Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Advice for the treatment of runner

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Davey, Jul 29, 2009.

  1. Kent:

    After you have carefully read the above third step of the tissue stress approach to treating musculoskeletal injury, you should be able to note that you are fully allowed to modify your treatment plan that will A) heal the injured anatomical structure. This may include heel lifts in the acute phase of Achilles tendinitis or include eccentric stretching exercises in the more chronic stages of Achilles tendinosis. This is the beauty of the tissue stress approach: the biomechanics of all mechanically-based injuries to the structural components of the foot and lower extremity are the prime determinants in deciding how the patient will be treated.
     
  2. Kent

    Kent Active Member

    Kevin,

    I think we're on the same page here - it's just that you say tomato and I say tomato.:drinks

    I guess if I was teaching young podiatry students or if I had a new grad working for me, I'd first emphasize the importance of a thorough assessment to formulate a specific diagnosis and then apply the tissue stress approach to treat it.
     
  3. Kent:

    Good to see we are on the same page.:drinks

    The tissue stress approach I have outlined does not preclude the clinician from using other diagnostic measures to better determine the appropriate diagnosis and does not preclude the clinician from using the best available treatment methods for their patients. The best thing about the tissue stress approach, in my opinion, is that it gets students and clinicians away from the orthosis prescription protocols of the subtalar joint neutral theory that advocated treating most feet with orthoses with the heel bisection vertical, with very little allowance for orthosis modification for the many different mechanically-based injuries that may occur within the foot and lower extremity.

    My three Precision Intricast books (Kirby KA: Foot and Lower Extremity Biomechanics: A Ten Year Collection of Precision Intricast Newsletters. Precision Intricast, Inc., Payson, Arizona, 1997; Kirby KA: Foot and Lower Extremity Biomechanics II: Precision Intricast Newsletters, 1997-2002. Precision Intricast, Inc., Payson, AZ, 2002; Kirby KA: Foot and Lower Extremity Biomechanics III: Precision Intricast Newsletters, 2002-2008. Precision Intricast, Inc., Payson, AZ, 2009) detail how I have treated patients using this tissue stress approach over the past 20+ years, even though, early on, I called this approach, thinking like an engineer.

    All in all, we have made considerable progress in promoting the tissue stress approach to the international podiatric profession, but still need to promote it further within the worldwide podiatric medical institutions.....there is still quite a bit more work to be done in this regard.
     
  4. Davey

    Davey Member

    Hi all, sorry it has taken me so long to post results of how my patient has progressed.

    Firstly I would like to thank all of those who posted for their great advice as it proved invaluable.

    The treatment programme I initiated for my patient was 6mm heel raises along with an intense stretching programme for all posterior muscles with emphasis on calf muscles as this was where he was very tight.

    Progress from this was a small decrease in pain while running but the patient was still having pain over a small distance running. At this time the patient was still quite tight in posterior muscles therefore to speed things up I arranged a few sessions with a sports massuse to loosen the muscles an give the patient better range of motion.

    The next time I reviewed the patient he had come on great increasing his distance almost every week with controlable pain levels, this is when I introduced the eccentric loading into his treatment and since then the patient has been running with little pain at all.

    I don't think I will get 100% pain free with this patient over 26 miles of the marathon but the patient will be able to finish the marathon whereas at bthe beginning he could not run further than 1 mile therefore a take this as a successful treatment.

    Again I cannot thank everyone enough for their input and hope to be bothering you all again soon with my problems!!

    Thanks
    Davey:drinks
     
  5. drsarbes

    drsarbes Well-Known Member

    Hi Davey:
    Thank you for your last post. It's always appreciated when a clinician follows through and reports on a Dx and then a Tx plan, that's really what this site is all about.

    When it comes down to it, Podiatry, as well as all of medicine, is really just "outcome" based.

    Please let us know if he is able to run the 26 miles. I will be duly impressed.

    Steve
     
Loading...

Share This Page