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Mobilisation as an effective treatment for chronic plantar heel pain

Discussion in 'General Issues and Discussion Forum' started by moe, May 9, 2012.

  1. moe

    moe Active Member

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    I am currently undertaking a literature review and am seeking any unpublished studies or appealing to researchers in this area as to any research currently underway.

    Iona Millar
  2. Dananberg

    Dananberg Active Member

    Nothing published (yet), but I have come to identify a subset of what appears as plantar fasciitis, but is really abd. hallucis muscle spasm. Manipulation of the cuboid can resolve this spontaneously.

    On exam, the abd. hallucis is quite painful to exam and is just superior (as examined from the plantar surface of the foot) to the actual medial slip of the plantar fascia. The two can be carefully differentiated by exam. If it is the muscle belly which is painful, then trying a cuboid manipulation can provide immediate resolution.

    Paul Connelly talks about dry needling of the abd. hallucis for the same purpose. Two different approaches to the same issue.

  3. TedJed

    TedJed Active Member

    Hi Iona,
    The presentation howard has outlined can also present and be confused clinically as a trigger point. Treating the trigger point can provide relief but usually is temporary at best. Cuboid and anterior talar displacements/stiffness are those most common etiological factors I've come across.

    A couple of final year students at UniSA were undertaking a lit review last year in this area. I don't have their details with me presently but I'm sure Sara Jones could point you in their direction.

  4. Stanley

    Stanley Well-Known Member

    Hi Iona,

    No reasearch regarding plantar fascitis. However, I am working on the lateral talus and posterior innominate.
    For mobilisation, you may want to look at anterior mortise for a large equinus.
    Look for a lateral talus, and also you can find a posterior calcaneus.

  5. Ian Linane

    Ian Linane Well-Known Member

    Hi Moe
    Are you looking at joint or soft tissue tissue mobilisation or both.

    If soft tissue then you may well find more information. Joint mobilisation may be more scarce.

    In terms of joint however then Brian Mulligan's MWM's (mobilisation with movement) may be a source. Quite a lot of research has gone on with this technique.

    In addition, if looking at joint work then you may need to consider whether the reported mobilisation technique of a joint in the literature is complete. For example the anterior and posterior fibular mobilisation is a common one used but, arguably, not completely done if the cephalad and caudad mobilisation aspect is left out. Just a thought.
  6. moe

    moe Active Member

    Hi and Thanks to all who have responded.
    Howard I have spoken to Paul re Abd Hall, I will usually look at joint mobility of the foot as well as trigger point therapy of Abd hallucis I hadn't considered cuboid in isolation but will look for that. Thanks
    Ted I grabbed the names of those students from a poster at the conference but as yet haven't yet contacted them. Thanks for the tip
    Stanley I am aware of a few studies with limited evidence suggesting an association between reduced AJ dorsifelxion and CPHP so I think including the ankle mortice could improve my chances of finding information, but will look further. Thanks
    Ian I had only considered joint mobilisation but as I have started looking at the literature soft tissue mobilisation keeps popping up. Thanks for the info I will follow that up.
    Thanking you all kindly
  7. Ian Linane

    Ian Linane Well-Known Member

    Hi Moe
    You're welcome and it has been interesting looking at others ideas as well.

    One other thing occurred to me last night. Will you be differentiating between joint mobilisation and joint manipulation in your literature review. There can be a significant difference in their application and use.

    Also, and it may be outside of what you are looking at any so ignore it if it is, but it would be rare, for me at least, that I would use a joint mobilisation in isolation from Soft Tissue work when treating plantar heel discomfort/pain. There are times when I might incorporate a joint mob into soft tissue work and vice-versa. In effect however they may be part of a single treatment session.
  8. moe

    moe Active Member

    Hi Ian
    I was looking specifically for joint mobilisation but will include manipulation as the literature looks bleak thus far.
    Thanks again

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