Mrs S is a 32 year old property administrator and mother of 2 who recently presented with an 18 month history of heel and foot pain. She had consulted several different practitioners over this time without success and her pain had stopped her running. Walking, epecially in the morning, was also painful.
In our assessment with Mrs S, we looked for biomechanical factors within her musculoskeletal system that could possibly contribute to her heel pain.We found a whole host of imbalances including altered neurodynamics, lumbar, thoracic and cervical tension R>L, depression of the navicular bone in the R midfoot as well as hypomobility in the cuboid joint of the same foot. She also had trigger points and muscle guarding in the R subscapularis, tib posterior and glut medius. Mrs S could not heel raise on the R without pain in her heel and foot.
After normalising her neurodynamics, and through various treatment directed tests (treatment trials), we found that releasing her subscapularis virtually eliminated her pain when she heel raised. This also changed some of the other objective findings.
Treatment progressed to address other areas of imbalance and to improve her general strength and conditioning. Mrs S reported an 80% improvement in her symptoms before the 4th session and we were confident in gaining further improvement over the next 2-3 sessions. She started running again in that time.
This case highlights the fact that symptoms may not be triggered from local causes and can be caused by a build up of various imbalances throughout the body.