunk series: The ribcage.
For more information about Zoe and her approach, check out her bio.