Dear Mother Superior,
She said: I've got a client-man, banker, travels a lot. His left foot, middle (3rd) toe bothers him. Hurts at the head of the metatarsal, at the MP joint, plantar surface. Mostly with direct pressure, but with forced/PROM ext/dorsiflex as well.
I said: Shoes? Inspect them. soles, insides, how he walks in them, foot bed, toe box. You're CSI!
She said: Same guy has a "knot" @ ~ T8, right side of the spine.
I said: Can you see it? Feel it? Can he feel it? What does it feel like? How long has it been there? What's his doctor say it is?
She said: Also has had Lt groin/hip pain recently- fixed with knee folds, find Psoas.
I said: We're a one piece machine, it's all related.
She said: The TOE is my concern right now. I watched him walk...keeps his feet parallel...seems to push-off from middle toe... so we discussed 8degrees of external rotation in the feet (from the hip) to push off from the first toe.
I said: Disaster form! Train wreck! Make him stop! Is it coming from his hip or is his knee rotating?
She said: Foot work on the toes is too much, so we are only doing arches and heels for now.
I said: How many springs? Even on one spring it's too much? With one spring, it's not even as much resistance as his own body weight vertically loaded. What hurts when he tries FW first position? Make him tell you all about how it feels and compare and contrast to how it hurts when he's walking.
She said: I told him to stretch his toes....but I can't honestly say it is a good idea.
I said: Should stretch his whole foot, not just his toes. I'd suggest rolling slowly over a tennis ball, the spike balls are going to be too invasive until his fascia breaks up.
She said: He is tight all over, so I figure it can't hurt....but I don't know which side he should stretch and which side to strengthen.
I said: He should stretch it all, my guess is his right side will be tighter due to the overload if he favors his left side.
She said: I had him doing towel scrunches with toes, but he said it made it worse...
I said: Toes are supposed to stay out of the action in towel scrunches, do you mean "scrunches with FEET?
She said: I can't seem to get it straight in my head...
I said: I'd recommend Irene Dowd's book Taking Root to Fly, the chapter entitled In Honor of the Foot. It's a complete education on what's in there and how it's supposed to operate/load, and there are easy to follow instructions for massage that should be just fine for him. Is he married? Can he bring in his wife/partner so you can show them how to rub his feet? Toe Corrector/Foot Corrector will be too much for him now, but eventually will be great. His hips have to open a bit in order for that femur to set up the strike of the foot off the rolling big toe. Practice walking with him, every session, bare foot, so he can begin to pattern proper form. I'm guessing his left side is weaker. Try to find out full injury/activity history that would have been birthing ground for this defect. Let me know what you think/find out.