Heel pain / Achilles Tendonitis

[emad]

Hi all :


Do you think could we help the patient with heel pain ?


Regards

Emad

[EricM]

Yes?
But maybe you could expand on your idea a little bit further for us emad!

Eric

[emad]

Hi Eric:

I have a patient with heel pain , was referred as that diagnosis after long way of investigations from X-ray to laboratory tests ........., took lots of drugs , but no benefit .

I think the issue could treat the cases of tendinitis for example this case .

By the way , i assessed the case ;

SLT + DF :arrow: no pain
SLT + PF :arrow: No pain
SLT + Eversion :arrow: no pain

Resisted planter and dorsi :arrow: no pain
just pain in morning , with palpation of the heel .

The patient problem begun since around year , his job demands standing long time as 5 hours or more daily , but now he is OFF-work since one month , pain is little in relation to the time of wrok-on

Regards

Emad

[bernard]

Emad,

I do not know the abbreviation SLT = Straight Leg T=???

[emad]

Yes ,bernard :

SLRT =Straight leg raising test


Regards

Emad

[flaviovitor]

Emad,

have you examined de acessory movements for pain and or stiffness of the transverse tarsal joint, tarsometatarsal joint and more specificaly, the articulation formed both by tibia and talus and talus and calcaneous?

These are important issues you must examine.

A problem located in hip can reffer pain into the heel without any pain in hip. Finally, examine the knee.

Tell us more about these findings.


Flávio Vitor.

[emad]

Hi FLavi :

Back , hip and knee are free .

All joints surrounding the forefoot are free , both physiologocal and accessory motions .

No referring pain type.

you wrote :
A problem located in hip can reffer pain into the heel without any pain in hip

like what Flavo???

Regards
Emad

[flaviovitor]

Emad,

in agreement with Wroblewski (1978), osteoarthrosis and/or osteoarthritis.

Could it be a posterior tibial muscle trigger point?


FLÁVIO VITOR.

[nari]

emad

You did not mention SLR/T with DF or PF with inversion.

Worth a try.

Failing that, slump with the SLR combinations.


Always neurodynamically.

Nari

[bernard]

By the way , i assessed the case ;

SLT + DF Arrow no pain
SLT + PF Arrow No pain
SLT + Eversion Arrow no pain

Resisted planter and dorsi Arrow no pain

Nari you need some glasses! :roll: :lol:

[nari]

Bernard

I still can't see inversion....

maybe it's a mental blockout or senile dementia.


Nari

[bernard]

Sorry Nari,

I need glasses for true! :oops: :?

[nari]

Bernard, you would look very distinguished with a monocle...


Nari :wink:

[emad]

Hi all;

For that case , i prefered to use Amercian Physical Therapy Paradigm , so that I applied Continous Ultrasound , Paraffin Therapy around the heel .As well , some neurodynamic ex.

One point , the patient asked me , what i do for that pain in the morning , it is the worst , i replied him without any deep thnking , put your whole foot in a moist heat water before going to bed for 5 minutes .

He came back after 32 sessions /visits saying my pain decreased 60 % , no pain in morning when put my foot in hot water before sleep , i can walk very well ???? I advised him to do that without any reasoning ???


By the way , this patient is about 35 years , and during his eriod with me he stoped standing and walking long times.

Regards

Emad

[slopoke]

perhaps it's the rest and not standing for a long period of time which helped your patient. Retracalcaneal bursitis appears more likely in the patient's symptomatic presentation if the pain is around posterior calcaneus.

[emad]

Hi slo;

8 months , i can not remember any thing about that consumer .


Regards

Emad