Soccer Ankles

Soccer players are some of the most interesting people I work on as they know the possess the stamina of a warrior but the amazing ability to abuse their bodies without even considering later consequences in most cases. Some of the most difficult cases I've worked on involve soccer players and I want to going to depth today about one particular aspect of soccer players health and that is the ankles.

The ankles of soccer player and rather unique because of the constant twisting jerking in pivoting motions they're involved in the game and the sheer amount of energy required to keep it running pace for extended periods of time really transforms the ankles over a period of time very very few sports they come even close to such demands on the ankles. The only sport I can think of I comes anywhere near the level of endurance and flexibility required would be the game of basketball. However the one thing that soccer does have that basketball is not is extented gameplay time.

From this point on a recommend that people Google the bones of the foot and look at an image of the foot before continuing some of the aspects that I'm about to get into a rather anatomical in nature and technical in your explanation. This is all to aid people in a better understanding of the importance of taking good care of these particular of athletes. So let's first talk about the basic anatomical structure of the human foot.

Starting at the top we have the Tibia in the Fibula this would make up the primary and secondary bone emerging from the knee and going down to what we commonly referred to as the human ankle. This area of the foot has the greatest range of motion of all the areas of the foot it pushes down on the rest of the foot causing traction and providing a force source for things like running and stretching. The Talus is the phone directly under the tibia it is the seat of the flexibility of the tibia which means that it receives all of the force of the lake directly upon it and provides for surface area to allow point of articulation for the Tibia and Fibula. Directly underneath that is a bone called the Calcaneus most people would know it as the bone that makes up your heel bone. This is also the bone where many bones spurs associated with plantar fasciitis are located and is well for the Achilles tendon pain caused by bone spurs is located as well. Because of its area of high mobility are you at a great deal of weight force projected upon the score holds happens causes a great deal of concern it comes to injury treatment. Many of the tenants but vessels and other vital tissues are located around these for bones. So when you have injury in this area often times find a great deal of internal scarring and a great deal of concern when it comes to mobility of these joints in the future which is why so many people need constant monitoring of the feet while in sports. 

I will at this point making important distinction for male athletes and female athletes comes to the abuse of their feet. The women to oftentimes wear high heels that are too high causing damage to these areas of the foot and it tends to be much more severe and man whore athletes in this area as far as repairing the damage and more chronic abuse during high intensity situations. You don't see too many women running marathons and high heels for example. 

Women's feet tend to be physically smaller near where the map again that's a generality not the rule in which case you must remember then force quit harassing to each gender is very different. Classically you do not see women having the same problem areas you tend to see more issues with women for athletes in the lower bones of the foot those closest to the toes because of sports like: ballet, tap dancing, figure skating, and gymnastics. 

In the upper part of the foot what I tend to see the most of is frozen ankle coming from internal scare tissue that formed after injuries. These injuries can be hours or years old. Not treating this scar tissue and removing it will cause a number of problems and athletic performance and because of the nature of internal skirts wish you could impact other parts of the body through decades of life thereafter. Simply soaking feet in Epson salt for example will certainly help but it will not remove this fibrous scar tissue from around these major joints and can also cause fluid retention in the body as a result because it will interrupt lymphatic drainage which is essential to good overall health. 

As we go down the foot will be given to explore the bones that help make up our toes. These bones are called metatarsals. And the parts that we see as toes are actually called Phalanges. Soccer players will oftentimes pivot on their toes this could put pressure on the phone so I connect to them as referred to previously the metatarsal bones. This reversed trance for a pressure can cause damage not only to the four joints that lead to the upper foot but can also become disfigured over time. Women can suffer this damage much more than man overall as a gender class however in this case soccer players tend to see more damage because of the nature of the shoes which protect her feet during play. Very similar to ballet shoes they don't offer a great deal of support on the tolls they tend to flex and move with the foot instead of protecting the foot. 

Again a note: when it comes to gender in this case though ballet dancers will spend more time on their toes it is the overall action and vigorous nature of the activity on the foot that I claim soccer players to have greater overall stress on their feet. 

The most common areas of the lower foot which I will treat when it comes to athletes will be the plantar muscles. These particular muscles act like a springboard to help the foot stay in its proper shape to allow the bones of the lower floor to stay in alignment and to provide more ergonomic walk. Especially as an athlete your foot will constantly be changing shape due to the type of physical activity that you're doing your bodyweight and the type of footwear you choose to use. Most often what I see is a therapist is a need to separate the tendons and other vital structures from each other as a result of scar tissue damage or tightening of ligaments as the foot has changed shape so often. 

Another important note; it is vital as an athlete understand that footwear manufacturers are not always taking your foot care too hard when designing shoes for particular applications. As long as the shoe is relatively comfortable and relatively ergonomic so that people do not complain about pain most manufacturers are allowed to make whatever design should they wish. This does not mean is the healthiest thing for your foot overall. A fantastic little tidbit that I picked up recently while doing research for the squawk post was that terms of our human history we can actually do fine when shoes were invented and more widely worn. The reason that they believe they can pinpoint this to such an accurate time frame is because her feet actually changed shape and phone density as a result of putting on flatware. The density of human foot actually decreased by a remarkable percentage within a few generations of having footwear this is because they believe that they foot did not have to change shape with the environment as much but because most indigenous people live on hard surfaces your phone density did not have to be is great to cushion their body the more salad terrain such as rocks gravel areas and other hard surfaces but were equally as flexible walking in soft sand or in vegetative areas.

When I work with soccer players overall I pay very close attention to their body stance and do a visual assessment of all the major joint areas in their body in order to look at how squarely their body stands. As I continue assessing each person I will oftentimes need to go to their hips first down to their knees and then again into their feet for more extensive review of their tissues. If you were seen your body stiffened up its range of motion such as bringing the heel into the center of the body are trying to push the outside of the foot outboard away from you this could be a sign of scar tissue and foot as well as your bill you point your toes down I'll point them up towards the ceiling pivoting at the ankle.

Most often in terms of correcting any major foot issues this is something that depends on your activity level and any other aggravating factors within your health history that could affect the healing process. In general most active athlete with no significant bone injuries can be treated and get back most of the range of motion if not all of it within a series of several appointments mixed in with other treatment goals. As part of my trip and philosophy I very rarely will spend an entire session or series of sessions on the foot and less I know that their activity level is relatively reduced and that any changes made in the body will be well compensated for and not counteracted with high amounts of physical activity.

If you have any questions regarding this topic for your particular needs you were always welcome to contact me. I would also suggest making an appointment with a diet tryst to ensure you were receiving consistent information from a different set of eyes and specialties in order to verify all of the information you were getting is correct and consistent. Consultations I'm putting issues are usually done within the office and are usually done at no charge to you when you see me as your massage therapist.

Rehabilitation Devices PART TWO (Ultrasound)

So recently I had a question from a client regarding an ultrasound device I want to answer that. Depending on where a massage therapist went to school and what state they practice in ultrasound could've been included in their education. In my case is within the scope of practice within the state I work in and it was included in my education to perform ultrasound under the guise of a doctors oversite. Recently ultrasound manufacturers have been making a wide range of affordable handheld ultrasound devices many of these are sold for under $300. I want to go over why you might look at one of these devices for personal use and some other vital in information as far as who should be using them who should not be using them. 


Clinical ultrasound technology has been around for many years in a variety of applications in this case we are only talking about therapeutic ultrasound therapy. The mechanics are pretty simple a machine with a wand to be set to vibrate at a particular frequency and intensity for certain period of time in order to help loosen up tight tissue in the body. There are variety of settings you can use for particular types of therapy in particular place is in the body so it important to know what the settings are and what they mean that's why only qualified technician should be using them in my opinion. For those that choose to not heed that advice the major problem with such a method of therapy is exposure time. If you leave an ultrasound device in an area for an extended period time especially near bony prominences heat can be created inside of the bone from the constant vibration this can cause discomfort or even damage to the body. In some cases held long enough in the same spot permanent damage.


In general these handheld devices have only one particular setting and if it has a second setting it is relatively inconsequential to most users because they don’t know how to use the device in the first place. Operating at 1 MHz or 3 MHz makes a tremendous difference which is why most manufacturers only have a setting of 3 MHz. 1 MHz can penetrate much deeper into the body and effect denser tissue while 3 MHz works in general better in soft tissues closer to the surface of the skin. Ultrasound gel is also required for this particular treatment which is typically sold separately from the unit itself and is absolutely necessary for proper results. Ultrasound gel can come in several size containers ranging from just a few dollars to +$50 dollars for a much larger container. Simply put ultrasound gel amplifies the vibration that created by the machine that directs it into the body. Gel must be cleaned off the device head immediately and is water-soluble so will come off the skin just as easily.


When I use ultrasound therapy I use a very particular sequence in order to encourage the body to get rid of any scar tissue and debris being held within the muscle tissue or the damaged joint I maybe working on. Most appointments last about 30 minutes but as I say I have a very particular sequence nor to encourage the body to give the best results this is something that most people or not training this device tonight understand for optimum results get the work done by a qualified medical professional. Many times massage therapist will not even advertise this on their websites or in promotional ads because the general public does not understand exactly what therapeutic ultrasound is. 

So if you made it this far let me just say I believe in the therapy I believe it works extremely well and is very cost-effective for patients however it should be done by a qualified professional. This is not meant to sound as is as if it's in my self-interest it's meant to protect you the consumer from self inflicted harm. If you find yourself pondering any type of therapeutic device please feel free to contact me if you have basic questions at the very least I can point you in the direction of other people who might be able to answer your questions better if I cannot. Please keep submitting questions asking questions getting second opinions and seeing only way that our healthcare system will become more cost-effective and more consumer friendly.

Legal Disclaimer: Due to the litigious nature of many people I am forced to issue this statement: Any information contained within blogs, websites, postings, or news articles suggestions which I make to be open for interpretation that if you believe it may fit a concern or medical problem you may be having or suspect that you may have that you discuss it with your qualified healthcare practitioner including your physician. I do not take responsibility in any way for any content provided to you that you choose to act on without talking to a medical doctor or other qualified medical practitioner with legal standing of authority. You are free to act on any information from any source that you choose of which the consequences are your responsibility.