< Help with Pt | Tissue/physical stress theory and only using 1 orthotic device >
  1. cpoc103 Active Member


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    Hi just a thought!!

    is it possible to strain the quadratus plantae or abductor digiti minimi, by inverting/ supinating the foot??

    Friend has 5 year Hx of heel pain had several orthoses, on an earlier thread here I was advised to try and increase the heel raise for recurvatum, and this seemed to help for a period, but now back to original pain.

    When I examined him at the weekend his pain was no longer at medial tubercle of calc as it was a year ago rather more central and lateral.
    Only thing is he has had an MRI which showed nothing at all other than possibly early fasciitis!!! Very strange. he assures me it is not in his head lol, I had to ask the question.... any suggestions would be greatly welcomed!!! Michael, Eric, Dr Sha
    Thanks

    Col.
     
  2. footdoctor Active Member

    Obviously fell on deaf ears col ......trigger points

    scott
     
  3. efuller MVP


    Is this the same guy? If it is, you should ask the question in that thread.

    I don't see how you would strain quad. plantae by supinating foot. I think it would be highly unlikely that you would strain the other muscle, but it's theoretically possible if you rolled onto lateral boarder of foot and the patient choose to try and plantar flex 5th toe to spread load off of met head.

    On the other hand the plantar fascia has 3 bands and if someone avoids medial slip pain by choosing to supinate their foot they may increase load in the central or lateral slip of the fascia.

    Eric
     
  4. drsarbes Well-Known Member

    Hi

    I have found it rather common to have patients with chronic heel pain develop pain more laterally.
    I had always blamed it on altered gait since transferring weight laterally will relieve classic fasciitis pain.
    I have also found that although patients state that their pain "has moved" or is on the "outside" - if you palpate the medial plantar tubercle you still elicit quite a bit of discomfort.

    The "domino" effect in the foot never ceases to amaze me.

    Steve
     
  5. Ian Linane Well-Known Member

    I agree with Steve that the domino affect is quite amazing.

    Similarly when doing soft tissue work on the foot and low leg the patient seems to suggest that the pain has "moved".

    In the case of the painful heel it is a mistake to think that the affects of pain remain localised (even if not symptomatic elsewhere) and any soft tissue work would be applied to the tissue structures around the more obvious sight of pain as well as the site of pain.
     
  6. G Flanagan Active Member

    Baxters nerve entrapment?
     
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