I need some exercises for my athlete who is complaining of pain in the arch.
Hey Mary…
Great question.
First of all, athletes are a really special bread of clients and live by rules that are seperate from which we would assign to the average client. When talking about an athlete, we are talking about someone who is “training,” to perform better and not necessarily someone who “wants,” to workout or just trying to live a healthy lifestyle and alter body composition. Although, we never want to injury any client, the way we program an athletes training is going to be much different and at times through a little more caution in the wind.
That being said, irregardless of an athletic goal or not, all clients should always start off with an assessment. Everyone in this world who moves has to deal with gravity and how the earth pushes back on our body. Our kinetic chain starts off at our foot and ankle and continues up through the head and neck. Basically, what this means is that if there is a dysfunction at your foot it will change how your knee, hip, shoulder, so on is effected. So my recommendation is to not wait until their is a problem to take action. Remember our number one goal is that our player, plays.
So lets pretend this is day one with your client and ask yourself “WHAT SHOULD I DO?”
I think its important to sit down with everyone and figure out what it is that they want, and also what they are going through. Listen to their history with pains an injuries at any joint and begin a profile. The next step would be to assess their structure.
I wont drag this out too much for you, but we will look at foot in great detail. For me, I take a lot of time looking at the feet. Its a requirement for me to see the foot without shoes and socks. From a standing position, I will visually compare each foot from the front, side and back. From the front, I will look mostly for clues in the toes. With someone who suffers from overpronation, you will probably see a bunion and a big toe that looks like it is trying to “get out of the way.” From the sides (both lateral and medial) I look at arches. Again, the overpronater is typically the person with plantar fasciitis, they will show flat feet with little to no arch. When, I look from behind the client, I am looking to see if I can see the big toe or the lesser toes. Usually a person who loses their arch, you will see more of the lesser toes, which means their feet are abducting.
All this information is really important because it tells that joints aren’t in their correct spots and therefore cant be doing their jobs the correct way. Particularily with the feet turned out, the Achilles tendon is getting all twisted up behind the heel and wont be able to its job correctly and create the tension necessary to keep the arch when weight is being transferred with each step. It would probably be a good idea to test the soleus at this point. You can do this by kneeling (keepin your heel down) and sliding your knee forward. Note from each side which is tighter or seems more restricted. Anyways, if the soleus is too tight it wont be able to slow the knee down and all kinds of stress is ultimately going to placed in the IT band because the glute wont be able to turn on.
Hopefully, that wasn’t a waste of your time because I know we don’t have time machines we can use.
Anyways, what do you do now?
If this wasn’t an athlete or that athlete wasn’t in season you would totally have to advise them to stop running. Each step they take is kinda like driving on a car with break pads that are severely worn. The strategy at that point, you have already read. SMR for soleus, gastroc, and peroneals, but DONT FORGET THE ARCH ITSELF (golf ball is great for this). Active isolated stretching for the same areas PLUS the IT band, glute and piriformis. At this point you are trying to lengthen short muscles, the next step is to increase communication of synergistic muscles and get the glutes working efficiently with the rest of the body. This is done with progressive strength training.
If your athlete is “in-season,” you are in a little a bind because it is much harder to get them to “not” run.
hope this helps,
Jeremy