Study of the Force Applied During Anteroposterior Articular Mobilization of the Talus and its Effect on the Dorsiflexion Range of Motion
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Journal of Manipulative and Physiological Therapeutics
Volume 30, Issue 8, October 2007, Pages 593-597
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here is Howard Dananberg's 2000 paper on this:
Manipulation method for the treatment of ankle equinus
HJ Dananberg, J Shearstone and M Guillano
Journal of the American Podiatric Medical Association, Vol 90, Issue 8 385-389, 2000
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Are you just padding your posts now Kevin by listing this twice?
Craig did provide a link anyway you know!:dizzy:
Bruce -
Thanks for the posting Kevin, :)
Bruce- we don't all have JAPMA access!!! -
Last edited by a moderator: Nov 14, 2007
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Like x 1 - List
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Hylton questioned the internal validity of the article; but I question the clinical significance and EV to all ankle equinus presentations.
Danenburg's method is only applicable for a very small percentage of equinus presentations. Its the tip of the iceberg. Its the rare tool down the bottom of the tool-box that you might find useful once in a long while. Nothing more.
References:
None. -
How wrong you are.
Hopefully by Sunday aussie time, I can post the worlds first comparing foot pressure plate/ ankle dorsiflexion/ shoulder abduction pressures and CT 3D angle changes pre and post mobilisation and manipulations.
Many may cringe but few are chozen. I like this better than Craig's mumble.
comeon sunday!
musmed -
Bruce -
I greatly disagree with you. So much knee pain is perpetuated by unidentified AJE on a daily basis! In general, mobilising or manipulating the AJ will help tremendously to aid that patient population as well as most other foot complaints.
We all use different tools, but I would now be lost to achieve the outcomes I do for my patients without utilizing manipulation on a regular daily basis.
Sincerely;
Bruce -
Bruce there are several ways to mobilise/manipulate an ankle joint. Danenburg and his superior tib-fib joint attention is not the only way. Danenburg's method as described in his article, would only improve to sufficient clinical significance a small percentage of ankle presentations. There are better, more effective means of increasing ankle joint dorsiflexion in a majority of presentations.
If you read my posting Bruce, I am not knocking mobilisation/manipulation; so I don't know what your are greatly disagreeing about. -
You have my attention. Could you expound on this?
Regards,
Stanley -
Paul C musmed -
If you have your ankle immobilised as per typical POP for 4-6 weeks, what tissues have been affected adversely (reduced length). Even a 2nd year student will rattle off "joint capsule, tib-post, peroneals, gastro-soleus etc...etc...".
But in the clinical world, why are we foolish enough to think that one joint based technique is going to be the magic trigger of a wonderful cascade of ankle dorsi-flexion attainment?
Come on...it aint rocket science. You have maitland mobilisations; you have mulligan mobilisations; you have chiropractic manipulation; you have distraction....and that is just for the passive tissues. I haven't even got on to addressing active tissue yet.
These dogmatic practitioners that believe everything is caused by one thing (and solved by one thing) are deluding themselves. Many chiropractors think everything is caused by matters spinal; many physiotherapists think that everything is caused by matters core.... and so on.
And Musmed, why wait for me? I am waiting for the 2nd coming Sunday 'aussie time'. -
What time Sunday, I want to prepare myself and hide in the walk in robe with the laptop. That way I might be able to read something to its completion before the kids find me.
Cheers
Iona -
The paper Howard D wrote also included other procedures.
I feel unless I have missed something that you have still not answered Stanley's question.
I did not see anyone write about a leg in plaster....etc
Regards
Musmed -
And "leg in plaster"? You're not that simple to fail to understand the use of analogy.
Then again... -
I noted what you say,I also note that there is salt in atlas
Paul C -
Atlas,
I still do not have the answer I requested. :(
I think that you are saying that we should look at all the tissues around the ankle.
The Plaster of Paris analogy is interesting, :wacko: but the problem lies in what is the affected parts and how does it affect the ankle joint.
People that manipulate think that the joint has been knocked out of aligment:bash:, and it needs to be knocked in.
The Plaster of Paris analogy implies an immobilization etiology to the problem.
So do you treat all the structures around the ankle :butcher:eek:r do something else?
Regards,
Stanley -
And Stanley, that is exactly what I am saying. Look at all structures, mainly the limiting one at the time. Regarding etiology, yes the POP analogy implies pre-existing immobilisation. However a typical impingement will not allow full ROM in a particular plane. A typical ankle sprain, with its inflammation etc around the joint will immobilise the region similarly. Here's another analogy...like a floating device that children wear around their arms; imagine this around a joint.
Pure and simple, most musculo-skeletal pathology anywhere in the body (neck, shoulder, knee, hip) will co-exist with some degree of immobilisation. If you wake up with a sore neck, how far can you move it? If you pain and this 'limited movement' were to exist for some time (weeks-months) you will have tissue shortening in affected and previously non-affected structures.
Ron B.
Atlas (aka salt) -
I see what you are trying to say:
If I wake up with a sore neck, I should treat the tight muscle.
Do you treat the cause of the tight muscle, or the tight muscle directly:dizzy:?
Regards,
Stanley -
This is an acute situation Stanley. A disc pathology might need traction? Facet joint pathology might need manipulation/mobilisation? Muscular pathology....
I was talking about the post-acute period.:bash: -
You wake up with a stiff neck, and as a result there is some immobilization which causes a secondary tight muscle two months later. You then see the patient and examine him and find there to be something wrong which is a result of the immobilization phase due to the spasm of the neck muscle. You treat the pathology you see.
My question is why did the patient develop the stiff neck, and what are you going to do to prevent it from happening again?
Regards,
Stanley -
Sunday came and went without us reading about the world's first study comparing foot pressure plate/ankle dorsiflexion/shoulder abduction pressures and CT 3D angle changes pre and post mobilisation and manipulations. What a disappointment. You build us up.....and.....nothing happened.
I just had to spend Sunday listening to biomechanics researchers who have published extensively speaking about their experimental data and its clinical interpretation at the San Diego PFOLA meeting.
Maybe ...... some other Aussie Sunday ....... the world will get what it has been waiting for.;) -
This ankle joint mobilisation patent was applied for in 2005, but was only granted this week:
Method and apparatus for anterior and posterior mobilization of the human ankle
Last edited by a moderator: Nov 20, 2007 -
Paul, just like Kevin and all following along I too was waiting for Sunday, what happened? -
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If the cause is simple and one-dimensional, then yes, it makes complete sense to address it.
If I am a patient with pain and stiffness, I don't care what your half-truth theories are; just get me right. If it returns again down the track, well, either the therapist must change tack, and/or more consideration can be given to recurrence. Common sense isn't it???
But to appease your penchant for underlying neck causes with the hypothetical neck sufferer...who awakes with a stiff neck? Is it the pillow and/or bed not being 100%? Is it what he/she lifted last night? Is it the sustained un-ergonomic position assumed for 5 minutes the day before? Is it the motor car accident 6 months ago? Is it the way they carried their school bag 3 years ago? Is it the way they style their hair every morning by flicking their head? And that is the tip of the iceberg.
Lets just worry about getting them as pain-free as we can, and as functional as we can. If you improve them, and they remain pain-free and fully functional, it would have been a waste of time to come up with a white-board tree diagram of 'possible' contributing factors. -
Atlas,
Thank you for not writing in your typical cryptic style.
Regards,
Stanley -
Atlas,
Thank you for not writing in your typical cryptic style.
Regards,
Stanley -
In relation to your question "why did the patient develop the stiff neck...?"
My response was...
"who awakes with a stiff neck? Is it the pillow and/or bed not being 100%? Is it what he/she lifted last night? Is it the sustained un-ergonomic position assumed for 5 minutes the day before? Is it the motor car accident 6 months ago? Is it the way they carried their school bag 3 years ago? Is it the way they style their hair every morning by flicking their head? "
So, none of the above are possible causes of neck pain? -
Are you not so lucky?
Dear Kevin et al
On sunday last we generated some 7GIG of raw data so unfortunately not everything can appear at once
Here in the attachment is the right foot of ONE of the 24 participants, demonstrating the changes in foot pressures comparing pre and post mobilisation
This is the data from a 63 year old man with foot pain.
M1, M2, M3, M4, M5 are the average MET head pressures calculated at 200Hz using the RS scan from Belgium.
You will see the values of (M1 + M2) - (M3 + M4+ M5)
The closer to zero shows that the pressure in the medial and lateral MET heads approach equal pressure.
From this you can see there is a massive change towards the first MET head. The higher the value indicates that the 1st MET head is taking more pressure, as it should in normal walking.
We also have data for elite athletes, walking, jogging and running. All this will be munched over the christmas period and probably much longer.
Hope this is what you are looking for and I am not just making things up.
Any comments?
Musmed.Paul C.Attached Files:
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As you do not like what is posted, what do you like?
Musmed
ps. Musmed was shortened from muscle-medicine for the likes of some, let alone musculoskeletal medicine. -
Regards,
Stanley -
Dear Podiatry Arena
I have now written a six part course in mobilisation and manipulation as CPD for Podiatrists.
Part 1 is The foot to the knee.
Part 2 is The hip to the first lumbar vertebra
Part 3 is The thorac.
Part 4 is The cervical area.
Part 5 is The cranium.
Part 6 is The Upper limb including the thoracic girdle.
In 2009 I have trained over forty podiatrists in the United Kingdom
The learning outcomes, which every participant has attained so far, is the ability to diagnose and treat structurally correctable deformities such as fixated talocrural joints or displaced cuboid bones. And that was only Part 1.
Part 2 provides the skill to correct a functional short leg instead of either referring the patient or fitting an unnecessary heel lift.
This is an exciting Continuing Professional Development (CPD) course for Podiatrists, which opens a massive professional development - the ability to compete in the market place with chiropractors, osteopaths and physiotherapists.
For those in private practise, this CPD can increase competetiveness and profitability.
In addition:
Parts 1 & 2 - gain between 30 and 60 CPD points.
All parts have, included in the course documentation, a detailed portfolio for submission to the HPC, if needed.
Graduates can obtain malpractice insurance at competetive rates.
OTHER NEWS
This year I was invited to speak at the Northern Ireland Branch of the Podiatry Society.
Other invitations by various groups are on the table for 2010.
A group of NHS Orthopaedic Podiatrists have requested training.
Manipulation techniques are now being used within the NHS by graduates.
There are two course places available at Holcot near Northampton for the last course of the 2009.
The course is on Saturday 28th November and Saturday 12th December.
The closing date for completed application forms and cheques is Thursday 12th November.
If you or any colleague is interested, please complete email mail@brettscourses.com for the Holcot Part 1 Application Form and send with the fee as soon as possible to guarantee a place.
More details of the courses are available from
http://www.brettom.com and
http://www.brettscourses.com
Tom Brett DO, BSc(Hons) LL.M (Medical Law)
Master Bonesetter, Podiatrist and Master of Laws. -
Foot Mobilisation Techniques (FMT) Courses will be conducted in England in April 2010.
Further information available at www.footmobilisation.com -
The acute effects of ankle mobilisations on lower extremity joint kinematics
Louis P. Howeemail
Journal of Bodywork and Movement Therapies; Article in Press
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The effects of posterior talar glide and dorsiflexion of the ankle plus mobilization with movement on balance and gait function in patient with chronic stroke: A randomized controlled trial.
Kim SL, Lee BH.
J Neurosci Rural Pract 2018;9:61-7
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<
Ultramarathons Cause Less Damage Than Shorter Races
|
Testosterone replacement therapy is associated with increased odds of Achilles tendon injury
>
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