Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Marfan Syndrome

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Sammo, Jan 30, 2009.

  1. Sammo

    Sammo Active Member

    Members do not see these Ads. Sign Up.
    Hi All,

    I've just had a young (7y/o) chap in to clinic who has Marfan Syndrome.

    He presents with bilateral pes planus, ligament laxity, low muscle tone, he is very tall and skinny, tons of nav drift and a bit of drop, has abducted forefoot and adducted toes. so his foot looks a bit like this: ~ (best I could do with time/materials)..

    C/o pain in heel/ankle area, unable to run for more than 5 minutes (I get that too.. should I be worried???) , poor coordination and occasionally bashing one ankle into the other whilst walking (although no obvious varum/valgum). On palpation, deltoid ligaments and tib post tendon, insertion (nav process) and muscle belly of left side are sore (5/10). Right side not so bad.

    He seems to present similarly to regular hypermobility so I was planning on treating it similarly (combination of Footwear and insoles).

    I was just wondering if any one else had experience with this condition and could share any nuggets of information/guidance with me??

    To save you googling - Marfan Syndrome: http://en.wikipedia.org/wiki/Marfan_syndrome

    Kind Regards,

    Sam Randall
  2. toughspiders

    toughspiders Active Member

    Hi Sam

    I think id be more concerned about him conkin out on your treadmill!!! (Joke)

    No seriously i used to be friends with a girl who had the condition. She was the same (part of the condition) that they all tend to be hypermobile (connective tissue cause) and lots of sufferers have the aortic problem that goes with it. She regularly had to go and have the diameter checked. She lives with the fact it could pop at any time. She will need surgery when it gets too distorted.

    Personally, i think its a minefield i wouldnt want to go treading in, as the disorder is systemic, needless to say. You cant kick the poor guy out on his arse.

    I think i would tend to go easy biomechanically at first and see if the other joints can cope. That way you can always increase.

    Sorry not much use

    oh...i also would speak with his specialist!


  3. Sam:

    Patients with Marfan Syndrome have ligamentous laxity of varying degrees. Abraham Lincoln was thought to have Marfan's Syndrome. To treat their flatfoot condition, I use deep heel cupped orthoses with medial heel skives and good medial arch contour but don't try to aggressively support the medial arch too firmly or irritation may occur. For more severe cases, like the case you describe above, a high top boot will help tremendously. I treat them nearly identically to the way I would treat any moderately severe to severe pediatric flexible flatfoot deformity with orthoses and high-top shoegear.

    Here's a chapter I wrote on flatfoot deformity about 18 years ago.

    Attached Files:

  4. stewartm

    stewartm Member

    Hi Sam,

    Further to the posting from Kevin, I'd also recommend the following:

    Lindsey, J.M., Michelson, J.D., MacWilliams, B.A., Sponseller, P.D. & Miller, N.H. (1998) The foot in Marfan syndrome: clinical findings and weight-distribution patterns. Journal of Pediatric Orthopaedics. 18 (6), 755 - 759.

  5. pgcarter

    pgcarter Well-Known Member

    I have had a few and have been told there is a bit of a spread of presentations and is related to the Ehlers-Danloss connective tissue condition. In terms of orthoses I have found it really idiosyncratic, a bit of a process to find the best support that they will also tolerate, one 30's lady I deal with has significant fluctuation in the level of her pain and she has a variety of device types that she uses depending on pain and activity level. Good luck, and keep reminding yourself that this is one for which there is no cure and that it will need addressing again as time passes.

    regards Phill
    regards Phill
  6. Sammo

    Sammo Active Member

    Many thanks to Kevin, Stewart, phil and B for their help and guidance. Appreciate it guys! :drinks
  7. Freeman

    Freeman Active Member

    I have had several patients with Marfan's.I have known some for almost 30 years for many years, it is hard to see some of their declines, however, that they return continued help and encouragement is very full fulling. Cardiac surgery is a sure eventuality however that there is that help is a tremendous.

    Cheers to all

Share This Page