Self-Myofascial Compression Technique (MCT) and Ankle Mobility

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Below is an abstract on initial data I collected for a research study I designed to better understand the immediate effects of myofascial compression technique on foot & ankle mobility.

Within the running and sports performance industry there is a push for athletes to perform MCT before running and training which is theorized to free the foot and therefore reduce overuse injuries and proximal joint compensations. Everywhere from the Boston Marathon to the NFL training camp Combine 360 they are using this technique.

I get asked by many athletes about the benefit of addressing myofascia before working out but there is no data, especially on this self-technique.

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The Immediate Effects of Myofascial Compression Techniques (MCT) on Foot & Ankle Mobility during Walking: A Descriptive Pilot Study

By Emily Splichal, DPM, MS; Joseph Jimenez, MD; Frank Colabella, ATC

Goal: Although many therapists and athletic trainers apply myofascial techniques to manipulate, mobilize and rehabilitate joints and muscles of the foot and ankle, little has been done to investigate any qualitative and quantitative effects of such techniques on foot and ankle mobility and walking gait parameters. This pilot study describes the immediate effects of myofascial compression technique (MCT) on foot and ankle mobility and stride length during walking in order to analyze the benefits, if any, to prospective athletes or patients undergoing this therapeutic modality.

Methods: Two subjects were assessed for baseline measurements of foot pressure distribution utilizing F-Scan technology. OptoGait® Technology was used to assess baseline gait parameters on both a 1 meter treadmill at a walking pace of 2.5 mph and on a 5 meter flat surface. Baseline foot and ankle biomechanics were measured on a 1 meter treadmill at a pace of 2.5 mph using Motion (3-D) DNA.

Both subjects were introduced to the proper execution of self-MCT utilizing a TP Foot Baller® from Trigger Point Performance Therapy. After assessing baseline measures both subjects performed self-MCT to the gastrocnemius, soleus, peroneals and posterior tibialis utilizing protocols set by Trigger Point Performance Therapy with 5 minutes applied to each lower leg. No manipulation or stretching was applied to the intrinsic foot musculature.

Immediately following self-MCT, foot pressure distribution, walking gait parameters and foot biomechanics were re-assessed following the same protocol as all baseline measures.

Results: Because this was a pilot study, conclusive results cannot be made, however results did trend towards altered foot distribution post-MCT intervention. For both subject A and B, initial foot dispersion was to the lateral aspect of the foot. Post-intervention foot pressures were more evenly distributed with increase pressure to medial foot.

Results also trended toward altered gait parameters. Subjects A and B had a significant decrease in step length discrepancy post-intervention (Subject A 3.0 in. to 0.3 in. and Subject B 2.4 in. to 0.5 in.). In addition, both Subject A and B had increased dorsiflexion at heel strike and increased plantarflexion at toe-off, suggesting increased ankle mobility post-intervention.

Conclusions: As we gain a deeper understanding into the role myofascial tissue has on human movement and joint function, advanced research is necessary. Although this pilot study is not conclusive, it is suggestive of altered foot pressure distribution and ankle mobility post-MCT intervention. Techniques such as this could find a role in pre-athletic performance and in injury prevention. Additional studies need to be done before any conclusions can be set.

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I understand this is very initial data but I wanted to share this info and see if anyone else out there has looked at the association of trigger points specifically as it relates hypmobility of the foot and ankle.

My thoughts are:

1. If addressing myofascial adhesions before running or training, can an athlete improve shock absorption, therefore reducing overuse injuries?

2. If addressing myofascial adhesions before running or training, can an athlete reduce compensatory subtalar joint pronation which increases the valgus stress to the knee joint? This would be specifically important in an athlete with PFPS or at risk of ACL injury.

If anyone wants to learn more about the product I used, their website is www.tptherapy.com

 

Hi Emily,

Congratulations on completing the pilot study.

I advise patients to use self MCTs very regularly with out really having laid eyes on much research as to its efficacy. Patients often report immediate improvement on decline single leg squat after foam roller release on their IT band, vastus lateralis and TFL.

Study below may be of interest?

Cheers,
Athol

1.
The immediate effect of soleus trigger point pressure release on restricted ankle joint dorsiflexion: A pilot randomised controlled trial

Rob Grieve MSc, MCSP , , Jonathan Clark BSc, MCSP1, Elizabeth Pearson BSc, MCSP1, Samantha Bullock BSc, MCSP1, Charlotte Boyer BSc, MCSP1, Annika Jarrett BSc, MCSP1

Department of Allied Health Professions, School of Health and Social Care, Faculty of Health and Life Sciences, University of the West of England (UWE),
Received 31 August 2009; revised 9 December 2009; Accepted 17 February 2010. Available online 23 March 2010.

Objectives
The primary aim of this study was to investigate the immediate effect on restricted active ankle joint dorsiflexion range of motion (ROM), after a single intervention of trigger point (TrP) pressure release on latent soleus myofascial trigger points (MTrPs). The secondary aim was to assess aspects of the methodological design quality, identify limitations and propose areas for improvement in future research.

Design
A pilot randomised control trial.
Participants
Twenty healthy volunteers (5 men and 15 women; mean age 21.7 ± 2.1 years) with a restricted active ankle joint dorsiflexion.

Intervention
Participants underwent a screening process to establish both a restriction in active ankle dorsiflexion and the presence of active and latent MTrPs in the soleus muscle. Participants were then randomly allocated to an intervention group (TrP pressure release) or control group (no therapy).

Results
The results showed a statistically significant (p = 0.03) increase of ankle ROM in the intervention compared to the control group.

Conclusion
This study identified an immediate significant improvement in ankle ROM after a single intervention of TrP pressure release on latent soleus MTrPS. These findings are clinically relevant, although the treatment effect on ankle ROM is smaller than a clinical significant ROM (5°).

 

Hi Emily,

I was at the ACFAOM conference also. I was probably right beside you at the biomechanics workshop!
Anyways an interesting research topic. A couple of observations:

It would be interesting to see the results when the subjects actually run after after the MCT to see if the changes are maintained for the entire distance. In sprinting (which is my main interest), there needs to be a level of stiffness maintained throughout the run.

I have done some reading and research about fascia the past year. I had a privilege to interview Dr. Robert Schleip for my office blog and I was led to believe that changes in the fascia can be achieved, but it would take time for long term changes to be seen.

Just my two cents. Keep up the great work!

 

Thanks for the study Athol. I actually had read this study and referenced it in my study. The thing about this study was the trigger point release was manually done by a trained therapist and the DF was static active dorsiflexion. But a good study nonetheless demonstrating the association between trigger points and hypomobility.

Thank you both for taking the time to read my post!

 

Hi Emily,

I realise there is quite a difference between your study and the static dorsiflexion one. Just put it up there as I had recently come across it.

If you have a PDF copy of your study I Would like to read it if possible?

My is Email

info@multisportpodiatry.com

Sincerely,
Athol