Case Study #3
Condition: 1st MPJ, Ankle, knee and Tibialis Posterior Shin Pain. Right leg and foot worse.
Duration of Pain: 10 Years on and off, depending on activity levels.
Overview: The first video shows the Right foot pronates more than the Left swinging outwards, externally rotating to compensate for the over pronation. In the video of the pressure mapping, you can see how the 1st Metatarsal head doesn’t make ground contact so the weight goes into the Distal Phalanx to stabilize the foot, before heel raise. These forces through the metatarsal head, can stress the joint and make it painful. The Tibialis Posterior Muscle has to work harder as the feet over pronate, with the internal rotation of the leg causing maltracking of the knees.
Treatment: The feet were aligned on the VFAS, with more correction needed on the Right foot. The patient has a foot that flattens, not a flat foot which you can see in the pictures showing the natural arch height with the FootAligner being held against the foot. Two MLA/RF cookies, one Cuboid cookie (for lateral column support) and a 5mm wedged Morton’s Extension were applied to both orthotics to stabilize the feet. Extra cookies in the arches and heels were added to control the pronation. The wedged Morton’s Extension, brought the ground up to meet the medial forefoot, removing the need for the patient to externally rotate. The patient felt instant relief from the changes in his the gait cycle and better alignment.