The Peroneus Group
When a client is complaining of pain in the Rhomboids or QL, the IT Band is the Platform we use for the Reverse Trigger Pointing Scar Tissue areas that you use to release those TP.
However, the IT Band is typically in the middle of a pain pattern. Meaning that the IT Band is responding to force from opposing ends of the body – the head and the foot. This is in relationship to one of our favorite laws of physics: For every action there is an equal and opposite reaction.
What we are going to talk about today is how to work with the Scar Tissue that forms at the region of the foot first. The ankle – specifically the Peroneus group and ligaments of the ankle. To understand why the ankle affects the Rhomboids (through the IT Band), it will help to have a little physics lesson in Scar Tissue.
PPS talks A LOT about Primary Injury Scar Tissue and Compensating Scar Tissue. A Primary Injury is just an injured area that formed Scar Tissue to heal. Scar Tissue, doing what Scar Tissue does, will bind and shorten the tissues where it forms.
Because we are all bound by physics and force, that shortening of Scar Tissue creates a new “force”. That newly formed force can now change what muscles do and how they work. At some point, to keep balance and function, the body will require an “equal and opposite reaction” to stop the action of force of shortening. This has to happen to keep function in the muscular system as a whole unit.
That balancing force will typically occur in the opposite end or directly opposing area of the body and we call it a “compensation” or compensating Scar Tissue.
The only tissue strong enough to oppose Scar Tissue is Scar Tissue.
The body forms Scar Tissue in equal proportions, opposite the injury, to compensate and match the original injury.
If you can see it, there are now 2 “new” forces working in the body that were not there before. Each are pulling in opposite directions at the same time. The dynamic they set up is like a tug-o-war rope. Since we are discussing the foot and head being opposing areas for the IT Band, that opposition is vertical (between the head and foot) and not horizontally.
For a tug-o-war, in the middle of the rope there is going to be extreme amount of force. The same thing happens in the body. If there is Scar Tissue on both ends (head and foot), then somewhere in the middle there is going to be an extreme amount of force. That middle in the body is going to be 2 places:
The IT Band (always)
The IT Band and the Sacrum (if the pull downward is hard enough)
In this tug of war, however, the rope is flexible tissue and has some ability to give. That tissue can and will micro-tear. That is how it knows to respond to the amount of force placed on it. In order to heal after micro-tearing, it will form more Scar Tissue to oppose both ends. Your body works the same way when you lift weights to build more muscle mass – and becomes stronger in the process.
The IT Band will form Scar Tissue and balance the ends beautifully. It will form Scar Tissue that opposes both ends at the same time so you are seeing equal and opposite reactions from both directions balanced through one structure- the IT Band.
Muscles Vs Scar Tissue? No competition – Scar Tissue Wins
All that balancing with Scar Tissue will begin to impact the muscles ability to contract correctly. They start to get placed into uncomfortable positions because they are involved in the tug-o-war through shared attachments of bone, ligament and tendons. Those muscles get pulled where the Scar Tissue pulls but they are no match to Scar Tissue.
Scar Tissue is sold tissue. Think of it like duct tape – human duct tape. It repairs and holds anything! Muscles are like rubber bands. They will adapt to whatever pulls on them and there is a lot of stretch it can give until it hits a point where it can no longer stretch, typically resulting in tearing. Scar Tissue takes advantage of that stretch and many muscles get placed into a point of full extension when trying to fight Scar Tissue.
That is what happens to the Rhomboids and Quadratus Lumborum when Scar Tissue forms on the IT Band. Through shared attachments of the IT Band on the Iliac crest, change occurs to the Rhomboids from the Latissimus (attaches to the Iliac Crest) to the arm (shares attachments with the Subscapularis) to the scapula (rhomboids attach to the medial border of the scapula) to the spine. The greatest lengthening of the elastic band (rhomboids) occurs between the spine and the scapula.
The Rhomboids’ flexibility loses the tug-war to the immobility of Scar Tissue on the IT Band. Let’s tie this together with the ankle Scar Tissue.
Ankle Injuries and Scar Tissue on the IT Band
There are primary injuries that occur at the head that create compensating Scar Tissue to oppose equally in the feet.
And then there are primary injuries that occur at the feet that create compensating Scar Tissue to oppose at the head.
The foot to head connection is the injury cycle we are talking about today.
One of the most common Primary Scar Tissue areas of the foot is the ankle. This ankle Scar Tissue can create some heavy compensating Scar Tissue in the IT Band.
A common injury that people get as a young kid or teenager is a sprained or strained ankle. Just to be clear about a sprain and a strain, below is definition of each.
Sprains and strains, while sometimes used interchangeably, are not the same thing. A sprain is an injury to a ligament, the tough, fibrous tissue that connects bones to other bone. Ligament injuries involve a stretching or a tearing of this tissue.
A strain, on the other hand, is an injury to either a muscle or a tendon, the tissue that connects muscles to bones. Depending on the severity of the injury, a strain may be a simple overstretch of the muscle or tendon, or it can result in a partial or complete tear.
When working with clients in this area, I think that an injury to the ankle will always involve both the ligaments and the muscles/tendons. There is tearing in the structures of the lateral ankle from “rolling” the ankle too far to the outside – it is hard to just isolate the muscle or the tendon in that injury. I think several kinds of tissue commonly tear. That is the purple ankle you see from this sort of injury: sprain and strain.
Scar Tissue is what will heal those tissues, create function again, and make them stronger. The ligaments have Scar Tissue and so do the tendons and muscles of the Peroneus Group. They all get stuck together in the healing process. Because Scar Tissue does shorten wherever it is formed, that shortening can pull down on the outer leg (and hip and IT Band) down towards the foot. Sometimes a little and sometimes a whole lot.
This is one of the illusions of the pelvis tilted down to one side and the “one leg longer than the other” that you see. It is being pulled downward by an “invisible force”. That is the power of Scar Tissue.
Depending on the amount of pull, you can see this force go up into just the Rhomboids of the same side or cross over to the other side if it is a really aggressive pull. Force, when it pulls hard enough (which means LOTS of Scar Tissue), will cross over the spine.
When pain from one side of the body crosses over to the other, that right there tells you how significant an injury may have been in the past to create that pattern in the present.
The IT Band or the Sacrum and IT Band help in both scenarios of injury (little or a lot). But when you want to get the IT Band to STOP responding and recreating the Trigger Points in the Rhomboids and QL, you must go to the source. For the lower leg or foot “Primary Injury Scar Tissue” that will be the Peroneus group Scar Tissue formation.
There are times when working just the outside structures of the ankle and muscle group as it travels up the Fibula will stop the pain in the Rhomboids and QL without working the IT Band.
Below is a video of the where the Peroneus group is located on the outside of the leg.
Peroneus Group Drawing
Working with this area can provide much relief a long distance away.
The detailed training information for the Peroneus Group Platform is in our Intermediate 1 class. If you are interested in learning about this group and how to work with it, go to the link below for class information.
Compensating Scar Tissue for Ankle Primary Injuries
I know what you are thinking – where does the Scar Tissue form in the head then for the equal and opposite reactions? What does that mean for those muscles in the upper body? In the Intermediate 1 class, we also discuss the opposite – head injuries and how they create different force and pain in the body through Scar Tissue.
We will cover some of this next week on our blog. In the meantime, start exploring the lateral ankle in conjunction with the IT Band Reverse Trigger Pointing techniques to see what you find and how it can dynamically change pain for your clients.
Intermediate 1 Link Below
(PPS Basics must be completed before this class can be completed)