Members do not see these Ads. Sign Up.

Hi
I have a patient who is an Osteopath and has come to me to see if there is anything I can do for the pain she is experiencing in her left lateral lower leg over the superior Fib/Tib joint.

The patient reports a dull aching pain after walking for about 1 mile on flat surfaces but this is made worse when walking up or down hill. The pain radiates down the lateral side of the left lower leg with minimal paraesthesia. The patient also noted on a recent holiday when walking down hill that her foot started to supinate and twist round as the pain worsened.
Pain eases with rest but it is very tender around the Superior fib/tib joint on palpation. There is no obvious swelling in the area. The condition is aggravated by walking, crossing the legs and lying with the left leg abducted and knee bent.
Hips Knees and ankles all have a full ROM and are pain free.
Previous Medical History = R & L adhesive capsulitis in shoulders.
No history of injury to the leg and no medications.

Pt. thinks it is a strain of the sup tib/fib joint but is not sure why and what the maintaining factors might be.

Any advise would most greatly be appreciated.

 

Fibula moves as foot forsiflexs (as anterior part of dome of talus is wider) --> maybe trial a heel raise to see if that limits movement.

 

Ask more about that. Was the twisting around, pain avoidance or caused by a cramping muscle? Make her demonstrate the twisted position.

 

Thank you Craig, I am seeing the patient tomorrow and will try the heel raise out.

 

Hi Debs

I would look along the biceps femoris, fibula a/p glides at superior and inferior tib/fib, and superior/inferior glides. Also look for pain at lateral TCJ and cuboid joints.

Let us know what you find
Ian