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Hi all,

A patient came into the clinic today and when I checked his motor responses, I found that he had plantarflexion problems (I rated it a 2/5). I informed him of this, and suggested that he visited a physiotherapist to strengthen his plantarflexors. However, he was reluctant to see one and preferred that I give him some advice instead. This is not a strong field of mine and I would prefer to be certain before giving out any advice. Any advice? Would weights attached to the ankle be a good idea to strengthen plantarflexors?


Cheers :)

 

Hi...
I am a PT who also has been making orthotics for about 17 years mostly on referral from podiatrists. I am interested in your question about strengthening the plantarflexors. I don't know if we grade strength the same way but if the patient truly has 2/5 plantarflexors, my first question would be why? And does the patient have weakness elsewhere? Also, is it plantarflexion you tested or did you test a specific muscle? To strengthen plantarflexors you can use theraband or various forms of a heel raise, but I would strongly encourage you to determine the reason for the weakness and whether there is weakness elsewhere.

Ann, PT

 

A belated reply, sorry Ann. Have been a bit busy lately.

If the patient truly has 2/5 plantarflexors, my first question would be why?
Probably due to old age and has been doing very limited exercise since undergoing second knee operation.

And does the patient have weakness elsewhere?
Both knee and calcaneal reflexes suggest nerve impairment.

Also, is it plantarflexion you tested or did you test a specific muscle?
No, I think it may be the gastrocs or soleus?

I have recently set the patient up to see a physio as this is not exactly my forte. Thanks for the help though.