Ligamentous Articular Strain: Osteopathic Manipulative Techniques for the Body, Conrad A. Speece, DO; William Thomas Crow, DO; Steven L. Simmons, DO; 2001; Eastland Press.

Ligamentous Articular Strain is an osteopathic manipulative technique developed by William G. Sutherland, D.O. This technique is how Dr. Sutherland was treating the areas of the body outside the core axis of the craniosacral system.

I taught a live course on the hip and lower extremity this weekend and the curriculum did not include this technique that I find myself using quite a bit with patients with foot issues such as plantar fasciitis.

This bootjack technique can help release restriction in the calcaneus as well as the forefoot.

In order to do this technique:

1. Patient lays supine
2. Practitioner stands at the side of the table facing the patient’s feet on the same side as the leg to be treated.
3. Have the patient flex their hip and knee up toward their chest and then abduct their hip out toward you.
4. The practitioner then places his/her arm on the inside of the tibia and stabilizes the tibia between his/her arm and side.
5. The practitioner’s forearm should be in line with the patient’s tibia.
6. The practitioner grasps onto the patient’s calcaneus with thumb and PIP joint of one of hand, while the other thumb grasps under the first metatarsal and fingertips wrap around the little toe and lateral aspect of the forefoot.
7. Now the practitioner leans backward toward the patient’s head and in doing this their arm creates tension against the femur therefore causing a distracting tension between the foot and the lower leg.
8. Balance tension in the metatarsals and tarsals between your two hands while you carry the calcaneus inferiorly and monitor for a release.