Plantar Fasciitis / Heel Pain/ Heel SpursMany people can suffer from Plantar Fasciitis at some point in their lives. It is a very common condition that presents itself as pain in front or side of the heel bone (Calcaneus).What is Plantar Fascia?The soles of our feet have a tough complex layer of Plantar Fascia (PF). This dense fascial web creates a flexible springy cushion under the soles of our feet.  It protects the bones by reducing impact and reinforcing the musculature giving our feet strength and resilience.  It connects the bones of our toes to the Calcaneus, merging into the Achilles tendon and calf.  In Anatomy Trains this is just one part of the Superficial Back Line. (Image showing part of Superficial Back Line in Anatomy Trains, Myers 2000)What is Plantar Fasciitis / Plantar Heel Pain / Heel Spurs?Plantar Fasciitis is the medical term for thickening of the Plantar Fascia (PF) in the sole of the foot.  The thickening causes shortness in the length and breadth of sole pulling the Calcaneus forward causing inflammation - Plantar Heel Pain.  If untreated Heal Spurs can also develop.  The thickened / shortened PF pulls the heel bone forward towards the toes, it tugs on the periosteum (membrane) of the Calcaneus creating a gap between the edge of the Calcaneus and periosteum.  Over time Osteoblasts fill this gap with new bone which forms into a Heel Spur. (Image from Anatomy Trains, Myers 2000)The cause of pain underneath the foot and heel is commonly suggested to be from over-use, weight gain and age.  KMI Structural Integration Practitioners can recognise the signs and treat before the pain begins, meaning Plantar Fasciitis, Heel Pain and Heel Spurs are unlikely to develop. In practice it is extremely common to find feet that are stiff and tight. Their movement into dorsi flexion (lifting foot/toes towards head) and plantar flexion (pointing toes/foot towards floor) is limited and the arches of the foot have lost their spring.  If left untreated and an individual either over-uses their feet and/or increases in body weight, the PF may begin to show signs of strain resulting in Plantar Fasciitis.When we walk, run and play; feet are our shock absorbers, they need to be flexible.  The arches should be sprung to allow the foot to spread on impact and propel us forward on strike off. Over time the whole foot can lose its shock absorbing ability. This could be due the types of shoes worn which prevent the foot from moving freely; physical inactivity; poor flexibility and tightness in the whole Superficial Back Line.Postural Problems Associated with Plantar Fasciitis.Sufferers of Plantar Fasciitis can present aches and pains elsewhere in the body because of subtle subconscious compensations needed to avoid exacerbating the pain.  If for example pain is felt in the right heel we naturally avoid putting weight onto this area.  Weight may be taken 1; on the sole of the foot, 2; to the inside or outside of the heel or 3; carried through your left foot.Putting weight on the sole of the foot to keep our heels off the ground shortens the calf which is myofascially linked to the sole of the foot through the Achilles tendon.  A shortened calf puts more strain on the Achilles tendon, Calcaneus and PF. Although this relieves the pain it shortens the Superficial Back Line further and can make the overall problem worse.  Putting more weight onto the inside or outside of the heel avoiding the sore spot directly effects left to right foot balance. Your inside arch will be higher when protecting the inside of the heel, or collapsed if protecting the outside of the heel.  The balance of the arch immediately affects the balance of the knee. If the inside arch collapses the knee will also collapse which may develop into a weakness and over time cause uneven wear to the knee joint.Carrying more weight on the left foot, we alter the forces going through the pelvis which impacts spinal function. Optimum pelvis function comes from both horizontal and front-to-back balance. By taking more weight through the left leg, we upset this balance. If this is for a long period of time, we will develop a permanent postural compensation. Pelvis horizontal balance is lost, putting strain on the lumbar vertebrae in the back causing back ache. The left shoulder will become sore causing strain on the right hand side of the neck.These may sound extreme but if the compensations are left un-noticed or worse, untreated problems surface in the knee, lower back, shoulder and neck long after the Plantar Fasciitis has been cured.   How can Plantar Fasciitis be cured?Whatever the reason for loss of flexibility in the foot, the wonderful news is that living connective tissue and fascia can be improved. Fascia is a living organism and whilst we are still alive it continually adapts to its environment.  Common remedies like stretching the sole of the foot by rolling it over a ball, lowering the heel off the stairs, hamstring and calf stretches will all help cure Plantar Fasciitis.  Taping may also offer some relief by preventing the foot moving beyond its place of comfort straining the inflamed PF.Feet that present these symptoms often feel hard and grainy (like sand paper) beneath the skin to a trained practitioner.  This is due to dehydration in the plantar fascia. The beauty of having hands-on KMI Structural Integration is that it can help cure Plantar Fasciitis faster by getting to the root of the problem - thickened and shortened Plantar Fascia (PF).  A KMI practitioner will work to specifically increase the length and flexibility of the PF and calf whilst balancing the arches of the foot. The PF will rehydrate regain its suppleness and health.  Your whole foot will feel more supple, toes will become more spread apart, you will feel more connected to the ground, your feet will be more comfortable in shoes (or barefoot) and your body will feel like is has a solid base on which to perform all that you ask of it.To find out more, have a free consultation or to experience KMI Structural Integration, please do contact Angela Donovan of Structural Balance via telephone 07950 028 016 or email info@structuralbalance.co.uk.  

Do you suffer from shin splints?It is common for athletes to suffer from shin splints. Many do not know they can be resolved through KMI Structural Integration.Shin splints is a term used to describe medial tibial stress syndrome which is felt as pain and inflammation on the inside or more rarely, outside of the shin bone (tibia).   For the lower leg to function correctly all the muscles need to freely slide over each other, expanding and contracting as the foot moves.  When tightness or imbalance of these muscles occurs, fascial connections to the tibia become strained causing pain. What is fascia? Please click here for more information.The diagram below shows the anatomy of the lower leg, looking internally from above, below the knee.  The area of shin splints being identified by the red box on the left.  The lower leg can be split into four fascial compartments  published by Tom Myers in Anatomy Trains 2001. Within each fascial compartment, each muscle has its own fascial wrapping.  When running, the demand for function is greater, impact and planes of motion increase because of varying terrain and techniques.  Incorrect function, over training and/or lack of stretching can lead to muscle tightness.  When muscles don’t contract or expand as they should, the fascial wrappings which connect to the periosteum of the tibia become over stretched and strained causing inflammation and pain - shin splints.To relieve shin splints, many sufferers rest and begin running gradually with the aim of improving muscle contractile ability and function.  However this may take time and does not work for everyone.  KMI Structural Integration can remove these fascial restrictions, release tightness held in the muscles of the lower leg and regain correct function.How is KMI Structural Integration different to a normal massage?Massage is excellent for restoring muscle function and improving blood flow. KMI Structural Integration works at a deeper fascial level.  When looking at person with shin splints, the whole gait of the foot and leg is assessed.  The aim is not only to relieve the pain of shin splints but also restore correct balance and function of the foot and leg which affects whole body balance and function. To find out more, please contact Angela Donovan of Structural Balance

If you are suffering from knee pain, you are not alone - it is a very common complaint. A postural example to share that I often see in practice is where patients have an X leg pattern (below images) ‘knocked knees’.  This can be in one or both knees, the example below is showing the right knee. When this happens the pattern seen in the soft tissue is as follows:The L image below shows the right side of the pelvis being lower than the left which we call a right tilt of the pelvis.  The alignment of the right knee is being compromised, creating a strain on the inside of the knee.  The left hip is higher changing the weight distribution into both legs.  Instead of the weight being even through the centre of both legs, the right leg becomes a stabiliser with the line of force moving to the outer edge. The weight distribution into the left leg will be less and the line of force will be to the inside of the leg. Often clients are aware of feeling out of balance when they walk and be experiencing lower back pain.  So whats happening in the soft tissue when this happens?The left femur (thigh bone) is held deeply into the hip socket by tight Gluteus Medius and the anterior Adductor muscles. The inner arch of the foot can also lift.  In the Anatomy Trains lines, we are looking at tightness in the Deep Front Line below the pelvis. On the right side the deeper muscles underneath the Glutes tighten, Gamelli's and Quadratus Femoris, plus the lateral hamstring - Short Head of the Bicep Femoris (SHBF) and Vastus Lateralis tighten. Over time a fascial adhesion builds between the femur and the SHBF which pulls the knee inward and we experience pain on the inside of the knee and/or underneath the Patellar.  Beneath the knee the foot balance is altered dropping the inner arch because the Peroneal’s tighten on the outside of the Fibula reducing ankle mobility and unbalance the calf and Soleus. This is the Anatomy Trains Lateral Line.  When this happens we have no option other than to move out of alignment putting our right knee, ankle, hips and spine under strain. Often we are told to strengthen our quads to support our knee but if this imbalance is not corrected, no amount of quad strength will help. Above the pelvis the compensation pattern continues. The left side/waist becomes very tight superficially beacause Quadratus Lumborum and the diaphragm become restricted. The right side of the ribcage becomes restricted and the right Psoas and spinal muscles tighten to stabilise you. This pelvis imbalance is often the primary cause of lower back L4 & L5 spinal problems. The shoulders and neck become compromised too because superficial tightness of the ribcage restricts shoulder movement which tightens our Trapezius and Pectoral muscles and a tight Psoas pulls the neck forward and down creating problems in the C7 Vertebrae area. Standing tall and upright becomes increasingly more difficult. What can help correct knocked knees reducing knee pain?Orthotics can help lift the inner arch of the foot but if used for long period of time also weaken the foot structure.  Stretching can help release tight areas and strengthening exercises will assist; but many people do not experience lasting change until the pattern is addressed.KMI Structural Integration can alleviate knee pain and its compensations felt throughout the body.  In this example lengthening the stabilising R Lateral Line and releasing the Left Deep Front Line through hands on techniques and movement will bring the pelvis back into horizontal balance and balancing the weight distribution taking strain away from the affected joints.What makes KMI different is the approach of fascial release whilst focusing on whole body alignment which creates lasting change.  To find out more, have a free consultation or to experience KMI Structural Integration, please do contact  Angela Donovan of Structural Balance via telephone 07950 028 016 or email info@structuralbalance.co.uk. 

This is a good little stretch for you hamstrings. My own invention... My intention here is to draw your attention to any imbalance you may have between the inner and outer hamstings and begin to balance them. Many, if not all clients have a difference between in tension on the inside of the leg to the outside and it is commonly the opposite in the left to right leg. This imbalance acts as a pully system to your pelvis putting it in a torsion which upsets your whole structure often resulting in aches or discomfort in our back and or knees. Follow my instructions and slowly feel where you may have an imbalance. Slowly rock your pelvis and body left to right. Try to not let one side of your pelvis, creep forward, keep it level with the opposite side, this will isolate the shortness in your hamstrings and make the stretch effective. Move slowly, not fast.  Moving fast with only engage elasticity, moving slowly will start to change your tissue. Who this exercise is not forAnyone in acute back pain or who has unstable lumbar vertebraeAnyone with knee instability Anyone who will struggle to put weight through their hands or shoulders. Raising the surface you lean on will make it easier.  

My Pilates teacher taught me this. It is a gentle Feldenkrais exercise to help mobility of the lower back. The intention here is to improve the ability for your pelvis to move separately from your ribcage and thus improving mobility of your waist area. Follow my instructions and slowly feel which side of your waist and even thigh feels tightest. Dont necessarily feel for discomfort as it can be misleading. Look at how far your knees can move side to side, how much of your body is pulled in that direction. You should be able to rock your knees to the side without your shoulder moving. I.e if when swinging your knees left, right shoulder should stay comfortable and flat not lifting.  When you lie on your side and rock the top knee forward. Be sure to stabilise your ribs with you arm so they stay still in the exercise. It is a common mistake to allow your ribcage to roll with the moving knee. Again be slow and look to see how far forward and back your knee can move. Work gently until the movement becomes the same and then swap to do the other side. Move slowly, not fast.  Moving fast with only engage elasticity, moving slowly will start to change your tissue. 

I am a keen horse rider and getting tight in my inner thigh is very common. I do this exercise and it makes a tremendous difference to my pelvis position, gait and to influence how the horse can lift its shoulders and back beneath me.   The intention here is to improve the ability for your femur to move in relation to your pelvis. Reduce an anterior tilt if you are lordotic in your back or reduce a flat back if you have a posterior tilt of the pelvis. The difference between the two is how you stretch. Anterior pelvic tilt - lordosis of the lower backYou will be tight in your quads and front half of your adductor group (inner thigh).Posterior pelvic tilt, flat backedYou will be tight in your hamstrings and the back half of your adductor group (inner thigh)Don't assume it's the same in both legs, they have the opposite tightness happening. :-)Follow my instructions and slowly feel which side of your pelvis you can do those little circles with easier? Don't necessarily feel for discomfort as it can be misleading. Look at whether you can get into that position with your legs wide without your lower stomach / pubic bone being pulled downward towards the ground. If it is, reduce the width of your stance and keep trying to increase it daily. Move slowly, not fast.  Moving fast with only engage elasticity, moving slowly will start to change your tissue. Slow small circles, maintain the stretch throughout the circumference of the circle.