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  • Chronic Ankle Pain

    While in Moorhead, MN teaching last weekend I met a man, one of the students, who told me he had a bullet go through his right ankle 40 years ago. No surgery, no pins, no plates, no metal, just chronic edema, lack of range of motion, and pain. He asked me if I would check it out while he was on the table at some point.

    We were teaching SMRT: Neck & Head and SMRT: Arm & Hand, so no one else would be touching his feet. I worked on his foot, ankle, and lower let twice throughout the 3 days for about 20 minutes each time. Deep pressure of any kind was rather impossible. There was little to no give in the tissues.

    Lymph drainage massage alone would not have addressed the shortening in the tissues at the ankle. I first addressed the immobility of the subtalar joint by using an SMRT position to unlock the connective tissues around the joint. When I released the position 30 seconds later, I found a substantial increase in the mobility of his ankle, the lymphedema had softened and decreased, and the tendons crossing the ankle were longer (not long, but less shortened).

    Next, I addressed the distal lower leg by releasing extensor digitorum longus, extensor hallicis longus, and peroneus tertius. Finally I worked flexor digitorum brevis across the bottom of the foot and released the interosseous muscles to create space between the metatarsals. All of this the first time I worked on him.

    The next morning he came in and said his sock and shoe fit better (meaning the lymphedema had lessened) and he had slept better than he had in decades because he had no pain to wake him up. In the second 20 minute session I worked more proximal on his lower leg, worked the ankle again – including a release for the deltoid ligament that gave immediate pain relief and fantastic space to his talocrural joint – and spent time unlocking the connective tissues around his tarsal bones.

    At the end of class that day, while we were saying our goodbyes, he had tears in his eyes as he told me this was the first time in as long as he could remember that he did not have pain in his right ankle and foot.

    Learn more about how to do this in our SMRT: Lower Leg & Foot course.