Good afternoon.
Members do not see these Ads. Sign Up.
Ulcerations due to medial column biomechanics are generally easier to both understand (for me) & successfully manage. Rarely do I struggle to get, and keep, these ulcerations healed. Therefore a lot of my thoughts the last few months has been geared towards the 'high arched' 'pes cavus' 'laterally deviated STJ' foot types with ulcerations.
I have found that these feet with ulcerations under the 1st MPJ respond very well to a heel raise, lateral forefoot post and occasionally a lateral skive. After being in insoles for some time, I have observed less tension in the peroneal tendons and musculature and a general relaxation of the soft tissue contracture/relaxation of hallux retraction improving medial slip of the fascias ability to be used appropriately instead of being in maximal tension. This makes logical biomechanical sense and 1st MPJ ulcerations are, in my opinion, predominantly sheer bought about by hip external rotation when there is no available saggital plane motion available at the 1st MPJ.
I have found that those with ulcerations under the 5th MPJ do not respond either; as well, or not at all to a similar prescription. I really do struggle to rationalise how I can get pressure off of the lateral column. These patients do have eversion range available in standing. I naively assumed that increasing STJ pronation would move pressure medially to the forefoot through propulsion.
My questions are as follows: why do these similarly structured feet appear to load either the 5th or the 1st MPJ? Is this related to 1st & 5th metatarsal length with those loading the 5th MPJ having a shorter 1st met??
What can I do, or what prescription/assessment variables have I not considered, to be able to better help my patients with 5th MPJ pressure & ulcerations??
Any recommended reading would also be appreciated.
Thanks in advance.
Tags:
<
Running in MBT Shoes
|
Foot structure is significantly associated to subtalar joint kinetics and mechanical energetics
>
<
Running in MBT Shoes
|
Foot structure is significantly associated to subtalar joint kinetics and mechanical energetics
>
Loading...
- Similar Threads - Laterally deviated foot
-
- Replies:
- 0
- Views:
- 2,575
-
- Replies:
- 1
- Views:
- 5,726
-
- Replies:
- 4
- Views:
- 6,988
-
- Replies:
- 6
- Views:
- 17,032
-
- Replies:
- 1
- Views:
- 11,463
-
- Replies:
- 51
- Views:
- 27,475
-
- Replies:
- 6
- Views:
- 12,549