Monday, December 22, 2008

The path of least resistance

Being on the spot when injuries happen expedites healing time and is cost effective. This is one of our football lineman who, in the transition to indoor shot put, developed achilles tendinitis. The etiology is a planus foot structure aggravated by some lower extremity force reduction issues.
ATC's love to tape, and I'm no exception. With some Coverroll & Leukotape, simply pull the calcaneus firmly in a varus direction with the tape beginning & ending with the lateral & medial malleoli respectively. Then, another strip directly across the achillis tendon pulling medial to lateral in the same fashion. The subtalar joint will have a medial bias when you are done, but this will self correct when the foot hits the floor.
This is not a wait and see procedure. It should bring immediate relief of symptoms. I will repeat it for about 2 weeks. This is without any modalities or remedial exercise or any further intervention. The trick is catching the injury in it's infancy, with a few pennies worth of tape.

2 comments:

Brian said...

Joe would that theoretically off load the medial aspect of the Achilles more so due to the lengthened medial aspect of the tendon with a Pes Planus/valgus foot....?

Joe Przytula said...

Another article in this month's JOSPT discusses the role of excess counter clockwise torsion during the eccentric phase of running/jumping in the lower extremity as being very irritating to the achillis. I think the tape provides a proprioceptive effect that might reduce that "amaturization period", as well as your theory.