Working With Ankles and Feet

There is a lot to like about the ankle joint. It has a simplicity and mechanical clarity which other joints could envy. If you start from the neck, go to the shoulder, then down the vertebrae to the lower back and through the sacrum and end up in the ankle, each joint gets progressively more stolid and immovable (except the poor knee which is why it so often injured). The neck moves the most, the ankle the least; in between the sacroiliac joint moves somewhere in between. Because of this solidness, the ankle, which can be a crippling problem, recovers from injury in a sometimes miraculous fashion. Patients love you when you fix their ankles.

The tibia- talur joint in the ankle only moves 4 or 5 degrees. Unlike the sacroiliac joint, which for years was thought to move only 5 degrees but really moves 30 degrees, this joint where the leg comes into the foot really is almost fused. It is thick and strong with a series of adaptable muscles in the leg to help support it.

But the body demands a lot of this hinge; so much weight upon it, so much responsibility for our uprightness. And consequently, when trauma twists our strong ankle into numerous sprains, their effects will pile up. And, even though the ankle is the scene of the injury, the pain and problem is frequently projected to the foot. Often, one last lateral sprain and the foot doesn’t fit underneath your ankle anymore; it feels as if it juts sideways. Bunions begin to form, plantar fasciatis inflames, metatarpals get sore and the arch collapses. And as anyone who has gone through this misery can tell you, even a short walk for exercise is out.

But what can be done for this beat up joint? Surgery for this problem is risky. But so often, manual work results in some help but a lacks long term stability. To remedy this, Vascular Bone Therapy takes a unique approach.

The common wisdom says healing the ankle and foot is about supporting the arch by setting the bones which form its keystone. If you look on the internet, you can find dozens of u-tube videos showing how to balance these keystones; the cuboid and navicular bones of the tibia talur joint. This is very valuable work, but frequently, pushing this from underneath is a prop up job. The real problem is higher on the leg.

In VBT we take a different viewpoint; i.e. we get the tibia in place then adapt around it. The tibia must not be bent and torqued for the cuboid and navicular to have an anchor to gather around. 80% of the weight coming through the leg is carried by the tibia. This does not mean the fibula is unimportant, only that we look at its dislocation as a sideways sprain on the tibia. Because much of the support for the ankle comes from musculature which connects to the tibia; (particularly the tibilias posterior and anterior on the inside plus the peroneus longus and brevis on the outside), if the tibia is out of joint, it does not matter if the navicular and cuboid are under it, the bone will not sit properly. The tibia has to be worked and stretched to allow a place for the navicular and cuboid to fit onto. You go back and forth between the tibia, the fibula (a related to the tibia) and these two arch bones.

But in Vascular Bone Therapy, we need also to look at the ankle joints relationship to the veins and arteries of the ankle. For a long time, I thought this heavy joint was a place where the protection of the blood supply was not so important. This was wrong. The ankle tends to shear when it is injured, and this puts the blood vessels, even deep within the heavy bones, at risk; often, these sprains pound into the bones sideways; creating trauma translating to compression around the arteries of the lower leg.

To correct it, we use a combination of release, stretching and strengthening. But always we begin the healing by undoing vascular bone spasms. Often the bones are actually bent from protecting the arteries and when the pressure from these boney spasms is released, the joint will frequently slip into place. Then it is time to work the cuboids and navicular bones into joint under and around the tibia. Finally, we strengthen the arch up into the leg to give support through the long muscles; particularly the mentioned tibialis posterior which is the protector of the popliteal artery.

After this muscle is released from its spasms, exercises to strengthen the inside of the leg can be a powerful upward help for fallen arches. Because the arch is completely unable to sustain itself without the help of these muscles (tibialis posterior, peroneus longus, brevis), working the structure into place gives the leg leverage upwards rather than torqueing sideways. This added lift, plus the correct positioning of the tibia provides a stability which will not be knocked out every time the foot twists upon a small rock. These margins give the individual confidence to go on the walks, hikes and climbs which previously made him/her sore and lame.


I came to Brian with a foot so sore that I could not walk around the block. I had seen a massage therapist, a physical therapist, an acupuncturist, and a chiropractor and had little to no reduction of pain.
I am a very active person, and I exercise vigorously daily, lifting weights, running, jumping rope and doing pilates. I am also a massage therapist, and was willing to do anything I could to help my foot to heal. Nothing was helping. I was discouraged and depressed with my inability to exercise and the loss of mobility. My life was completely disrupted by the pain in my foot.
The Bonewhisperer found an old injury to my knee from a motorcycle accident that happened 15 years ago. I was told at the time of the accident that there was no ligament, muscle, or bone damage, but Brian noticed that the tibia, as well as the fibula and other bones in my foot, were completely out of place. When the knee released, the tibia worked its way back into place and my foot felt back to normal. My function was completely restored, and I am currently back to all of my activities, thanks to Brian!

Some twelve plus years before I came to see Brian Dobbs, I severely injured my foot and ankle from a fall from a ladder. I went to all kinds of specialists, which helped a little, but really the injury never fully healed. Because of its compromised condition, the ankle and foot would get reinjured from simple missteps. Eventually, I thought I would just have to live with the pain of walking for the rest of my life, and at the time of the injury, I was in my mid-thirties.

During the first session with Brian, he felt the bones and tissues, listened to my description of my injury – and accurately deduced the condition of my foot bones and ankle. From there, he gently manipulated and finessed the bones into their proper alignment. I needed one more session to have everything just right, and when that happened, when I came off the table and put my weight down, walked a bit – all I can say is – my mouth fell open and my eyes got wide. For the first time since the injury, my foot felt normal. I felt such relief then, and further, knowing that I could walk pain-free, perhaps for the rest of my life – was a godsend. It has been months since then, and my ankle and foot remain fine.

Andrew James, BA


I was referred to Brian over a year ago by another body worker who told me that Brian did the deepest work she had ever experienced and was able to re-start the healing process for old injuries that had stalled in other methods.

It was true. Brian has treated an ankle and foot injury from a scaffolding fall over 14 years old that I had treatments almost weekly during that time with only partial recovery.

The work that Brian has done has allowed natural movement, circulation, reduction of pain and optimism regarding the ability to heal unlike anything I have experienced.

Brian, whom has spent so many years in the bodywork and healing profession, still has so much energy, enthusiasm, and curiosity, that he makes a great partner in the healing process.

Brian’s techniques are different than any other therapy I have experienced, but I am most interested in results, and what he does works.

Jay C, Builder