Remedial massage for foot and ankle osteoarthritis

Overview: Arthritis is inflammation of one or more of joints. It can cause pain and stiffness in any joint in the body, and is common in the small joints of the foot and ankle. There are over 100 types of arthritis. The most common forms are osteoarthritis (degenerative joint disease) and rheumatoid arthritis.  Osteoarthritis is a disease that affects the whole joint including bone, cartilage, ligaments and muscles. It may include:

·       Inflammation of the tissue around a joint

·       Damage to joint cartilage

·       Bony spurs growing around the edge of a joint

Osteoarthritis is a progressive disease; signs and symptoms gradually worsen over time. There is no cure.

Anatomy of foot and ankle osteoarthritis:

Three bones make up the ankle joint, primarily enabling up and down movement. There are 28 bones in the foot and more than 30 joints that allow for a wide range of movement. The foot and ankle are the focal points to which the total body weight is transmitted in ambulation, and they are well tailored to that function. The thick heel and toe pads perform as shock absorbers in the acts of walking and running and the joints are capable of the adjustments necessary for fine balance on a variety of terrain. Because of this concentrated stress, the foot and ankle are often involved in static deformities not ordinarily affecting other parts of the body.

Cause of foot and ankle osteoarthritis:

Osteoarthritis also known as degenerative or "wear-and-tear" arthritis, it is more common among females than males, especially after the age of 50 years. Younger people may also be affected; usually after an injury or as a result of another joint condition.

Symptoms of foot and ankle osteoarthritis:

·         Tenderness or pain (when walk, or bear weight)

·         Stiffness (especial in the morning)

·         Swelling in the joint

Benefit of massage for foot and ankle osteoarthritis:

·         Improving circulation

·         Reduce swelling

·         Relax and soften injured, tired, and overused muscles

·         Increase joint flexibility

·         Reduce pain

Massage techniques:

1.    Effleurage

A/ Effleurage each digit firmly from phalanges to tarsus

B/ Effleurage from phalanges to tarsus cover all dorsal surfaces

C/ Effleurage along Achilles tendon with fingers

2.    Kneading

Thenar eminences together on dorsum; fingers on plantar surface, gently separate each metatarsal using a scissoring action. Work medial to lateral.

3.    Friction

Thumb friction cross fiber, backwards and forwards, on both sides of the ankle ligaments

4.    Knuckling

Circular and rectilinear frictions to plantar surface, using knuckles and fists

5.    Passive movements to foot

A.   Rotation of phalanges: Grasp proximal phalange with one hand, support proximal to MTP joint with other hand. Rotate each phalange slowly and gently in both (clockwise and anti-clockwise) directions.

B.   Traction of phalanges: Support at above. Apply tension gently to separate joint. (Use a hand towel if a better grip is needed.)

C.    Extension of phalanges: Support proximal to MTP joints with one hand. Grasp phalanges with other hand and gently extend

D.   Flexion of phalanges: Support as above. Grasp phalanges with other hand and gently traction and flex.

E.    Rotation of talo-tibial joint: Support calcaneus with one hand; other hand proximal to MTP joint. Rotate talo-tibial joint clockwise/anti-clockwise/figure of 8.

F.    Dorsiflexion of talo-tibial joint: Support calcaneus with one hand and lift slightly; other hand on plantar surface. Move foot into dorsiflexion, using body weight.

G.   Plantar flexion of talo-tibial joint:Support calcaneus with one hand and lift slightly; other hand on dorsum. Move foot into plantar flexion.

H.   Inversion: Thumbs together on dorsum, proximal to MTP joints, turn plantar surface medially.

I.    Eversion: Thumbs together on dorsum, proximal to MTP joints, turn plantar surface laterally