Treating Bunions & Hammer Toes

Bunion or Hallux Abducto Valgus

Bunion or Hallux Abducto Valgus

Hammer Toe

Hammer Toe

Claw Toe

A hammer toe, or Hallux Abducto Valgus, is a structural distortion caused by contracted toe flexor muscles, also called flexion contractures, usually in the 2nd, 3rd, or 4th toe. Two of the toe joints are in extension and one joint in the middle is in flexion causing it to be bent resembling a hammer.

 Claw toes is a similar condition where two joint are both in flexion resembling a claw.

 Causes: The most common cause of hammer toes a is wearing poorly fitting shoes that force the toe into a bent position, such as high heels or shoes that are too short or narrow. Having the toes bent for long periods of time can cause the muscles to shorten, resulting in deformity. This condition, could be hereditary, and is often found in conjunction with bunions or other foot problems. Other causes include tight muscles, muscle imbalance, neuromuscular or joint disorders such as gout or arthritis, stroke, or diabetes.

A bunion is a deformity where the big toe points laterally, toward the second toe when pressure is applied to the side of the big toe forcing it inwards towards and sometimes under or over the second toe. Symptoms include irritated skin around the bunion, joint redness and pain when walking, and a shift of the big toe toward the second toe. Blisters may also form more easily around the bunion. It occurs more often in women than men, but it is undetermined if this is due to a structural cause or associated with a particular type of shoe.

Causes: The deformity is caused by a variety of biomechanical, structural, or genetic factors including poor footwear, lax ligaments, weak muscles, or abnormal bone structure. The most frequent explanation for bunions is caused by wearing narrow shoes that squeeze the toes.   Orthopedic Assessment by Whitney Lowe

Treatment:  Soft tissue treatment for hammer toes and bunions is similar. I always balance the pelvis first, then release fascial restrictions and balance all the muscles in the legs and the feet before stretching the muscles and plantar fascia that flex the toes.  Arthrokinetics, which is joint movement—compression and traction followed by gentle lateral flexion of the restricted joints, creating joint space and mobilization, can help reduce calcification and start to reverse the effects of bunions and hammer toes.   Clinical Massage Therapy, James Waslaski

More severe or longstanding cases may require orthopedic surgery, where the doctor detaches part of the bone of the affected joint, to correct the deformity

Home Self-Care: It’s necessary to wear correct footwear to restore your feet back to their natural shape. Avoid narrow shoes that push your toes forward and focus your body-weight down on your toes instead of evenly distributing it along the length of your foot. Wear less restrictive sandals whenever possible.

Spending as much time as possible walking barefoot can prevent and even heal some bunions. Walking on uneven terrain, sand specifically, is especially good exercise that strengthens your toes and allows your joints to work naturally.


Osteoarthritis Relief

Lengthening the Fascia of the Palm

Myofascial Spreading Stroke

Arthritis is the most common cause of disability in the USA. The major complaint by individuals who have arthritis is joint pain, often localized to the joint affected, making it very difficult for the afflicted to be physically active. It’s estimated that the total cost of arthritis cases is close to $100 billion.

There are over 100 different forms of arthritis, the most common form, osteoarthritis, a degenerative joint disease, is usually a result of trauma to the joint, infection of the joint, wear and tear, or age.  The other major type of arthritis is rheumatoid, an autoimmune form of arthritis. Septic arthritis is caused by joint infection Stedman’s Medical Dictionary for the Health Professions and Nursing Defines osteoarthritis and rheumatoid arthritis:

Osteoarthritis – Characterized by erosion of articular cartilage, which becomes soft, frayed, and thinned; pain and loss of function result; mainly affects weight-bearing joints, more common in women, the overweight, and older people, characterized by swelling, redness, pain, and restriction of motion.

Both osteoarthritis and rheumatoid arthritis cannot be cured, but the condition can be prevented from worsening. Structural imbalances cause uneven stresses on the joints, between cartilage, ligaments, and other supporting soft tissue around the joint.This structural misalignment and tension from the imbalance often causes binding and uneven pressure in the joint capsule leading to joint degeneration. Physical therapy and clinical massage therapy & bodywork can be very helpful by balancing muscles around the joint–strengthening the weak inhibited side and lengthening the strong contracted side.

Rheumatoid arthritis – A systemic disease, occurring more often in women, affects connective tissue; arthritis is the dominant clinical manifestation involving many joints, especially those of the hands and feet, accompanied by thickening of articular soft tissue,  often chronic and progressive, leading to deformities and disability. Drugs to treat rheumatoid arthritis range from corticosteroids to monoclonal antibodies given intravenously.

 Common symptoms: varied levels of pain, joint swelling and stiffness, ache around joints, difficulty walking or difficulty using hands, weight loss, poor sleep, difficulty moving the joint, muscle weakness, loss of flexibility, and decreased aerobic fitness.

In addition to Osteoarthritis, and rheumatoid arthritis, several diseases where joint pain is primary, and considered the main feature include: gout, septic arthritis, ankylosing spondylitis (arthritis of the spine), juvenile idiopathic arthritis, and still’s disease (a form of juvenile chronic arthritis).

Joint pain can also be a symptom of other diseases, where the arthritis is considered to be secondary to the main disease including: psoriatic arthritis (resembling rheumatoid arthritis often involving the digits), reactive arthritis, hepatitis, Lyme disease, Crohn’s disease, ulcerative colitis, and systemic lupus.

Clinical massage therapy and bodywork can be an effective way to ease the pain and stiffness associated with osteoarthritis. Treating it by creating joint decompression and space releases pertinent muscles and tendons, reduces stress in the joints, structurally realigning the joint, which can alleviate the pain and increase range of motion. Holistic doctors, recommend therapeutic massage and bodywork to their patients with osteoarthritis.


Range of Motion and Flexibility

Gentle Pain-Free Cervical Stretch

Gentle Pain-Free Cervical Stretch

Gentle myofascial stretch of the posterior cervical fascia

Lengthening Posterior Cervical Fascia

 Movement is more enjoyable when our bodies are flexible and capable of performing without restriction. One way to regain our childhood flexibility is to regularly practice flexibility stretches. Stretching has been popularized through sports and through activities such as dance, exercise classes, television fitness programs, video cassettes, yoga classes, and related books and publications. Therapeutic exercise also plays a crucial role in the treatment of disease or injury, and specific exercises and techniques have a significant impact in preventive medicine.

 Range of motion (ROM) is the amount of motion available at a specific joint, and flexibility, the common synonym for joint ROM, is a major consideration in sports ability, physical fitness, comfortable posture, and physical medicine. Components that determine each joint’s specific ROM include:  joints, ligaments, muscles, tendons, and connective tissue.

In his well illustrated book, Active Isolated Stretching, Aaron Mattes, one of the world’s leading health authorities, you will find movements for every area of the body designed to insure maximum ROM to relieve muscle tension, and to prevent injury. I recommend his book, and therapists who have been trained in Aaron’s Active Isolated Stretching stretching protocol.  He is the best at what he does!

We become stiff and inflexible for a number of reasons, overuse, inactivity, injury, vocational repetitive posture compensations, which produces dysfunctional soft tissue—our muscles, tendons, and fascia surrounding joints. When the tight soft tissue surrounding a joint is stretched and the weak tissue is strengthened regularly, balance between joints and normal ROM is restored.

Besides increasing and maintaining our ROM, a few other advantages of stretching include:  reducing muscle soreness by providing increased blood and oxygen circulation to the muscles, improving capacity for activity—elongated muscles require less energy to move, decreasing unnecessary muscle tension, invigorating circulatory, respiratory, and neuromuscular systems—mitigating many of the symptoms of stress, and promoting general body relaxation.

 One of the Principles of Aaron Matte’s Active Isolated Stretching, is that all the stretches in this program are held for duration of only 1.5 – 2 seconds. Longer periods of stretch will cause prolonged activation of the stretch reflex, which is a regulatory mechanism of the nervous system that is activated as a defensive protection in an attempt to avoid over-stretching and help prevent muscle-tendon injuries.

 Information from: Active Isolated Stretching, Aaron L. Mattes, registered kinesiotherapist, author, teacher, and licensed massage therapist

 By assessing my client’s range of motion I can determine which muscles are restricted and what is preventing them from performing a normal ROM. I identify tight or restricted muscle groups for my client, help the body to return to structural and functional postural alignment by removing tensions and restrictions in areas that have been held tight, by further balancing myofascial relationships throughout the entire body, and emphasizing that the home self care stretches must be performed pain free.


Common Foundations of Bodywork

Releasing Abdominal Fascia

Releasing Abdominal Fascia

Softening and mobilizing the cervical connective tissue

Softening and mobilizing the cervical connective tissue

One of the first books I read shortly after I decided to pursue a career in bodywork, that explored various types of the work, was Bodywork by Thomas Claire, an informative read that gives a vivid, first person narrative account of what each of several types of the more well known bodywork modalities actually feels like. It also includes: A definition and origin of each type of bodywork, the theory behind it, healing properties and/or spiritual and relaxation benefits, contraindications (symptoms/conditions that makes a particular treatment inadvisable), and resources for further information regarding the many types of bodywork available at the time (1995).

Today there are hundreds of bodywork modalities from Abhyyanga to Zero Balancing to  help millions just feel better and/or achieve a greater integration of body, mind, and spirit.

Even though bodywork methods and practitioners can vary greatly, there are common foundations, or recurrent themes that underlie many of the modalities in the book:

Nearly all practices were developed by people seeking to cure their own conditions.

Movement is life; stagnation is death; pain and disease arise from stagnation. The human being is an organized, patterned whole; bodywork practices aim to restore balance and wholeness.

The self is the healer; the practitioner, who only encourages the client’s innate abilities to self-correct, might better be called a teacher, facilitator, guide, coach, or mid-wife.

Change is possible; no matter how chronic a problem may be, some relief is possible. A practitioner’s greatest tools are compassion, the intention to help and to heal; the more our society becomes high-tech, the more we crave high touch.

Bodywork modalities are first and foremost touch communication. The experience of a bodywork session is registered in the intuitive and free-flowing right hemisphere of the brain. During a session, an individual might experience concentric spirals of thoughts, emotions, spiritual insights, and physical releases. These sensations can occur all at once in a multidimensional dance that may feel like an instant or an eternity.

Bodywork therapies allow us to explore the hidden places of the soul, to own what is there without shame or judgment. They permit us to reestablish a direct link with our feeling selves, including our unconscious desires and fears. It is the most effective means I know of arriving at a place of inner certitude and peace.

Massage & Bodywork is empowering. It is at the forefront of complementary health practices that will guide us well into the twenty-first century. Up to 90% of all visits to medical doctors are promoted by conditions that result from stress and lifestyle choices, such as diet, exercise, and smoking. These are all conditions over which each of us has some control. The practices presented in this book can help you become more aware of your state of health so as to prevent the onset of illness.

Information from Bodywork, Thomas Claire, practitioner, author, and teacher in New York City