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The last 4 pts I've had with PF type discomfort have all had a common site of pain in the dorsal aspect. Light to moderate pressure to the dorsal 3rd and 4th met heads elicits very sharp pain. The other met heads are fine. The pain seems to be seated in the capsule area and slightly proximal to it in these mets.

Curious to see if others have seen this as a frequent occurence in PF type discomforts ( I recognise that not all PF type discomfort is not necessarily actual PF heel pain.) Could of course be that I've missed it on everyone else :eek:

cheers
Ian

 

Can't say I have noticed that, but have noticed more dorsal midfoot interosseous compression syndrome in plantar fasciitis. (Kevin Kirby just did a workshop on this here last week)

It is intuitive that dorsal compression syndromes and maybe what you seeing in dorsal MPJ's are common in those with PF - we now know more about the types of windlass dysfunctions that are associated PF and those same dysfunctions can be associated with dorsal compression of midfoot joint and assume to be associated with MPJ problems (ie the 'reverse' windlass is problematic)

 

It is very common for patients with plantar fasciitis of over a few months duration to develop symptoms associated with them walking in a more supinated fashion and thus increasing the dorsiflexion loading forces on the lateral metatarsal rays that may cause a variety of secondary pathologies related to this antalgic gait pattern. Lateral dorsal midfoot interosseuos compression syndrome, lateral metatarsalgia or tenderness at the dorsal aspects of the metatarsal necks due to the increased dorsiflexion bending moments on these metatarsal rays may result due to gait compensations for plantar fasciitis. I would expect that this is what you are clinically describing.

 

Hi Kevin and Craig

Thank you for the helpful replies. Pleased to say that 3 of them have improved with transverse frictions and orthoses and one with deep transverse frictions and massage alone. (But I suspect this is temporary as the fascia on that side is tighter than on the none symptomatic side - pt wanting to put off orthosis intervention really).

Cheers
Ian

 

Ian,

What exactly do you mean by transverse and deep transverse friction?

Cheers
Dom

 

http://www.om-cyriax.com/577-glossary/Friction-massage.htm
http://www.cochrane.org/reviews/en/ab003528.html

Google: transverse frictions