HI, I'm a 4th year podiatry student. I have a few queries with regards to a patient that presented to the uni clinic for treatment that I hope some fellow pods may be able to shed some light on.
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A 12 year old girl presented to the uni clinic with medial plantar arch pain and some tib anterior pain on palpation.
On assessment I found her to have genu valgum, excessive STJ pronation, tight plantar fascia and gastrocs, abducted stance/gait and abductory twist.
She had previously been prescibed orthotics which had been working very successfully at reducing her pain. However, the pain had come back.
Upon viewing the orthotics, several adjustments had been made by different students and the rearfoot (RF) to forefoot (FF) alignment was totally out. The medial anterior edge had been wedged to try and improve the alignment. This does not seem to have been successful as it wasn't very stable.
From reading the current literature and my limited biomechanical knowledge and experience, to treat a patient with these symptoms, I thought an inverted device with a fascial groove and 3mm heel raise could be quite successful in improving her symptomology. However my lecturer told me that there are just some people that you can't help. He said the an inverted device would invert the calcaneous and evert the tibia as genu valgum is a frontal plane deformity. He said that an inverted device changes the moments around the knee and cause greater valgus forces and so inverting the RF would not be very good.
My questions are:
1. As the STJ is triplanar, shouldn't using an inverted device actually increase the supinatory moments or decrease the pronatory moments, and cause external rotation of the tibia and thus abduction at the knee?
2. Would an inverted device help this patient?
3. Are there any other treatments that may provide some relief to patients like this?
Many thanks for your responses :))
Tags:
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Thought Experiment #4: Effect of STJ Axis Location on Sinus Tarsi Compression Forces
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Don't jump out of planes unless they're crashing.
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Thought Experiment #4: Effect of STJ Axis Location on Sinus Tarsi Compression Forces
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Don't jump out of planes unless they're crashing.
>
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