When is ankle pain not ankle pain?

❄️❄️ I had a new client come in today ❄️❄️ with possible planta fascia issues / ankle pain. Given the presentation, I wasn’t convinced the ankle, in this case, was the issue. They were getting lower back pain as well, specifically around the SI (sacroiliac) region, so we looked at the core.

The diaphragm, transverse abdominals, lumbar multifidi, and pelvic floor muscles work together to generate the intra-abdominal pressure, that stabilises the lumbar spine. It’s why everyone that comes for a consultation has a core check performed.
If one of the ‘core’ muscles doesn’t perform properly, extra work is undertaken by the others to help make up this ‘shortfall’. When things get really bad, this can put extra strain on the local joints and ligaments which can also become dysfunctional.

But what would make one or more of these muscles switch off? 🤷🏻‍♂️

The brain not feeling safe using a particular muscle will do it. Why wouldn’t a muscle feel safe though? 🤔 Injury, trauma, surgery to name but a few.

It turns out there had been an abdominal surgery many years ago. The resultant scar, although barely visible, was effecting their motor control, the result being all of the muscles in the core, and some in the suffering leg tested weak.
We activated the sensory afferent nerves around the scar, and everything started working again 👍🏻

This will be a multi step rehab – bring the core online, resolve the SI dysfunction once the core is able to take the load, then address the ankle, IF there is anything wrong locally. 🧠💪🏻

It’s important to look at the whole picture – holistically if you like – to make sure we don’t go after the symptoms instead of the true cause. 👨🏻‍🎓

Image credit Pexels free

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