SomaSimple Discussion Lists  

Go Back   SomaSimple Discussion Lists > Persistent Pain Problems > Clinical Cases
Albums Quiz PubMed Gray's Anatomy Tags Online Journals Statistics

Notices

Clinical Cases Typical cases of PPP

Reply
 
Thread Tools Display Modes
Old 13-04-2006, 03:18 PM   #1
leanPT
Junior Member
 
Join Date: Sep 2005
Posts: 4
Thanks: 0
Thanked 0 Times in 0 Posts
Default ANKLE FRACTURE

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?
Thanks and have a nice day.
leanPT is offline   Reply With Quote
Old 13-04-2006, 03:35 PM   #2
emad
Forum Moderator
 
emad's Avatar
 
Join Date: Mar 2004
Location: The Earth Planet
Age: 39
Posts: 2,067
Thanks: 2
Thanked 2 Times in 2 Posts
Default

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

Regards
Emad
__________________
emad is offline   Reply With Quote
Old 13-04-2006, 03:37 PM   #3
Diane
Human Primate Social Groomer and Neuroelastician
 
Diane's Avatar
 
Join Date: Mar 2004
Location: Weyburn Sask.
Posts: 23,222
Thanks: 3,323
Thanked 6,525 Times in 2,965 Posts
Default

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.
__________________
Diane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page

@dfjpt
SomaSimple on Facebook
@somasimple

"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 03:39 PM.
Diane is offline   Reply With Quote
Reply

Bookmarks

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump

Similar Threads
Thread Thread Starter Forum Replies Last Post
Bilateral ankle pain and sympathetic tone Tim Clinical Reasoning 5 20-05-2006 08:34 PM
Ankle sprain and neuromobs bernard General Discussion 17 06-04-2006 11:16 AM
A nauseous ankle! nari Clinical Cases 20 26-07-2005 06:53 PM
Ankle problem marosen General Discussion 1 14-06-2005 09:10 PM
A trap in the ankle! nari Clinical Reasoning 1 17-05-2004 04:34 PM


All times are GMT +2. The time now is 05:21 PM.


Powered by vBulletin® Version 3.8.8
Copyright ©2000 - 2014, vBulletin Solutions, Inc.
SomaSimple © 2004 - 2014