I did my re-screen with Dr. Clancey and Bryan...well, part of it. I completed the first few test exercises , but then everything came to a halt when I got to the deep squat test. I don't want to believe I was completely delusional when last week I was so sure my squat was getting better, but apparently I was. My squat looks exactly the same, even with all the calf stretches and exercises (and positive thinking) I've been doing for the past four weeks. Totally disappointing.
Originally the theory was that my soleus muscle - the deeper calf muscle that attaches to the Achilles tendon - was super tight. But as they put me through a few more tests for that muscle, I said, you know, I don't really feel an actual stretch in my calf - it actually feels more like something is just blocking the movement. (Right after my first screen I posted that I really couldn't feel anything or tell in any way that my soleus was tight, but I went with it). I could see Dr. Clancey's wheels turning.
They had me lie facedown on the treatment table in the PT room, and they started flexing and bending my feet. No sensation whatsoever in the calf; yet, I had almost zero dorsiflexion (bending the foot up toward the shin) in either foot. Bryan, at one point, grabbed my feet and starting trying to move the bones that are situated where the foot meets the leg - particularly the talus http://www.podiatrychannel.com/pod/Images/ftbns_sdvw.gif).
The way Bryan explained it, when the lower leg comes forward over the foot (that's dorsiflexion), the talus is supposed to rotate out of the way to allow forward motion of the tibia (that's the shin bone). It's likely that my talus - on both feet - is locked up and won't rotate. It could have begun back in high school, when I played lots of basketball and ran hurdles on the track team. The impact on my heels, particularly during the hurdling, could have, over time, pressed up into my talus and caused subtle changes in the soft tissue surrounding it. Adhesions and scar tissue could very well limit the mobility of the talus. And after all those years, I'm left with almost no dorsiflexion. And I never knew.
For good measure, Dr. Clancey decided to treat both my calves using a technique called Active Release. Active Release is a sort of movement-based soft tissue treatment designed to help "release" muscles, tendons, ligaments, and even nerves that can become bound by dense scar tissueor adhesions. It involves shortening the tissue, applying pressure, then lengthening the tissue while under pressure. So while Dr. Clancey pressed (ow), Dee slowly flexed my foot to its end range of motion (double ow). Mercifully, it lasts only a few minutes.
Finally, Bryan did a joint mobilization exercise with me to see if he could get the talus to rotate. I stood on the treament table and lunged forward while he applied pressure on the talus. At the same time he pulled me further into the lunge using a wide strap looped around his waist at one end and my calf at the other. (This hurt almost as much as the ART...). He was able to get a bit more motion out of the joint.
The conclusion: it could still be lack of mobility in my soleus, but it's looking likely that it's actually my locked-up talus bones. There are some treatment options, which involve trying to break up the scar tissue and some additional manual joint mobilization by Bryan. The other option is to just compensate for it by raising my heels during my squats, either by putting something under my heels or purchasing power lifting shoes, which come with a raised heel built in. The shoes are ugly and expensive, but might be necessary for some of the Olympic lifts Crossfit promotes, where you have to sort of "drive" your body under the bar and both feet leave the ground a fraction of an inch for a fraction of a second. Not sure I want to be thinking about where to place my heels when there are so many other positional subtleties in those lifts to focus on.
Over the weekend - which happened to involve two squat-centric workouts - I placed my heels on weight plates to do the squats. It gave me about an inch of lift, and my squats felt great and looked almost perfect. I was quite pleased (okay, I was thrilled...). This doesn't mean, though, that I can stop stretching my soleuses (soleii?).
There is a point to all this: while TPI didn't directly solve my my squat issue, it certainly opened the door for my favorite top-notch professionals (blatant shout-out to Dr. Clancey and Bryan) to figure it out. Now I know how to proceed from here. And that is freedom, my friends.
But I still have that thoracic mobility issue to contend with...stay tuned.
Jill
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