patient came to me as she was concerned that her gait was causing the muscles in her lower leg to over work and enlarge. Specifically the postero-medial aspect of the lower 1/3, palpation of this area was quite painful. During gait this area bulged giving the impression of over pronation. She had been fitted with anti-pronatory footwear for the last 8 years or so. Assessment of her foot revealed hypermobility of the ankle and STJ, but rather high arched and restricted MTJ. All the usual suspects (sup resistance test, jacks test RCSP/NCSP) came out as normal to supinated foot position and on closer analysis of her gait, her foot does function relatively normally, so much so that no matter what I put in her shoe (if I was to do so) is not going to resolve the problem she came in with. Most of the lower limb mucsles are tender on palpation but specifically tib ant especially at its insertion. Here's a bit of an analogy; Its as if there is something that needs to be drained from the lower leg as it is strangeling the muscles and preventing them from functioning effectively. My instinct is telling me something else is going on but I'm needing a point in the right direction as to where to go to next. Your thoughts would be hugely appreciated. :confused:
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