My first blog entry is a case study of a woman who came in with primary complaint foot/ ankle pain x 1 week, inability to fully wtb on affected extremity with ambulation. She relates mechanism of injury as getting a new exercise app on her phone, which had her running on her toes in place, for extended periods of time.
On PE, she had + talar swing test for decreased talar mobility, strength testing revealed 4/5 posterior tib strength, and pain with resistance, and palpation revealed significant posterior tib trigger point.
First rx was talar manipulation to reseat the talus, stm posterior tib followed by Patla stretch. She was on Cape for short time, so I saw her the next day, prior to her returning to NYC. Second visit revealed 50% subjective improvement, improved/limited talar mobility, improved limited posterior tib strength. 2nd visit was same as the first, with HEP added consisting of posterior tib strengthening with L leg drived, lower leg strengthening exercise (side step, rotational reach with band) and gastroc-soleus triplanar stretching.