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Clinical Cases Typical cases of PPP

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Old 13-04-2006, 03:18 PM   #1
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Hi guys
I have a patient with fibula and tibia distal fracture, a significant fracture. Now he feel lot pain in the all foot especially in the sole. I did mobilization, stretching, walk reeducation and correct of ER of the hip with exercise and manipulations. What can I do? Mirror therapy, is good for this problem?
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Old 13-04-2006, 03:35 PM   #2
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Hi ;

I theorize ( put the hypothesis) that this patient had been immobilized and addressed by an Orthopedist ,For how long was the immoblization period ?

What are the most limited movements ? eversion ,inver...planter..dorsi ..?

Correct ER,,,,hip what was that ?

Sometimes pain could be evoked from over-exercising .As well ,those cases of post-fractures could take long time to return full free activity

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Old 13-04-2006, 03:37 PM   #3
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You could try spending some time with their soft tissues. Very slow and very gentle heel distraction might work well for the pain.

The grasp has to be slowly applied; it's good to take up all the skin slack slowly. Only skin slack. Wait patiently for the body to permit the increase in actual (or imaginary!) joint distraction. I take the heel into eversion usually through just slight twist to the skin layer, either into internal rotation, or into slightly more eversion. The heel doen't move so much as the tarsal tunnel gets some opening/lifting/refreshing. The other hand can be stretching skin either at the ankle, heel cord, or foot. You could try various places, and wait for just a few moments at each place. If that person's nervous system wants you to continue, you'll feel it get "busy" under your hand; i.e. you will feel motor outflow. The patient may go very quiet or spontaneously deep breathe, or may mention something strange they feel a long way away (like their eyebrow hurting or something). Back off a little if you are creating local discomfort, reassure them everything else is all normal, but take your own guidance from any improvement you witness in their autonomics, i.e. what you observe. Learn to trust your hands on other peoples' nervous systems, and good luck.

PS: Toe traction, coupled with a little plantar flexion (heel on the bed) can feel awfully good too. Light slow touch recommended so as to not threaten the hindbrain.
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Last edited by Diane; 13-04-2006 at 03:39 PM.
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