Saturday, 30 December 2017

SUCCESS STORY OF HEEL PAIN

Success Story of Heel Pain (Plantar Fasciitis)


53 year old female patient came with complaints in right foot.
Pain was worst in morning & aggravates by standing & walking for longer duration.
Professor by profession; standing for longer is the demand of occupation.

She has already consulted with many doctors. Tried medication & therapy but no long term relief. "Medicines will help to reduce the symptoms (pain & discomfort) which will help temporarily in this cases. Long term help will be to find out the root cause & manage it better way."
She was allergic to few anti-inflammatory medicines.

Bio-Mechanical Examination-

Static Examination:

  • Transverse Arch- Reduced Bilaterally
  • Medial Arch- Pronounced Bilaterally
  • Sub-talar Joint- Supinated Bilaterally (More on right side compare to left side)
  • Knee- Genu valgus (Right knee is slightly lower than left knee)
  • Calf & Hamstring muscles was moderately tight bilaterally.

Dynamic Examination:

  • Gait Pattern- Poor heel to toe pattern
  • Heel Strike- Lateral heel strike bilaterally
  • Stance Phase- Supinated at sub-talar joint bilaterally
  • Toe Off- From the 2nd Meatatarso-phalangeal joint bilaterally

Foot Size:

  • Right Foot- US 5 1/2 wide
  • Left Foot- US 6 wide

Investigations:

  • X-rays reveals Calcaneal spur right side.

Diagnosis:

  • Right Calcaneal Spur
"Root cause of her right heel pain was stiffness of plantar fascia due to her high arch foot type. This resulted in spur formation at its origin.This spur developed because of repetitive pull of the plantar fascia which lies underneath of our foot sole. Appropriate arch support will stop this pulling of ligament will help her eventually."

For more details watch this video (Click the link)- Heel Pain diagnosis & Treatment
Or to read click this link- Heel Pain



Treatment & Advice:

  1. Cold Pack 3-4 times a day 20 minutes each time
  2. Prescribed Strive ready to wear orthotic footwear.
  • Follow up: After 2 week
  1. 80-90% pain relief
  2. Prescribed wide width sport shoe US 6 1/2 wide
  3. Bio-Advance Orthotic medium density insole along with lateral raise
  4. Customized exercise regime was given.

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Thursday, 14 December 2017

SUCCESS STORY OF FLAT FEET WITH POSTERIOR TIBIAL TENDON DYSFUNCTION



CASE STUDY: FLAT FEET WITH POSTERIOR TIBIALTENDON DYSFUNCTION (PTTD)

41 year old female complaints pain & swelling at inner side of left ankle since a year. Pain was gradually increased. Initially it use to heart on prolong standing & walking eventually pain got worst. Now not even able walk few steps also.

On Examination:
  • Swelling was present around left navicular area
  • Grade III tenderness at the navicular area
Biomechanical Assessment:
Static-
  • Clawing of toes left side
  • Medial Arch- Flat Bilaterlly (Flat Feet)
  • Transvrse arch reduced
  • Subtalar joint- Overpronation bilatrally more on lfert side
     
  • Navicular drop- Present bilaterally
  • Navicular drift- Present bilaterally
  • Calcaneum (Posterior view)- Eversion bilaterally more on left side
  • Knee- Valgus
Gait Assessment:
  • Gait Pattern- Poor heel to pattern
  • Heel Strike- Medial heel strike
  • Stance Phase- Overpronation at the sub-talar joint bilaterally
  • Limp on left side

Treatment & Advice:
Advice-
Bio-Advance

  • Complete rest for one week with cold pack 4 time a day over affected area for 20 min. each time.
Orthotic correction to improve lower limb biomechnical alignment-
  • Advised to wear sport shoes (Even indoor) with firm heel counter (Stable Shoes) few days as concidering her pain & sevirity of flat feet.
  • Prescribed Bio-Advanced medium density orthotic insole in her shoes & also to reduce stress on Tibialis posterior muscle tendon.

1st Follow up after two week
  • Demarkeble changes seen. More than 50% of pain was reduced.
  • Added correction in orthotics to further enhance arch support.
  • Advised to continue with cold pack. 
2 nd Follow up after one month
Strive

  • This time 90% pain reduced.
  • Now slight discomfirt only after long stand or walk.
  • Adviced Strive orthotic footwear for short distance (Near by) & continue the sports shoes for out door.
  • Exercises for strengthening tibialis posterior muscle.
3rd Follow up after 2 months
No pain & Adviced to continue with orthotics



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