> Hi - I just put the following on the Rolf forum, but since it
> describes a technique that I am often asked about, I though I would
> double the post on the SI forum. Apologies to subscribers of both
> like myself. I failed to expand the POV into the lateral arch,
> which is a usual site of related problems for those with stuck
> fibulae...

> Hello.
>
> Sweet and simple...
>
> Any techniques, suggestions, or tricks for "freeing" the fibula. I
> am looking at finding new and creative ways of doing so, and would
> like to know what everyone's favorite tool for doing so is.
>
> thanks
>
> jim


Jim

Actually, I am going to take a whack at this, with the hope that some
of my more learned colleagues will follow suit with their more
specific techniques.

The fibula is well-fastened to the tibia by the complex fascia of the
interosseous membrane, which amounts to a syndesmosis (read: suture)
at the ankle end, and a looser joint - sometimes even with a synovial
component - at the hamstring end. Although fibular fractures or
repeatedly sprained ankles can affect good function here, by far the
largest number simply shut down the pliability and motility of the
interosseous membrane. So the question becomes how to get it
pulsating and resilient again.

Knowledge of the primary respiratory (cranial) rhythm is really
helpful here; with that you can feel the bones rolling away from each
other (fibula in lateral rotation, tibia in medial, and then vice
versa). If you can not yet feel this motion, you can still do the
technique, but it will be more effective if you are following and
working with the inherent motion.

Prior to this technique, check the mobility of the upper fibula by
setting the client with the knee up, foot on the table. With your
inside hand, hold the front of the ankle firmly toward the heel/table
to steady the foot, and then with your third hand (I use my head, not
very professional, but who has a third hand on hand all the time?)
steady the inside of the knee. With your second, outside hand, pinch/
hold the fibular head (careful of the peroneal nerve behind), and
slowly take the fibular head through its A-P range. Hard to convey
these kinesthetic 'feels' in words, but it 'should' have a bit of
viscous play. I don't know - a quarter of an inch?

If it won't travel at all, if it is fixed at the upper end, then I
work to free this first, by working it in movement in this same
position, or putting the leg back down and doing more assiduous soft-
tissue freeing in the really stuck cases. I do this before I apply
the technique below. If it is too loose - closer to an inch of play
- I usually head for the distal end, which is often too fixed. But,
provided that there is more or less normal play at the top:

Set the client supine, knee straight, with the heel off the end.
Using your leg or knee, keep the client in strong dorsiflexion. This
is important as it keeps the thick end of the talus in the tibio-
talar joint. Having them maintain the dorsiflexion muscularly is
definitely second best, as it will limit the bone movement.

Now, take hold of the inner and outer aspects of the leg about
halfway up - IOW, you will have the tibia and its surrounding flesh
in one hand, and the fibula and its surrounding flesh in the other.
Feel through to the bones, and take up your listening post for the
cranio-sacral rhythm (make sure you get a warrant first!).

With or without this listening, have the client begin to rotate the
trunk so that the hip in question will go into a medial and lateral
rotation (again, not with the muscles of their hip - have them use
their arms, their trunk muscles, or the other foot on the table to
initiate this motion - the leg you are holding should be passively
moved so that you feel 1) the opening and closing of the pressure-
rising and pressure-falling, along with 2) the passive twisting of
the femur and knee joint above your hands that are fixing the tibia
and fibula.

I've found this works pretty well. There are other standing
techniques for freeing the lower end so that the fibular malleolus
moves toward the heel in dorsiflexion, but others may feel moved to
describe these in less wordy fashion than mine.

Tom M

>