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Is Manual Examination of the Foot a Dying Art?

Discussion in 'General Issues and Discussion Forum' started by Kevin Kirby, Apr 1, 2013.


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    For those that are interested, an article I wrote on growing tendency of podiatrists to be less accomplished at manual examination techniques of the foot and lower extremity here in the States was just published in Podiatry Today Magazine.

    Is Manual Examination of the Foot a Dying Art?
     
  2. David Smith

    David Smith Well-Known Member

    I would say the answer to that proposition is No! Not by my experience
    Dave
     
  3. Ian Linane

    Ian Linane Well-Known Member

    I suppose it depends on what level of manual examination you are thinking of Kevin and, in addition, are you also referring to the manual therapy (mobilisation / manipulation skills) in podiatry.

    That said, if it is a declining skill, it is not unique to podiatry. I am aware that within the UK, in the physical therapy world, there are those who are no longer allowed to apply manual therapy treatments, becoming more reliant on electrotherapy and exercise prescription, and have consequently become de-skilled. At least that is what I am told.
     
  4. blinda

    blinda MVP

    Nice article, Kevin. You make a very good point: It is important when examining a patient to obtain confidence from them. Unfortunatley, when faced with a dermatolgical condition many practitioners will only look at a lesion without touching it, which can cause further distress to the patient. We don`t need high-tec equipment to perform assessments (although a Woods light is a useful adjunct), just our senses of smell, sight and touch in a well lit room. Very few skin complaints are contagious (i.e. herpes simplex, scabies and impetigo) and can be examined safely, so long as there are not any open wounds on your hands. Obviously.

    Light palpation of lesions can help us to appreciate the changes in the outer layers of the epidermis, whilst a firmer touch can assist in diagnoses of lesions/inflammation in the dermal and sub-cutaneous layers.

    Just my two-penneth.
     
  5. Blarney

    Blarney Active Member

    Great article Kevin - only last week I had a patient tell me a similar story - the podiatrist never laid a hand on her during the examination - straight to casting.

    My clinic al practice has completely changed over the past number of years - we've got rid of the foot pressure plates and in shoe syatems.

    We examine and treat based on manual hands on basis and the results are outstanding.

    The physios that I know get best results with manual hands on treatments also - MSc Manipulative courses in Australia seems to be the gold standard in their profession and are always over subscribed.

    Justin

    podiatry.ie

    "Where people with foot pain come to get it fixed."
     
  6. Here is a clean pdf copy of my article on Manual Examination form the April 2013 Podiatry Today magazine for those that are interested.
     
  7. TedJed

    TedJed Active Member

    Thank you Kevin.

    I'm interested in your observations.

    Blarney's experience of 'they never laid a hand on me' is something we hear regularly.

    Ted
     
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