Bunions have become a normal appearance in many chiropractic and manual therapy offices. This has occurred due to shoe and footwear choices and improper ankle mobility. Surgery is the only option to decrease the size of the bunion, but to stop growth and decrease pain soft tissue work and rehabilitation is your best bet. Strengthening the peroneal muscles can help stabilize the big toe joint and ankle mobility exercises can help decrease the rate growth. Here is an easy way to start stabilizing the toe.
- Stand facing a wall using your hands to balance yourself.
- Spread your feet apart wider than shoulder width.
- Flatten your inner foot and raise your heels off the ground.
- Only raise the heels, do not come up on the toes.
- Repeat 3 sets of 25.
- This is not a calf exercise, do not perform calf raises.
I have only found one VMO exercise that consistently activates the VMO. Oh, and it does a number of the gluteus as well.
Diagonal Sit Backs
- Start with the patient on one knee and heel directly under opposite buttocks. (right knee on the ground with right heel in line with left buttocks)
- Now the leg should be at a 45 degree angle, slight hip external rotation.
- Instruct the patient to perform a brace & breathe and slow start to sit back onto their heel. Do not have them go into lumbar flexion.
- They may not be able to touch their heel.
- Return to the starting position and repeat.
- No flexion or posterior pelvic tilting should be noted.
- The arms can be raised for balance.
- This should be felt in the VMO and gluts.
Our bodies are bipedal, meaning that we were meant to stand on two feet. Sitting for long periods of time is biomechanically insufficient and places large amounts of stress on the spine. Sustained sitting can cause specific muscles to become shorter and joints to become hypomobile.
Classic seated posture:
- Places one’s head forward and rolls the shoulders, shortening muscles that commonly cause headaches.
- The shoulder blades more upward and outward increasing tension in the neck and shoulder muscles and inhibiting the stabilizing muscles of the shoulder blades.
- The mid back and low back round out forming a kyphosis, placing the disc of the spine under uneven pressure.
- The hip flexor muscles are shortened and the gluts are inhibited which can lead to Lower Cross Syndrome.
Commonly, sitting at a desk for a sustained period of time causes headaches, shoulder and/or neck pain, mid back pain, or low back pain. All of these can be prevented or decreased by taking microbreaks and performing a simple exercise.
A Microbreak consists of standing up, stretching and walking about for 30 secs. This should be performed every 30 minutes to an hour that one is sitting. Performing microbreaks will decrease the risk of muscles becoming shorter and joints becoming stiff.
Bruegger’s exercise will help relax short muscles and help strengthen inhibited muscles due to sitting.
- Sit down and spreading your feet shoulder width apart and your toes out.
- Pretend there is a string pulling your chest up and out, extending your upper back.
- Your arms should be at your side with your head looking straight in front of you.
- Gently tuck your chin and rotate your palms forward.
- Hold position for 30 secs every 30 minutes seated.
– You might feel a slight muscle squeeze between your shoulder blades, but not a strong contraction.
– You should still be able to talk when your chin is tucked, if you are unable to talk, relax a little bit!
Next time you are at your desk and you start to feel tension or pain, try taking a microbreak and performing Bruegger’s exercise. You will notice that you can sit for longer periods without pain.
Yours in health,
Dr. Justin Hildebrand