MTSS Case Study

01/11/16 PT Evaluation Report documented that the patient is showing good progress towards goals, with a decrease in pain in the right lower leg, ankle and foot when ambulating. But the remaining impairments, including reduced strength, limited ROM and gait deviations cause poor ability to ambulate. Continue skilled PT is necessary in order to address the remaining deficits. Sort-term and long-term goals were discussed.

If one finds a tender zone along the front or side of the tibia, this is an indicator that shin splints might be present.

Shin splints also known as medial tibial stress syndrome is a condition many people suffer. Shin splints is a condition in which the tiblias posterior muscle "inflates." About 60% of the time shin splints are the main cause of leg injuries. There are many ways one can obtain shin splints but the main causes are excessive pressure and excessive impact towards the muscle. The main people who suffer from this condition are the athletes. Although athletes are the main people who suffer from shin splints anyone can develop the condition at any time.

Stress fractures account for approximately twenty percent of athletic injuries, with eighty percent of stress fractures occurring in the lower leg. Stress fractures in the lower extremity are common injuries among individuals who participate in endurance, high load-bearing activities (2). The incidence of these injuries has risen due to earlier and longer participation in sports (3). Stress fractures occur when repetitive mechanical load exceeds the biological capacity of bone, causing micro-damage (1). This rate exceeds the rate at which bone can repair itself, requiring recognition and management of risk factors (2). The initial stage of bone failure is typically called a stress reaction. If the repetitive loading continues, the stress reaction can form into a true stress fracture (3).

Foot drop occurs due to one or a combination of the three categories: Muscle damage, Skeletal or anatomical abnormalities affecting the foot, and Nerve damage. Underlying medical problems that may cause drop foot include but are not limited to compartment syndrome, a lower back condition, a stroke or tumor, Parkinson’s disease, diabetes, motor neuron disease, multiple sclerosis, adverse reactions to drugs or alcohol, or an injury to the foot or lower leg. The patient may be with or without any symptoms of foot pain or leg pain. If pain is present, they may have neurological symptoms such as tingling or burning, ranging from a slight tingling sensation to a complete lack of feeling in the

50 subjects were divided into two groups: one group was given an Aircast ankle brace and the other only a supportive elastic tape. The subjects were evaluated at 10 days and then again 1 month after treatment. Both bracing and taping groups presented major progress in their results (p=0.028 and p=0.014 respectively of the Karlson score). Out of the 17 taping subjects, 6 dropped out which showed a poor compliance to ankle taping. Callaghan (1997) reinforced this reflection in their literature review by making a comparison of both ankle taping and bracing in the athlete. They stated that taping may be awkward and uncomfortable to the subject rather than a brace. Nonetheless, both Boyce et al (2005) and Capasso et al (1989) employed numerous evaluators to tape the subjects and collect the data. Using 1 evaluator instead of multiple ones would have increased the reliability of the data. In addition, controlled groups were used in neither studies therefore making it hard to comprehend the suggested benefits of both taping and bracing when the improvements owed to the natural healing process were not controlled

A young athlete complained of shin pain for the past 4 weeks. She noted the pain would occur after running. Shin splints do come from any activity related to the medial aspect of the tibia. There are various indications of what this type of injury is causing the pain. Some clinicians call it medial tibial stress syndrome ( MTSS) or tibial stress syndrome. The wide range of nomenclature puts up a debate over the exact diagnosis of this overuse symptom. A physical examination is useful to identify any risk factors contributing to pain. X-Rays are normal in MTSS and are usually taken for a stress fracture. An MRI will show any serious conditions of stress injury.

This case study presents an individual who is experiencing frequent leg pain upon participation in physical activity. Leg pain is a common condition experienced by competitive and recreational athletes. However, the diagnosis of leg pain can be difficult as there are numerous possible underlying contributors. A thorough comprehension of human anatomy and biomechanics is essential for a proper understanding (2). Chronic Exertional Compartment Syndrome is one of the most common conditions experienced by athletes (1,2). Of a group of 150 athletes who reported exercise- induced pain, 33 % were diagnosed with chronic exertional compartment syndrome (CECS) (2). Although mostly athletes experience CECS, it is still prevalent amongst non-athletes (3).

On my trek for some magical way to heal quickly, I went from place to place until a physical therapy clinic was recommended to me. Despite my multiple run-ins with the laws of physics, it was my first time going to physical therapy (PT). I met with one of the therapists there, and we began the torture session where she massaged my swollen ankle and tender lower shin. We finished with a couple exercises such as balancing on foam pads and ended with soothing bags of ice and electric stimulation.

Syndesmosis injuries involve the distal tibiofibular joint and can disrupt the normal stability of the ankle joint depending on their severity. This instability, if uncorrected, can lead to chronic instability and significant morbidity, ultimately leading to degenerative

This forces the impact to a smaller concentrated area on the outside of the foot, and again causes issues with supporting the body weight. The smaller toes on the outside of the foot are providing the push off phase. This can lead to the common injuries called iliotibial band syndrome (ITBS), Achilles tendinitis and plantar fasciitis. Under pronation require shoes that provide more support to the midsole and outsole.

For the three-direction SEBT, requirements include a level floor, some adhesive athletic tape positioned at one hundred and twenty degree angles to each other in the ANT, PM and PL directions, a measuring tape, a pencil and eraser (Gribble et al., 2013; Coughlin et al., 2012). Footwear will not be completely standardized for this study, as participants will be asked to wear whatever footwear they normally use during physical exercise as the majority of ankle injuries will occur during physical activity, during which athletic shoes are most often worn. Average peroneus longus activity, an ankle evertor responsible for maintaining ankle stability (Neptune et al., 1999), does not differ between a standard shoe and when a custom

Plantar fasciitis is more likely to occur in middle aged obese women or in those who are on their feet most of the day.[2] Colie C, Seto C and Gazewood J states that Due to the cumulative overload stress to the origin of plantar fascia results in acute or chronic injury that may cause pain.[3] As highlighted by S Cutts, N Obi, C Paspula, et.al. Ankylosing spondylitis, Reiter’s syndrome and osteoarthritis can all produce symptoms of PF and can be marked as differential diagnoses for PF.Top-notch interpretation of plantar fasciitis is a clinical one. Most day-to-day investigation is plain x-ray. Technetium bone scintigraphy is positive in plantar fasciitis.[4] As highlighted by Author, PF is considered a self-limiting condition. But 6-18 months is a typical resolving period of PF. Of many treatments alternatives available for PF rest and avoidance of aggravating activities one of the most essential and most effective self-treatment that provides significant relief. Other treatment options for PF are proper foot wear, foot orthotic, leaning wall stretch, curb or stair stretches, toe curls, and toe taps. Surgery for PF should be contemplate choice only after all other forms of treatment have failed.

The normal function can be however affected by excessive abuse of the feet, over-pronation, old age or being over-weight. As a result of the painful stretching the Plantar Fascia exhibits micro-tearing that leads to irritation, inflammation and pain at the junction of the Plantar Fascia and calcaneus or heel bone. The continued pulling of the Fascia joined to the heel bone can result in a bony growth on the heel commonly known as a Heel Spur. This growth triggers pain in the surrounding tissues that get

Foot injuries are very common in athletics as well as in everyday life. It’s very debilitating to have a foot injury since we use our feet in all of our daily activities. Research published in "Medicine and Science in Sports and Exercise” indicates that the average adult takes between 5,000 to 7,000 steps a day. Some sports require the most dedicated athletes spend multiple hours a day pounding their feet on the turf or pavement. Most injuries that occur in the foot require a person to try and stay off of it or completely immobilize it. Since this is very difficult for a person to do, a large percentage of foot injuries often have a very high chance of reoccurring. The severity of some injuries that can be deceiving as well. Often times a nagging pain is ignored and eventually becomes a much bigger problem.