Re: plantar fibromatosis

[Guest guest]

have a patient with possible plantar fibromatosis (ledderhose disease),

patient has tender nodules within bilateral plantar fascia, ortho tests

and symptoms negative for fascitis, has anyone treated this condition?

do you know if graston/ART would increase inflammation?

Kollar

Allied Chiropractic

________________________________________________________________________

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[Guest guest]

By design Graston would elicit the inflammation process. Problem here could

be excessive inflammation which is unmanaged, so go slow and use a lot of

ice post-tx! Reading about problem and medical management seems to be

plantar fascitis approach anyway, including surgical removal (with high

incidence of recurrence--again probably related to hyper-inflammation poorly

managed.) I'd definitely approach it with Graston-type treatment(SASTM).

Seitz, DC

Tuality Physicians

730-D SE Oak Street

Hillsboro, OR 97123

(503)640-3724

Re: plantar fibromatosis

have a patient with possible plantar fibromatosis (ledderhose disease),

patient has tender nodules within bilateral plantar fascia, ortho tests

and symptoms negative for fascitis, has anyone treated this condition?

do you know if graston/ART would increase inflammation?

Kollar

Allied Chiropractic

________________________________________________________________________

Check out AOL.com today. Breaking news, video search, pictures, email

and IM. All on demand. Always Free.

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[Guest guest]

Hey ,

Here's a review article on the condition...

http://www.emedicine.com/derm/topic874.htm

You asked " do you know if graston/ART would increase inflammation? "

From the standpoint of Graston Technique, the answer would likely be yes.

Indeed, the instruments are frequently used to break up old fibrotic tissue,

which will cause inflammation. The inflammatory infiltrate includes

fibroblasts and new collagen is deposited. The repair and remodelling

phases are then guided with appropriate exercises and stretching.

Whether that type of therapy is appropriate for this patient probably

depends on which variant of plantar fibromatosis the patient has. If it is

the plantar equivalent of DePuytren's contracture, I have heard of some GT

practitioners having success with that condition. However, if their variant

is inflammatory mediated, GT will likely make it worse. I recently also

read an abstract for a microfasciotomy procedure, using a large bore syringe

and local anesthetic to release local fascial bands in DePuytrens with good

results.

W. Snell, D.C.

Hawthorne Wellness Center

3942 SE Hawthorne Blvd.

Portland, OR 97214

Ph. 503-235-5484

Fax 503-235-3956

drpsnell.chiroweb.com

>From: dkollardc@...

>Oregondcs

>Subject: Re: plantar fibromatosis

>Date: Tue, 20 Jun 2006 22:17:41 -0400

>

>have a patient with possible plantar fibromatosis (ledderhose disease),

>patient has tender nodules within bilateral plantar fascia, ortho tests

>and symptoms negative for fascitis, has anyone treated this condition?

>do you know if graston/ART would increase inflammation?

>

> Kollar

>Allied Chiropractic

>________________________________________________________________________

>Check out AOL.com today. Breaking news, video search, pictures, email

>and IM. All on demand. Always Free.

>

[Guest guest]

,

I have seen several of these. Plantar fibromas do respond to light

Graston Technique, ultrasound, low level laser therapy and to some extent

EMS. But treatment always needs to incorporate pressure release over the

nodules through cutouts, donut pads, or plastazote. These things tend to

wax and wain proxismally, however will by aggravated by pathomechanics

(over/under pronation). Hence proper footwear/orthotics may be necessary.

Ted

Ted Forcum, DC, DACBSP, FICC, CSCS

ACA Sports Council, 2nd Vice President

Back In Motion Sports Injuries Clinic, LLC

11385 SW Scholls Ferry Road

Beaverton, Oregon 97008

On Thu, 22 Jun 2006 15:45:01 -0700 " Seitz " <dcdocbrian@...>

writes:

> By design Graston would elicit the inflammation process. Problem

> here could

> be excessive inflammation which is unmanaged, so go slow and use a

> lot of

> ice post-tx! Reading about problem and medical management seems to

> be

> plantar fascitis approach anyway, including surgical removal (with

> high

> incidence of recurrence--again probably related to

> hyper-inflammation poorly

> managed.) I'd definitely approach it with Graston-type

> treatment(SASTM).

>

> Seitz, DC

> Tuality Physicians

> 730-D SE Oak Street

> Hillsboro, OR 97123

> (503)640-3724

>

> Re: plantar fibromatosis

>

> have a patient with possible plantar fibromatosis (ledderhose

> disease),

> patient has tender nodules within bilateral plantar fascia, ortho

> tests

> and symptoms negative for fascitis, has anyone treated this

> condition?

> do you know if graston/ART would increase inflammation?

>

> Kollar

> Allied Chiropractic

>

________________________________________________________________________

> Check out AOL.com today. Breaking news, video search, pictures,

> email

> and IM. All on demand. Always Free.

>

>

>

>

> OregonDCs rules:

> 1. Keep correspondence professional; the purpose of the listserve is

> to

> foster communication and collegiality. No personal attacks on

> listserve

> members will be tolerated.

> 2. Always sign your e-mails with your first and last name.

> 3. The listserve is not secure; your e-mail could end up anywhere.

> However,

> it is against the rules of the listserve to copy, print, forward,

> or

> otherwise distribute correspondence written by another member

> without his or

> her consent, unless all personal identifiers have been removed.

>