After a long hiatus, we’re back with the conclusion to PMA (Peroneal Muscular Atrophy) treatment using massage therapy and home exercises. Here, we will explore the types of techniques to apply to your treatment of lower limb neuropathies and what to do over the long term outside of massage therapy.
It is vital to review the therapeutic goals for both you and your therapist. Make sure everyone is on the same page! Things may have changed in your life that have had positive or negative effects on the original plan, so perhaps an adjustment to time, pressure, or frequency of treatments might be required.
Some common goals to consider might include:
– pain relief
– balance support
– strengthening of weak leg muscles
- a robust exercise plan which works on strengthening and maintaining the muscles that remain in good health
The types of massage techniques performed should challenge your muscles into stretching and relaxing, but not so much as to over tax them. Ask your therapist about superficial reflex techniques like static contact and fine vibration to address overly docile muscles. Neuromuscular techniques may help to lengthen short muscles. Connective tissue work can help relieve muscle tension and restore range of motion. Superficial fluid work, applied to the same muscles, can be useful in dealing with inflammation at old injury sites, such as ankles and knees. Lastly, joint mobilization can be used in the treatment to assist with synovial fluid circulation and ligament stretching in and around stiff joints.
Any or all of these options can form thorough complements to your treatment from your therapist, but next, we can look at some stretches you can do at home. Stretching is vital! It cannot be emphasized enough for how beneficial proper stretching is for you, even if you don’t have a neuropathy.
- Using a blunt, round object (tennis or lacrosse ball), roll it underfoot using medium to heavy pressure to stretch your arch. Move slowly and hold the ball where the stretch is felt most intensely for 30-60 seconds, as many times a day as you can fit in.
- Using the stairs (carpeted or with cushioning), facing upstairs, gently press your toes into extension against the base of the step, again holding the stretch for 30-60 seconds. Next, turn around so you are facing downstairs. Sitting or standing, gently rest your arch onto the edge of the step and press your toes into flexion, holding for 30-60 seconds.
- For your hamstrings and heels, try sitting on the floor or bed, straightening your leg and back while holding your toes, holding for 30-60 seconds. You can also get the same effect by holding a towel around your forefoot and pulling toward you, but don’t let your knee or back bend.
For many, the most challenging aspect of stretching is putting in the time and frequency required to achieve results. Hang in there and make it a regular part of your day. The final element to include wherever possible is strengthening.
- To work the lateral calf’s peroneal muscles, use an elastic exercise band (or exercise rope) fixed to an anchor point (bedpost or doorknob) at one end and wrap the free end around your forefoot. You should be sitting so the band is crossing over your free ankle. Flex and evert your ankle against the elastic tension and hold for 5 seconds, doing 10-15 reps, morning and evening, every other day. Switch the band’s side and invert your ankle (toward other ankle), doing similar reps and times.
- To work your gastrocnemius and soleus, stand facing a wall and lift up to the balls of your feet (on tippy toes), holding for 5 seconds, 10-15 reps, morning and bedtime.
Don’t forget to include some aerobic exercise, too! Cycling, rowing and swimming are wonderful choices, but a good 30 minute walk with proper orthotic support is great, as well. As mentioned in the first article, neuropathies progress over time regardless of our best intentions. However, you hold the potential to dramatically stem its course and live a happy and active life if you choose to. Always be on the lookout for new developments in neuroscience and medicine as well. Our knowledge of neuropathies is growing rapidly and it seems only logical that we will develop treatments to completely reverse their symptoms someday. Let’s work together in health and positivity until then!
Written by Jason Epps RMT