|13-04-2006, 04:18 PM||#1|
Join Date: Sep 2005
Thanked 0 Times in 0 Posts
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?
Thanks and have a nice day.
|13-04-2006, 04:35 PM||#2|
Join Date: Mar 2004
Location: The Earth Planet
Thanked 2 Times in 2 Posts
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
|13-04-2006, 04:37 PM||#3|
Human Primate Social Groomer and Neuroelastician
Join Date: Mar 2004
Location: Weyburn Sask.
Thanked 7,133 Times in 3,212 Posts
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.
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
WCPT PhysiotherapyPainNetwork on Facebook
Neuroscience and Pain Science for Manual PTs Facebook page
SomaSimple on Facebook
"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley
“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial
“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis
"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth
"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire
Last edited by Diane; 13-04-2006 at 04:39 PM.
|Thread||Thread Starter||Forum||Replies||Last Post|
|Bilateral ankle pain and sympathetic tone||Tim||Clinical Reasoning||5||20-05-2006 09:34 PM|
|Ankle sprain and neuromobs||bernard||General Discussion||17||06-04-2006 12:16 PM|
|A nauseous ankle!||nari||Clinical Cases||20||26-07-2005 07:53 PM|
|Ankle problem||marosen||General Discussion||1||14-06-2005 10:10 PM|
|A trap in the ankle!||nari||Clinical Reasoning||1||17-05-2004 05:34 PM|