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i have a patient that came to see me about a year ago complaining of painfull 1st mtpj. there was 10 degrees max rom and he had been provided with ridgid off the shelf full length ach supports , no rearfoot posting, into which had been incorporated a long shaft pad which had been successfull in relieiving the pain he was experiencing,however the pad was excessively worn and he was again experiencing the original pain so I replaced it and once again he was pain free. This same patient came back to see me several weeks ago again copmpaining of the original pain, the shaft pad was still intact and so I assumed that it was still increasing weight bearing and reducing rom at the joint. his calcaneum was 10 degrees everted in rcsp so I placed 5 degrees medial rf posting to reduce some of the pronation. The patient has since returned and the pain is still there.

Q. would posting the rf contribute to the pain due to the fact that it would increase the inclination angle of the 1st met and therefore dorsiflexion of the hallux whereas prior to this the met was lying in the same plane as the hallux and therefore allowing the shaft pad to be more effective. any advice here would be well appreciated.

 

Hi Boomshanka,

:welcome: to Podiatry Arena.

I notice you joined in Sept. '08 so you possiby already know your way around. :D

The Biomechanics, Sports and Foot orthoses discussion area may provide more responses to your question.

Happy hunting.

Regards,

Mandy.