Case Studies
Calf (Gastrocnemius) Muscle Pain
, Doug Claridge - PhysiotherapistPete first presented to Doug at Russley Physiotherapy complaining of pain in his calf muscle.
Pete is an ex-rugby player who now plays social touch. Pete has also just started running again to increase his fitness, however he has had issues with his calf muscles for years. Every time he increases his activity, he ends up with pain similar to a pulled calf muscle. Pete’s pain is now starting to linger with diffuse tenderness along the muscle belly and surrounding structures.
check out the video
Severs Disease
Dominic presented with painful heels on both feet, which are much worse after prolonged activity. He has also experienced knee pain in the past. Dominic is a very active 10 year old boy, he plays representative football and training has recently increased to about 8 hours a week. He claims walking on the side of his foot helps relieve the pain and ibuprofen gel makes a small difference when massaged in to the area.
Medial Tibial Stress Syndrome
Practice: PodiatryMed, Christchurch, NZ
Chelsea presented with pain in her shins as well as few other issues.Chelsea is active and in her early 20's. She is social netball player and in addition to this has just joined a training group. Over the past 4 weeks she has increased her exercise greatly with interval training and running 3-4 times a week, 5-8k per run. She is experiencing diffuse tenderness along the medial border of the tibia. It is worse with increased activity and subsides with rest.
Bilateral achillies bursitis – pain free in 3 days with Formthotics™
Name: Yevgeniya Zinurova, Age 28, Ethnicity Russian
Practitioner: Dr. Kirill Shlykov
Initial Problem
Yevgeniya recently begun to experience pain in the heels and achillies tendons of both feet. This made training, competing and every day activity very uncomfortable to the point she had to limp. She eventually turned to a Formthotics™ specialist, Dr. Kirill Shlykov, who diagnosed her complaint as bilateral achillies bursitis.
Intervention
Dr. Kirill Shlykov fitted Yevgeniya with Original Dual Medium Formthotics™ in her training shoes and Comfort (¾) Single Hard Formthotics™ in her sprints shoes. Approximately 10 days after this a wedge was added to both to increase control. She is now also wearing Formthotics™ in her casual shoes.
Outcome
On day three of simply being fitted with Formthotics Yevgeniya's left achillies pain and bilateral heel pain had totally subsided, the right achillies pain had also decreased. Yevgeniya no longer felt any pain during everyday activity and was able to return to her full training load. With the added wedge adjustments Yevgeniya claimed pain during training was again lessened, furthermore her feet now feel good during and after training and no longer swell or ache.
Days after being fitted with Formthotics Yevgeniya competed at the Moscow Junior track-and-field Championship where she gained an out-of-contest officially recorded result of 2.00.27, which was the best time of the season worldwide. This result was later beaten and she currently holds second place. Following the adjustments to her Formthotics Yevgeniya went on to gain silver in the 1000m at the Russian Winter Race. Yevgeniya continued to wear Formthotics™ throughout the 2011 winter season.
Formthotics™ help heal leprosy ulcers
When Keith Aitken, Podiatrist contact us to ask for our support with his trip to Niger we were curious and intrigued. Keith was going to be working with leprosy patients and as we had never encountered patients with leprosy, we had never thought of his application for Formthotics™
We were impressed by Keith’s altruism and willingness to help others so proved him with some product to take to Niger.
In Keith’s words…
“These are pictures of one of the Leprosy patients that had a typical Leprosy Ulcer. He had the ulcer for an estimated 2-3 years, His feet were quite numb clinically. He could not feel any vibration below the knees and was insensitive to 75gm monofilaments. |
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I debrided the ulcer quite extensively and he couldn't feel a thing. He had good foot pulses so I knew that if we could get the pressure of the ulcer it would probably heal. I had the ulcer dressed and changed every 2-3 days with the patient living in the Hospital grounds in a millet hut.
The patients all use these types of sandals all year round. I heat fitted the Formthotics™ to his sandal. He was very grateful for all the treatment. Within 1 week the ulcer was granulating nicely from the base and getting smaller. I was there for about another 2 weeks after the fitting of this Formthotics™ and apart from some further debriding and dressings no other treatment was used. After I returned to NZ the Doctor looking this patient emailed me and said that the patient's ulcer had healed. They were very excited.
There were other leprosy patients with other ulcers that had Formthotics™ fitted and they have all done well. The whole hospital is dedicated to Leprosy. 90% of the patients had foot ulcers. Some had previous amputations. Some had infections that were not able to be resolved with the antibiotics that were available. These needed deep debridement and probing along facial planes to eradicate the infection, all done without x-ray or scanning equipment.
I also heat fitted Formthotics™ to a child that had cerebral palsy. The Formthotics™ helped him to improve his gait using a type of walker that they make over there”.
Keith is home now, please to be away from water shortages, high security and the constant underlying fear for your life. However, there is a lot more work to be done and he is planning a return trip. If you are interested in getting involved with Keith and his work please
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Pain-free footy
Rebecca Moriarty from Olympic Park Podiatry in Melbourne, Australia describes how she enabled her 24 year old patient to play state-level Australian Rules Football pain-free.
I recently saw a 24 year old state-level footballer with a 2 year history of bilateral shin pain. He presented with 2 year history of bilateral medial tibial stress syndrome, and occasional calf issues. He had been treated by a podiatrist when the injury initially presented itself and was prescribed custom made rigid orthoses. The patient could not tolerate the orthoses and after 6 months of trying, he removed them from his sport shoes.
The patient continued to try and play but toward the end of the first season, was forced to miss 6 weeks of games. He had a further 6 week’s rest in the off-season before commencing pre-season training again. In the meantime, he had changed his football boots and runners, had regular massage, and occasionally took anti-inflammatory medication for the pain.
Mid-way through his second season, the patient visited our clinic after struggling with his shin soreness for 5 weeks. We assessed the mixed aetiology of bilateral medial tibial stress syndrome (MTSS), and deep posterior compartment syndrome.
On examination, the patient appeared to have normal ranges of movement through the hip joint, no apparent leg length discrepancy, and slight hamstring tightness. He had normal range of movement in the sub talar and mid tarsal joints – although on the slightly stiffer side. He had adequate ankle joint dorsi flexion, and tight calves. He exhibited a moderate amount of foot pronation, and had not tolerated orthoses in the past. The pronation was a combination of rearfoot and midfoot, and he did exhibit a secondary internal tibial rotation.
At the time of the consultation, the patient was issued a pair of Single Hard (Red) Formthotics™ with extended rearfoot wedges that were ground slightly at the distal edge of the wedges. He was advised to adjust to these mechanical changes over the first week and in the second week; he was to run in them in his runners. Once this was comfortable, he was advised to wear them in his football boots. The patient was to continue the management plan that he was already doing – regular massage, stretching and post activity icing.
6 weeks after the initial consultation, the patient’s symptoms were reviewed, and he presented a very happy young footballer. Whilst he still had an element of calf tightness, he was not experiencing any sharp medial shin soreness, and had been able to play the past 2 games in full without medication.
The patient was monitored for the following 6 months and continued to be pain free. After 9 months, the Formthotics™ were updated for his running shoes, and the older pair was worn in the football boots. The Formthotics™ were better tolerated by the patient when compared to the rigid devices. MTSS is an impact-related pain, and I feel Formthotics™ are ideal to control some of the mechanical influences of the pains, without creating a “hard” platform within the sports shoe.
