Hi all
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I have a 50 something female suffering with blistering and heavy callusing over the medial aspect of her 1st MPJ LF. In gait she is pronated (L>>R) and apropulsive with associated abd twist and medial roll off. This essentially increases the pressure over the 1st MPJ and plays a substantial role in callusing and blistering of the area.
O/E it was noted that the client had had surgery on her LF. ROM of STJ was normal with ratio of inv:ev 2:1. Of interest though was the lack of movement through her MTJ. Muscle lengths and ROM of other joints were well within normal limits and the STJ seemed medially placed. J/Test proved v.difficult. Essentially in stance with her STJ "in neutral" her forefoot is in a varus position and is fixed (cannot reach the ground). I provided her with a 3 deg inverted device with a small 2mm skive to assist with resupination (SRT - hard). Perhaps stupidly I left the forefoot alone.
At review she is complaining of MLA and plantar foot discomfort and it is evident to me that in an effort to allow the forefoot to rest on the supporting surface she is pronating heavily on the device.
I have followed many discussions on this forum with regard to FF posting and the lack of need for them. Is there another way I can assist this lady. If I shouldn't use a FF post to aid her 1st met to contact the ground what do I do? :confused:
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