Plantar Flexion Case Study

He has pain in the back, primarily in the buttock and the hamstring, and there is still weakness on the foot in plantar flexion. He still has good strength on dorsiflexion and plantar flexion but there is still a clear weakness on the left side and he still has a significant pain. He does have a diabetic neuropathy which is probably what is making it difficult to heal at a faster rate. Assessment and plan notes that it was quoted from the radiologist that there is an annular tear, a broad-based bulge at L5/S1 and 2-mm broad-based bulge at L4/5, mild bilateral facet arthropathy and what the radiologist calls is mild bilateral neural foraminal narrowing, but what the radiologist says is there is no acute extrusion at either 2 levels. Diffuse disc degeneration, lateral recess stenosis and foraminal stenosis is prominent at L4/5 and at L5/S1 based on this report. It was noted that the provider recommends cortisone shot at L5 with a smaller amount of cortisone shot at L4. It was also bnoted that since there is stenosis at that level that can result in the

His dressings are removed along with the brace and his incision is a curvilinear laceration through the medial retinacular region. Extensor mechanism of the knee is intact and a straight leg raise is painful but normal. Range of motion is grossly limited in flexion secondary to pain but full extension is easily achieved. He is stable with varus and valgus stress testing at 0 and 30 degrees. Gentle Lachman's test does not demonstrate any gross instability. The ankle shows some dependent edema but no acute injury. Range of motion, dorsiflexion, plantar flexion, inversion, and eversion are all intact with adequate strength. Extensor hallucis longus, dorsiflexion, plantar flexion function of the ankle are all intact with 5/5 strength, L3-S1 sensory dermatomes are intact to light touch, though the patient does describe some mild periwound numbness. There is no streaking erythema. Wound is benign and shows no signs or symptoms of infection. Vascular tone is full and compartments are

Having read the case and knowing the situation, I would say the patient damaged his patellar ligament and posterior cruciate ligament. The knee joint consists of five ligaments—the patellar ligament, fibular collateral ligament, tibial collateral ligament, anterior cruciate ligament, and posterior cruciate ligament. The patellar ligament helps extend the leg at the knee. The fibular and tibial collateral ligaments stabilize the hingelike motion of the knee (Drake pg. 303). The anterior cruciate ligament restricts anterior displacement of the tibia and the posterior cruciate ligament restricts posterior displacement of the tibia (Drake pg. 303). Most likely, the cause of the blue color in the patient’s leg and foot is from lack

The patient underwent irrigation and debridement of the right foot per operative report dated 11/11/13.

O: On inspection, no edema or discoloration noted (patient was on ice for 10 minutes already at that time) Full ROM, reports severe pain (10/10) with overhead reach; Increased pain with Hawkins' Impingement

Although the ankle joint has significantly smaller surface area than the hip or knee, it withstands five times the body weight during stance in walking and up to 13 times the body weight during running (10,11, 17-19). Despite the increased weight-bearing force, the tibiotalar joint is more resistant to development of primary osteoarthritis (OA). However, it is more susceptible to post-traumatic arthritis based on many variables including gender, cartilage thickness, mechanical and metabolic factors. (10,11,19,20).

It looks very red (dependent rubor) compared to the other leg. It feels cool and his toe nails are thick and brittle. The skin of the leg looks taut and shiny with no hair. He states he has no pain in the leg but experiences sharp pain when pressure is applied around his ankle area. After breakfast, he moves to the bed, and the leg’s skin color becomes less reddish.

If you feel a sharp pain in the heel when taking the first steps in the morning, you may have a condition called plantar fasciitis. Plantar fasciitis is one of the most common causes of heel spurs and approximately 2 million patients are treated each year fasciitis.

The type of fracture in the knee X-ray is an avulsion fracture of the tibia tubercle. Avulsion fractures are the result of tensile loading on the bone (McKinnis, 2014; Smith, n.d.). Fragments of bone are pulled away from the main body of the bone resulting from a tensile loading on the bone, through active muscle contraction or resistance of a ligament. Additionally, an avulsion fracture will appear radiolucent on a radiograph as a result of hemorrhage and the space between the bone fragment and main body of bone (McKinnis, 2014; Smith, n.d.). An avulsion fracture of the tibia most commonly is seen in athletic males, aged 14-16 years, during the time of the transitional phase of physeal closure just prior to completion of growth (Ertl, 2014).

His main concern was his Tinea Pedis and Onychomycosis that has not been resolved and has required changes on treatment (refer to section 7). Ricardo had an episode of RT olecranon bursitis that was treated with steroids and analgesic gel, problems resolved w/o complications. Flu vaccine administered on 9/21/16. Hearing evaluation exam indicating mild hearing loss. No changes in mobility or daily activities; he remains on 1:1 level of supervision to prevent injuries.

O: Right Lower Leg: Mild edema and erythema present; superficial abrasion (Lateral Shin) 86mm X 52mm without bleeding; tender with palpation; surrounding skin intact; able to bear full body weight; pedal pulse +2;

As reported by Healthline, more than half of Americans are influenced with foot torment, regularly brought about by harm of the plantar belt – a slender tendon connecting the heel to the front of the foot. The condition is otherwise called plantar fasciitis.

Tsai CT, Chang WD, Lee JP. Effects of Short-term Treatment with Kinesiotaping for Plantar Fasciitis. Journal of Musculoskeletal Pain. 2010; 18 (1): 71-80.

Mr. M.T present to the clinic for a follow up of his left ankle that he sprained a week ago when he missed one step of the staircase that goes to his basement, fell and and twisted his left ankle. The x-ray of his ankle was normal. He has been taking Norco for pain and it has been helpful for him. His pain medication ended yesterday and he says he has been having a lot of pain. He rate pain 8/10. His pain is worsened by movement and touch. Nothing is relieving his pain except the pain medication. He says the swelling has decreased, but he noticed a bruise on his foot this morning. He says he is not able to bear weight. He has been wearing ankle brace and has been using crutches for mobility. He denies constipation and his last BM was yesterday.

d. Assessments reveals: Patient appears to be in moderate distress, left leg appears shortened with calf edema, ecchymosis, and limited ROM.