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Morning

My name is Chris Schafer, I am an Msk podiatrist working in London, and NW Middlesex area. I work for a very busy NHS physiotherapy service which, and I previously had a few years receiving referrals from the Joint Forces Nato HQ in my private clinic.

I recently had to do some in service training for the physios and realised how out of date things become and how things change and move on very quickly ( last 5-10 years)

A couple of interesting things I learned/ discovered is :

Hallux rigidus doesn't appear to be rigid any more- I keep getting referrals from a London teaching hospital radiology dept. for ' pain from halliux rigidus', and in some cases the hallux had 90 degrees non- wt bearing ROM

Then there was a paper I saw on the Arena which suggested that radiological assessment for Hallux Rigidus may be better than clinical assessment? It talked about varying degrees of 1st MTPJ ROM ? I would normally refer to this as functional/ structural hallux/ limitus?

When I went through some of the literature, and internet definitions , surprisingly it talked about restricted but not completely restricted ROM for H. Rigidus.

So am I missing something, or has the terminology been confused by other health professions who work in orthopaedics / radiology ?

Also the Cumberland Foot and Ankle Score Index came up by one of the more high flying experienced physios . Sent me a link on a recent paper:
http://www.ncbi.nlm.nih.gov/m/pubmed/26912285/









I had not heard of it, looks decent ,but wondered what peoples thoughts were on it- is this a standard tool now for assessment and rehab after an inversion injury?

cheers

Chris Schafer

Northwood, and North West London