Where is her Foot pain coming from?

Thanks to this patient for being a case study

Where is the pain coming from? Sometimes the problem is above or below where the patient is experiencing the pain.

This patient is having pain on the inside of her right foot. She reports it hurts to walk and stand for moderate periods.

Watching a patient walk and examine how the patient stands can help you find out where the problem is coming from. Standing and walking can give you clues into what causes the patient pain.

Look at the stickers on the patient foot and knee. See anything? There is an increase angle in the shin bone (tibia bone). It’s also called a valgus knee or knocked knee. Having this can cause increased load on the inside of the knee and foot/ankle.

When we are not symmetrical or vary off from normal, we will cause changes in the body. Some time we can deal with these changes and never develop any problems or pain. Other time these changes off can lead to break down and pain. Tissue in the body can breakdown when they fail to heal. Failed repair leads to tendonitis, tears, stress fracture, muscle strains and even disc herniations

In this patient she has developed pain on the inside of her right arch and plantar fascia. She has also developed tendonitis in a muscle called tibialis posterior.

Now to the video. The patient gait is even more telling. Patient has a very narrow gait, a kicking type leg swing and too much rocking of the hips and upper body. Her feet are turned outward or extrenally rotated

A narrow gait can lead to all types of problem, here just a few. Hip, knee and ankle/foot pain.

Weakness in the Glutes can cause a narrow gait along with a kicking type gait. The quadriceps are muscles in the front of the legs and can become dominant if the glutes become very weak.

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