hi need some help.
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Ive been treating this patient for variuos problems for the last 3 years.
two main are stress reaction left > right 3rd and 4th met heads
achilles and soleus pain right > left.
She is runs 5000 and 10 000 for Sweden and during heavy training can run up to 140 km weeks.
With regards to her forfoot pain she is now painfree.
Her achilles pain is now ok due to the fact that she is only running 70-85 km weeks at the moment. but as soon as the km´s go up the pain returns.
I have constructed 3 different device for her flats, racing flats and spikes. She is a feel runner and does not like to be over controlled.
Bx.
ff valgus
plantarflexed 1st
reduced triceps surea rom
slightly reduced 1st ray and 1st mtp joint rom
toe gripping
slightly increased rom stj and mtj
reduced hip flexor and lower core strenght
running mechanics
lateral forefoot striker
up right running position
´sits´at hips ie not good forward hip position
tx
orthotics
stretching
massage
eccentric program for achilles
heel lifts on and off.( if forefoot is slightly painful then out )
stregthening core and hipflexors.
She is about to go into heavy training in spain for 5 weeks and am wondering about changing the forefoot postion.
She tends to have problems when I change the device so will need to be alittle conservative.
My question is varus or valgus posting for the forefoot.
If I Valgus post the forefoot will be better balanced, but the load on the 1st ray and mtp will increase and so will the soleus load.
If I varus post it will more load on the lateral forefoot but reduced load on the soleus and will go against her natural forefoot position.
Im thinking ff valgus post with self mobs for 1st ray and 1st mtp at the moment anyone got any other suggestions ?
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