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mitigating pain associated with plantar fibro-fatty pad dysfunction

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Mart, Dec 6, 2010.

  1. Mart

    Mart Well-Known Member


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    Hi
    Does anyone have any ideas for mitigating pain associated with plantar fibro-fatty pad dysfunction causing plantar heel pain? I am trying to help a 45 YO lady with longstanding plantar heel pain, denied recollection of a traumatic event, diagnostic ultrasound exam normal for chronic plantar fasciosis but suggestive for overly compliant plantar fibro-fatty pad (visibly thin and overly compliant with probe pressure), normal radiographic exam. She has tolerance for pain of approximately1 hour weight-bearing wearing running shoes, this is increased to 2 hrs using foot orthoses with 10mm neoprene compliant heel ramp.
    My thoughts are; foot-wear with proven damping heel characteristics, possibly use of MBT which might reduce peak pressures at heel contact or other foot-wear modification which increases 1st rocker duration?
    Ideas/experiences or citations welcomed

    Cheers

    Martin
    The St. James Foot Clinic
    1749 Portage Ave.
    Winnipeg
    Manitoba
    R3J 0E6
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  2. nigelroberts

    nigelroberts Active Member

    Hi Martin
    May be worth checking out with MR as well. ?? problem with the calcaneum.

    Regards

    Nigel
     
  3. Hi Martin

    I´ve looked but did not find much

    but .... not sure it helps ??

    http://www.asbweb.org/conferences/2005/pdf/0780.pdf

     
  4. and check this one out again not sure if it helps.

     
  5. Mart

    Mart Well-Known Member


    Thanks Nigel; I have bone edema in my ddx - pain not severe enough to warrant cost of MR right now given that it is unlikley to change treatment plan. radiographic exam has ruled out bone cyst, stress # also less likely thiough not certain.

    cheers

    Martin

    The St. James Foot Clinic
    1749 Portage Ave.
    Winnipeg
    Manitoba
    R3J 0E6
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  6. Mart

    Mart Well-Known Member

    Thanks Michael

    I wonder how useful measuring this kind of data would be if we had clinical tools for that purpose. In the end the diagnosis would be based on history and PE aided by imaging and irrespective of biomechanically measured properties; irrespective the treatment plan would involve same ideas; stress reduction.

    I think that there would be some merit though in testing treatment modalities such as mechanical properties/ efficacy of foot-wear etc but am not aware of any studies specific to this issue other than generalised studies for plantar heel pain which seem to lack specfic differentiation for underlying injury (ie is chronic plantar fasciosis present or not?)

    cheers

    Martin

    The St. James Foot Clinic
    1749 Portage Ave.
    Winnipeg
    Manitoba
    R3J 0E6
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
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