Instep Podiatry and the Case of the Injured Runner
(c) Copyright 2008 Instep Podiatry Brisbane. All Rights Reserved.
Ms. Jane, a 42 year old fit woman, presented with a very
painful heel that she felt she had injured during a tennis game
and it was now keeping her awake at night. She walked favouring
her left foot and now had developed a sore right foot.
On getting up in the mornings she felt a tearing sensation
and pain but this went away as she walked. The same thing
happened when she had a cup of coffee and then stood up.
At Instep Podiatry a full assessment and history was
performed.
On discussion, the tearing feeling had been felt for about 6
months and only after the injury had Jane noticed that walking
was unbearable on the left heel. This condition was diagnosed as
Plantar Fasciitis and is very commonly involved
with heel pain problems.
She had also developed a sore lower back and had knee pain in
both legs. Both calf muscles were very tight and this was
affecting her movement.
Instep Podiatry referred her to Albany Creek Physiotherapy
and Sports Injuries Centre for a physiotherapy assessment and to
the local Radiological Centre for an X-ray of the heel.
The X-ray cleared any problems and the physiotherapy improved
her range of motion in the ankle and her back pain so that she
was able to be fitted with custom orthotics.
Instep Podiatry used both computerized gait analysis and
biomechanical assessment to diagnose the problem. Her left foot
had severe pronation and she agreed that she had always been
flat footed but that recently the left foot had looked as though
the "arch had dropped".
Dropped arches is a well known misnomer of the ageing foot.
The shape of the foot does change as the body ages and the
muscles are unable to withstand the forces placed on it. This
can give the appearance that the foot suddenly has no arch. One
foot can often be pronated to account for a leg length
discrepancy that often occurs in the dominant side of the body,
i.e. right handed people have a longer leg on the right side.
Leg length differences often lead to back pain as the pelvis
tilts during walking. Muscles in the back attempt to stabilize
the hips and spasms occur resulting in back pain.
By correcting the discrepancy with a heel wedge on the custom
made orthotic, Instep Podiatry re-balanced the pelvis, and after
physiotherapy corrected the muscular imbalance Jane was able to
function without pain.
She is now playing tennis weekly and has taken up hiking,
free of foot and back pain.
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