SPRAINS & STRAINS of the joints are such a common occurrence that most of us expect to be experiencing one or the other at some point in our lives. (click on picture for larger image)
They most commonly affect the ankles, toes, knees, wrists, and fingers. However, this type of injury may also occur at any joint of the body, such as the shoulder, elbow, jaw (TMJ), and anywhere along the spine. A strain only involves the muscle fibers, while a sprain refers to injury to the joint ligaments.
We tend to think of sprains & strains of being just a local event (at the joint) and treat the injury accordingly. However, sprains & strains rarely, if ever, are isolated events. In the picture above we can see the injury not limited just to the ankle but also extending to the leg above and the foot and toes below the ankle.
Joints are the connection points between two or more bones. They are reinforced by connective tissue such as ligaments and often protected by a joint capsule, also made up of connective tissue, containing synovial fluid for cushioning. Moreover, the ends of the bones of these joints are covered with cartilage that functions somewhat as shock absorbers for protection.
Furthermore, muscles attach to bones across a joint, sometimes two joints, via tendons, another form of connective tissue. To top it off, the whole package — muscles, tendons, joints, joint capsules, and bones — is covered by a another type of connective tissue (fascia) that wraps around every small and large component of this package. It’s important to remember that this package not only contains the muscles, tendons, ligaments, and bones but also blood vessels, nerves, lymph vessels, and meridians ( the energy pathways of the body).
Thus, a pull or tear of the tendons, muscle fibers, or ligaments also distorts the fascia, and is transmitted to structures further away from the location of injury. Let’s explore this point by looking at the ankle joint.
The ankle joint is formed by the tibia, fibula, calcaneus, and talus. These bones are held together by the deltoid ligament on the inside (medial aspect) of the foot, and the anterior and posterior talofibular ligament, as well as the calcanofibular ligament on the outside (lateral aspect) of the foot. These ligaments connect the lower (distal) ends of the tibia and fibula (lower leg bones) with the talus and calcaneus (foot bones).
The upper (proximal) ends of the tibia and fibula connect with the femur, forming the knee joint. Thus a strain or sprain of the ankle also travels up to the knee. Moreover, the femur connects to the hip bones (pelvis), forming the hip joint. The pelvis articulates (connects) with the sacrum, which is the large triangular bone at the lower end of the spine, and the spine articulates with the head. Therefore, the original injury to the ankle may have ripple effects all the way up to the head via the spine.
Of course, such an ankle sprain or strain also impacts the other foot bones and joints through the various tendinous, ligamentous, and fascial connections, potentially causing foot pain and/or restrictions as well.
This ripple effect is made possible by the tendinous, ligamentous, and fascial connections across all the joints. Nothing is seperate or isolated. When the ankle twists, the ligaments, tendons, and muscles twist as well. The muscles tell a similar story.
A sprain or strain of the ankle may pull the tibia out of alignment not only with the talus below but also with the femur above, making the knee unstable as well.
The gastrocnemeus muscle crosses the ankle joint via the achilles tendon, and the knee joint in the back of the leg via its other attachments. The small popliteal muscle crosses the knee joint in the back of the leg. Thus, an ankle sprain or strain may cause posterior knee pain and/or misalignment of the knee joint.
The quadriceps muscles (quads) of the anterior thigh cross the knee joint in the front of the leg to attach to the tibia via the quadriceps tendon below the knee cap (patella), which is part of the tendon. An ankle sprain or strain will tug at the quadriceps tendon, which transmits the force up the thigh to the frontal (anterior) aspect of the hip bone, called the anterior inferior illiac spine (ASIS).
Furthermore, the hamstring muscles of the posterior thigh attach to the tibia below the knee and the femur, as well as the seat bones (ischial tuberosities), which form the lower portion of the pelvis. Thus, an ankle strain or sprain may travel up the leg to the pelvis via the tendons of the muscles.
Not to forget, we have muscles that let us pull the legs toward the midline (closing the legs, or crossing the legs). These are the adductor brevis, longus, and magnus muscles, as well as the pectineus, sartorius, and gracilis. Pain from an ankle strain may thus also travel up the inside of the thigh and into the pelvis, where most of these muscles have attachment sites as well.
Again we see that, due to the intricate connections between all structures of the body, no injury, however small, happens in isolation.
With good luck, and physical therapy, the injury heals well enough. The pain disappears and function is restored. Often though, we loose some of the original range of motion and resilience of the joint. This occurs, because the fascia becomes sticky and toughens up. It tightens around the structures of the joint, restricting its freedom of movement in small or large ways. We often don’t notice this because we don’t remember excactly how well we used to be able to move the joint. We become used to the new way of being, establishing a new baseline for ourselves.
Sprains & strains not only affect the muscles, tendons, ligaments, and joints. They also twist, stretch, and compress the blood vessels, lymph vessels, nerves, and meridians of the joint. The injury thus impairs blood flow, lymph flow, and nerve conduction, resulting in edema (fluid accumulation), bruising, impaired transport of nutrients to, and transport of toxins away from, the tissues, as well as disruption of energy flow through the meridians (energy pathways of the body). The reduced energy flow along with impaired nerve conduction may lead to muscle weakness. Moreover, the connective tissue, which weaves through and envelops all these structures, is also stretched, twisted, and compressed by the injury. Over time, it becomes sticky and tight, holding the structures within it hostage, sort of like a straight jacket.
Energetic Unwinding of the Spine, Joints & Muscles is ideally suited to “untwist” the connective tissue (fascia, tendons, ligaments, etc), reducing its stickiness and tightness to restore more, or all, of the original range of motion and resilience of the joint. This unique therapy helps the body to heal from the injury, whether acute or chronic, not only at the site of the injury but also at the distal sites affected by the injury.
Energetic unwinding of the spine, joints & muscles is a tailormade fusion of craniosacral therapy, acupressure, and soft tissue work. This therapy is gentle and very effective.