Notes Session #2 The first gravity organization system is the relationship of the head with space. The inner ear and the suboccipital muscles are critical here. The second gravity organization system is the relationship of the feet with the ground. Balance depends on seeing, inner ear, feet touching ground Goals 2nd Session Begin to establish bilateral support in legs Overall goal of series for legs - Weight of the body can ground all the way down through the structure to the floor, lift from the ground up. These two forces can move equally, easily and simultaneously through the body. The 2nd session s part of this journey usually has to do with transmission of weight and impulse/lift in the feet and lower legs Differentiate Lateral and Medial arches (landing foot and take-off foot) - feet should not torque in walking: it would diffuse energy that should be directed up to the spine. Differentiation of lateral and medial arches allows foot to stay neutral while tibia rotates and talus glides. 3 arches have the next level of differentiation and function. Arches act both as spring and shock absorber. Lateral arch (landing foot) - As foot comes down (in walking) into heel strike, weight transmits down fibula, into calcaneus, navicular and 4th and 5th metatarsals Transverse arch - Functional differentiation between bones of sub-talar region - navicular, cuboid, cuneiforms - In weight bearing phase of walk, subtalar region flattens and distributes weight, in push off phase bones spring back elastically into arch formation.
- Capacity of transverse arch to transmit weight from lateral arch into medial arch and big toe for push off. Medial arch (take off foot) In push off phase of walk, impulse come through medial arch and off of the big toe. Lateral arch supporting medial arch-appropriate arch relationship. Begin to open "eye of foot", the space in front of the heel on plantar surface (an open "eye of foot" is a necessary componenet of a functioning longitudinal arch) More even tonus in plantar fascia Breathing interosseous membrane. weight comes down fibula into "landing foot". weight comes up tibia from push off foot. fibula can adjust to tibia up and down and side to side.. Allows for talar glide. Flexibility and softness in fascia of the shin (motility and mobility) A smooth coordination of toes, ankles and knees in walking (toes, ankles and knees can all bend) - Client uses toes - In standing, weight distributes onto toes - In walking, force of the pushing off comes off of big toe. - Functioning hinge movement in ankles when client walks - In walking movement, knee can fully extend, in push off phase (not hyper-extend) and can bend with differentiation from upper and lower legs in swing phase. Begin opening palintonic lines of the lower leg Next degree of differentiation and lengthening in erector spinae when client goes into a C curve. - In forward bending, erectors can span and lengthen - Spine can go into a long, smooth, unified C curve in sitting, with support from feet No toe hinge = no hip extension = no psoas
Ankle locked = locked/compressed lumbars Effect on diaphragms above Effect on gait Toes should orient the gait Feet should not torque on take-off Fibula / foot / IOM all adapt first to disorder elsewhere. Functional Explorations Session #2 Sitting and Standing Balance We're looking for a balance the person can let go into, instead of put in place and hold. Thus the change requires attention and presence, not effort Sitting Balance Chairs - Height - Knee slightly lower than thigh - Too high strains knees - Knee higher than pelvis puts pelvis posterior and loses support of pelvic floor. - Seat of chair is parallel to floor. You can correct it with folded sheet, telephone book etc, when it inclines backward. Sitting - Triangle of pelvic floor/weight just in front of sit bones - Feet - Contact of whole sole, toes, heels, lateral and medial arches. Eye of foot open triangle between pelvic floor and feet - Adjusting in Trunk - Hip hinge Lumbo-sacral hinge - LDH (weight of sternum can rest over pubes-center of chest block over the center of pelvis)
Breath in the belly will release and soften when you find this balance Shoulder girdle (yoke centered over support of rib cage) - Press down on shoulders to test Standing Balance Balanced Perception - Weight down into feet. Stimulating "out breath foot" (calcaneus, cuboid, Feet 4th and 5 th metatarsals and toes) will help weight come down into feet - Perception into kinesphere. Stimulating "breath in foot" (talus, navicular, cuneiforms 1 st, 2nd and 3r toes and metatarsals) will open space orientation and up direction Whole sole of foot can contact ground - Heels, - Toes /toe pads - Lateral and medial arches - Knees soft (neither flexed nor hyper-extended) Pelvic shift - Shifting pelvis forward, brings G1 post - Shifting pelvis backwards brings G1 forward. Weight of heart over eyes of feet Yoke of shoulder girdle balances over ribcage AO joint Experiential exercise: laying on floor, legs bent at a right angle, feet on the wall, pushing the wall away, while differentiating landing foot from taking off foot, and connecting to lumbars. Demo: working with the above exercise with a client a)laying on floor with feet against the wall; b) laying on table, one leg bent and pushing off from lumbars while differentiating other foot's medial and lateral arches.
Experiential exercise: laying down, pressing feet against the wall, as if wanting to send the wall away, and taking awareness to L foot sesamoid bones, while at the same time reaching across chest with R arm, then b) reverse (R foot sesamoid bones and L arm reaching across) Plantar fascia problems: lack of resilience in arches. Teach push and\reach with feet. Heel spurs: teach client to bring torso forward first. Bunions: differentiate medial and lateral arches and teach client about sesamoid Bones. Session 2 Principles and Order of Events for Structural Integration Adaptability (Preparatory) Principle Rolfing the foot is preparation for use of whole body in gravity. Rolfing the foot prepares the base of support for the whole back to be able to lengthen Motility precedes mobility- in the 2nd session look to the motility (liveliness in the tissues in the lower legs) Is the circulation good? Are lower legs whiter and skinnier than the rest of the body? Does the tissue have healthy spring to it or is there edema? Is there dry lifeless tissue that feels wooden? Differentiation/Mobility precedes position What kind of mobility or lack thereof do you see in the lower leg and foot? *toe hinge *subtalar region *arches are they nice and springy? high and fixed (no spring)? low and flat? * ankles--do they function like a hinge? * knees--do they bend when the person walks? Do they have hinge function or have rotational forces pulled them off true? What kind of mobility or lack thereof do you see in the spine?
*when the person lengthens foreward in the C curve is the movement of each vertebra distinct from the others? Are there flat spots in the movement? Can each vertebra lengthen away from the one beneath it? Appendicular precedes axial order-- support in the feet sets up the capacity of the spine to lengthen. continuity of motility, mobility and tonus with the spine in the c (primary) curve precedes healthy mobile, motile secondary curves--the second session back work is about mobilizing and differentiating the primary C curve Congruence of segments precedes higher order --in the rotations and counter rotations of the lower legs and feet is where frequently are found many contradictions and incongruences. Order and support in the legs and pelvic girdle precede order in the core Organization of sleeve, axial complex and cranium precede order in the core In the 2nd session we also begin setting up the core work. Appendicular order precedes sleeve order--the 2nd session sets up the sleeve work in the third and future sessions. Support Principle Order is a function of available support Jan Sultan and Jeffrey Maitland Functionally, how well the person is supported by their feet and lower legs will tie into issues of support and grounding on many different levels Better function at arches, better support from foot and better relationship between hinges of leg (metatarsal, ankle, knee and hip) is the basis of all our future work Order and competence in feet precedes functional economy at hip Adaptive capacity at hips precede order in the spine Order in axial complex precedes easy carriage of head In the 2nd session, we begin putting in the support that will echo all the way up through the body Palintonic Principle By easing the Lines of Transmission a Palintonic line/plane begins to be
revealed. The appearance of Palintonic Lines are indices of order Jan Sultan and Jeffrey Maitland The establishment of three working dimensions precedes working with rotational issues--having a well defined front and back of the foot (space for heel and eye of the foot ) works the front back dimension. Balancing the medial and lateral arches of each foot, and the feet with each other works with the side to side dimension. These changes open the posibility for the spine to lengthen (vertical dimension) -- In the 2nd session, we work both lateral and medial lines of the lower leg. Palintonic order and lines result in the leg when the medial and lateral lines balance each other. This balance manifests as more or less equal length in the medial and lateral lines and the capacity of both to transmit weight downward and lift upward. It will also manifest in horizontal function (which we begin looking for today) at toe, ankle and knee and hip hinges. We find this balance by beginning to ease the lines of transmission in lower legs and feet. -- The dimension being addressed in the 2nd session is the horizontal. --The 2nd session is the deep session in the 1st cycle (1-10) of the 10 series 1997 Lael Katharine Keen