MPJ pain and medial ankle pain in occasional runner

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Hi all.
Just thought I'd bring up a personal case study.
A 30 year old female. occasional runner who has recently stepped up her running to 10km sessions a few times a week.
Came to see me presenting with metatarsphal jt pain along plantar surface in right foot and medial leg pain in vacinity of just posteror to medial malleolus . Some soreness extending to area of navicular. Unsure of when it started but says she woke up with sore foot one day 3 weeks ago.
Her feet were significantly flattened both feet and an apropulsive foot function was presented during the gait cycle. Medial bowing of the tendoachilles was evident in both feet to a small degee.
I prescribed orthoses to help support both feet during walking and eventually running. Posted to 4 degrees inversion with medium arch support and the highpoint at the sust tali.
Also the usual footwear advice and stretching advice for quite tight calf complex. Also hamstring stretching advice.

Am I missing something here? treatment or management

Thanks

 

A diagnosis.

 

What Mr Griffiths is trying to say in a very verbose and round about manner is that you have prescribed a device for a patient who is experiencing pain without creating a diagnosis.

If you have no diagnosis, what are you treating?

You are treating a collection of anatomical observations that whilst they may be factors in precipitating her problems, are seen in a large number of asymptomatic persons/runners

You might find this tissue stress thread useful.

Also for getting maximum feedback on case presentation, this will help

presenting patients for clinical advice

Regards,

Robin