Re: Leg pain info- Suggestions?

[Guest guest]

From: Abrahamson <drscott@...>Subject: Leg pain info- Suggestions?"" < >Date: Tuesday, April 5, 2011, 7:32 PM

I met a young gal at a boot camp class who had recently been tested forcompartment syndrome. She clearly has tibialis posterior pain so I waswondering what the current conventional wisdom is regarding this.One theory holds that pronation causes the tibialis posterior muscle toattempt to raise the arch and frequently strains the muscle. Lifting thearches with orthotics cushions the collapse of the arch in mid step thusprotecting the muscle.It appears in reading ³Born to Run², that shoes and orthotics are makingrunner's feet weaker thus ushering in the concept of barefoot running. Thisis supposed to allow the intrinsic and extrinsic foot muscles to regainstrength so that we can run well into old age like our meat eating, grainavoiding, healthy as a pin, celiac-free ancestors! Of course, if the musclesare already strained there is going to have to be a rehab. period, butthen, look out prey,

here come de predator!Currently, as you can tell from the attached description, this gal is nowexperiencing pain from even mild activity. It's certainly interesting to seehow the sports medicine world reveals itself by observing their progressionof care.Suggestions? E. Abrahamson, D.C.Chiropractic physicianLake Oswego Chiropractic Clinic315 Second StreetLake Oswego, OR 97034503-635-6246Website: http://www.lakeoswegochiro.com------ Forwarded Message> > Hi !> > Sorry I didn't get the chance to shoot this email over yesterday-it was a> classic crazy Monday. In case you do get the chance to confer with any of your> friends or present the case about my unsolved leg-pain mystery, here's the> reader's digest version of the case history:> -first started

feeling consistent pain in March, 2009 when I began to run 3+> times per week. Pain can be sharp and stabbing around my medial calf muscle or> throbbing (like a bad bruise constantly being pushed on). If I push through> the pain, I tend to have residual pain even after stopping the activity. I> Initially thought the pain was associated with muscle fatigue from starting a> new exercise regime, but began to suspect shin splints when 2 months passed> with no improvement.> -Since beginning of pain, I have tried just about every form of conservative> pain management with no success: rest (up to 2 months), ice, arch taping, hard> orthotics (not specifically fitted to me though), massage, etc> -First saw a sports med Dr. in spring of 2010. He recommended PT with ASTYM to> treat what he thought was posterior tibial tendon dysfunction and possibly bad> shin splints (what you and

I were talking about at bootcamp-with the hard> plastic tools that are "massaged" along the painful areas) and I followed> through with 10 weeks of ASTYM PT. I saw no improvement. At that point I was> told I most likely had compartment syndrome, since shin splints and tendinitis> should have improved at least a little with that amount and type of treatment.> -saw an ortho surgeon to discuss compartment pressure testing and she referred> me to another ortho who specializes in foot and ankle because she still> suspected posterior tibial tendon dysfunction. An MRI showed definite> fluid/inflammation around the tendon, so the tendon dysfunction was confirmed.> Still, she wanted testing done for compartment syndrome because she thought it> was extremely odd that tendon inflammation would cause such consistent> localized pain in the medial calf, and thought I might also have

compartment> syndrome on top of the tendon problem.> -Compartment pressure testing was done a few weeks ago and showed normal> pressure in the medial calf.> > So now I'm back to square one. We know I have posterior tibial tendon> dysfunction that presents in an odd way. Unfortunately, I'm not any closer to> being pain-free when I do any kind of activity that involves the tendon. The> most recent recommendation was a steroid injection, possibly accompanied by a> boot to completely "rest" the tendon for ~6 weeks. This would then be followed> by PT to try to rebuild the muscles around the tendon so they can alleviate> some of what has caused the tendon to become inflamed in the first place...I> think. The goal is to get me "better" before I leave for my backpacking trip> to South America in mid-June.> > I'm always open to hearing suggestions about the

whole scenario, so thanks for> all your ideas thus far!!!!!> > Let me know if you could use any other info!> ------ End of Forwarded Message

[Guest guest]

From: Abrahamson <drscott@...>Subject: Leg pain info- Suggestions?"" < >Date: Tuesday, April 5, 2011, 7:32 PM

I met a young gal at a boot camp class who had recently been tested forcompartment syndrome. She clearly has tibialis posterior pain so I waswondering what the current conventional wisdom is regarding this.One theory holds that pronation causes the tibialis posterior muscle toattempt to raise the arch and frequently strains the muscle. Lifting thearches with orthotics cushions the collapse of the arch in mid step thusprotecting the muscle.It appears in reading ³Born to Run², that shoes and orthotics are makingrunner's feet weaker thus ushering in the concept of barefoot running. Thisis supposed to allow the intrinsic and extrinsic foot muscles to regainstrength so that we can run well into old age like our meat eating, grainavoiding, healthy as a pin, celiac-free ancestors! Of course, if the musclesare already strained there is going to have to be a rehab. period, butthen, look out prey,

here come de predator!Currently, as you can tell from the attached description, this gal is nowexperiencing pain from even mild activity. It's certainly interesting to seehow the sports medicine world reveals itself by observing their progressionof care.Suggestions? E. Abrahamson, D.C.Chiropractic physicianLake Oswego Chiropractic Clinic315 Second StreetLake Oswego, OR 97034503-635-6246Website: http://www.lakeoswegochiro.com------ Forwarded Message> > Hi !> > Sorry I didn't get the chance to shoot this email over yesterday-it was a> classic crazy Monday. In case you do get the chance to confer with any of your> friends or present the case about my unsolved leg-pain mystery, here's the> reader's digest version of the case history:> -first started

feeling consistent pain in March, 2009 when I began to run 3+> times per week. Pain can be sharp and stabbing around my medial calf muscle or> throbbing (like a bad bruise constantly being pushed on). If I push through> the pain, I tend to have residual pain even after stopping the activity. I> Initially thought the pain was associated with muscle fatigue from starting a> new exercise regime, but began to suspect shin splints when 2 months passed> with no improvement.> -Since beginning of pain, I have tried just about every form of conservative> pain management with no success: rest (up to 2 months), ice, arch taping, hard> orthotics (not specifically fitted to me though), massage, etc> -First saw a sports med Dr. in spring of 2010. He recommended PT with ASTYM to> treat what he thought was posterior tibial tendon dysfunction and possibly bad> shin splints (what you and

I were talking about at bootcamp-with the hard> plastic tools that are "massaged" along the painful areas) and I followed> through with 10 weeks of ASTYM PT. I saw no improvement. At that point I was> told I most likely had compartment syndrome, since shin splints and tendinitis> should have improved at least a little with that amount and type of treatment.> -saw an ortho surgeon to discuss compartment pressure testing and she referred> me to another ortho who specializes in foot and ankle because she still> suspected posterior tibial tendon dysfunction. An MRI showed definite> fluid/inflammation around the tendon, so the tendon dysfunction was confirmed.> Still, she wanted testing done for compartment syndrome because she thought it> was extremely odd that tendon inflammation would cause such consistent> localized pain in the medial calf, and thought I might also have

compartment> syndrome on top of the tendon problem.> -Compartment pressure testing was done a few weeks ago and showed normal> pressure in the medial calf.> > So now I'm back to square one. We know I have posterior tibial tendon> dysfunction that presents in an odd way. Unfortunately, I'm not any closer to> being pain-free when I do any kind of activity that involves the tendon. The> most recent recommendation was a steroid injection, possibly accompanied by a> boot to completely "rest" the tendon for ~6 weeks. This would then be followed> by PT to try to rebuild the muscles around the tendon so they can alleviate> some of what has caused the tendon to become inflamed in the first place...I> think. The goal is to get me "better" before I leave for my backpacking trip> to South America in mid-June.> > I'm always open to hearing suggestions about the

whole scenario, so thanks for> all your ideas thus far!!!!!> > Let me know if you could use any other info!> ------ End of Forwarded Message

[Guest guest]

Thank you for your reply Greg,

Can you walk me through the mechanism? The patient has had a lot of therapy including deep tissue, ice massage, KSTYM, assisted stretching, and lots of self massage.

What does Fascial Manipulation involve that addresses the mechanism of constant reinjury?

I don’t sense that this young, healthy athlete has muscles which are adhered together with fibrotic scar tissue. I could be wrong as I frequently am.

Enlighten me grandfather,

Signed,

Grasshopper.

(Do NOT tell me that you young people didn’t watch reruns of Kung Fu!!!)

E. Abrahamson, D.C.

Chiropractic physician

Lake Oswego Chiropractic Clinic

315 Second Street

Lake Oswego, OR 97034

503-635-6246

Website: http://www.lakeoswegochiro.com

From: " Dr. Kahn " <gregorykahndc@...>

Date: Tue, 5 Apr 2011 20:21:07 -0700 (PDT)

< >

Subject: Fw: Re: Leg pain info- Suggestions?

From: Abrahamson <drscott@...>

Subject: Leg pain info- Suggestions?

" " < >

Date: Tuesday, April 5, 2011, 7:32 PM

I met a young gal at a boot camp class who had recently been tested for

compartment syndrome. She clearly has tibialis posterior pain so I was

wondering what the current conventional wisdom is regarding this.

One theory holds that pronation causes the tibialis posterior muscle to

attempt to raise the arch and frequently strains the muscle. Lifting the

arches with orthotics cushions the collapse of the arch in mid step thus

protecting the muscle.

It appears in reading ³Born to Run², that shoes and orthotics are making

runner's feet weaker thus ushering in the concept of barefoot running. This

is supposed to allow the intrinsic and extrinsic foot muscles to regain

strength so that we can run well into old age like our meat eating, grain

avoiding, healthy as a pin, celiac-free ancestors! Of course, if the muscles

are already strained there is going to have to be a rehab. period, but

then, look out prey, here come de predator!

Currently, as you can tell from the attached description, this gal is now

experiencing pain from even mild activity. It's certainly interesting to see

how the sports medicine world reveals itself by observing their progression

of care.

Suggestions?

E. Abrahamson, D.C.

Chiropractic physician

Lake Oswego Chiropractic Clinic

315 Second Street

Lake Oswego, OR 97034

503-635-6246

Website: http://www.lakeoswegochiro.com <http://www.lakeoswegochiro.com/>

------ Forwarded Message

>

> Hi !

>

> Sorry I didn't get the chance to shoot this email over yesterday-it was a

> classic crazy Monday. In case you do get the chance to confer with any of your

> friends or present the case about my unsolved leg-pain mystery, here's the

> reader's digest version of the case history:

> -first started feeling consistent pain in March, 2009 when I began to run 3+

> times per week. Pain can be sharp and stabbing around my medial calf muscle or

> throbbing (like a bad bruise constantly being pushed on). If I push through

> the pain, I tend to have residual pain even after stopping the activity. I

> Initially thought the pain was associated with muscle fatigue from starting a

> new exercise regime, but began to suspect shin splints when 2 months passed

> with no improvement.

> -Since beginning of pain, I have tried just about every form of conservative

> pain management with no success: rest (up to 2 months), ice, arch taping, hard

> orthotics (not specifically fitted to me though), massage, etc

> -First saw a sports med Dr. in spring of 2010. He recommended PT with ASTYM to

> treat what he thought was posterior tibial tendon dysfunction and possibly bad

> shin splints (what you and I were talking about at bootcamp-with the hard

> plastic tools that are " massaged " along the painful areas) and I followed

> through with 10 weeks of ASTYM PT. I saw no improvement. At that point I was

> told I most likely had compartment syndrome, since shin splints and tendinitis

> should have improved at least a little with that amount and type of treatment.

> -saw an ortho surgeon to discuss compartment pressure testing and she referred

> me to another ortho who specializes in foot and ankle because she still

> suspected posterior tibial tendon dysfunction. An MRI showed definite

> fluid/inflammation around the tendon, so the tendon dysfunction was confirmed.

> Still, she wanted testing done for compartment syndrome because she thought it

> was extremely odd that tendon inflammation would cause such consistent

> localized pain in the medial calf, and thought I might also have compartment

> syndrome on top of the tendon problem.

> -Compartment pressure testing was done a few weeks ago and showed normal

> pressure in the medial calf.

>

> So now I'm back to square one. We know I have posterior tibial tendon

> dysfunction that presents in an odd way. Unfortunately, I'm not any closer to

> being pain-free when I do any kind of activity that involves the tendon. The

> most recent recommendation was a steroid injection, possibly accompanied by a

> boot to completely " rest " the tendon for ~6 weeks. This would then be followed

> by PT to try to rebuild the muscles around the tendon so they can alleviate

> some of what has caused the tendon to become inflamed in the first place...I

> think. The goal is to get me " better " before I leave for my backpacking trip

> to South America in mid-June.

>

> I'm always open to hearing suggestions about the whole scenario, so thanks for

> all your ideas thus far!!!!!

>

> Let me know if you could use any other info!

>

------ End of Forwarded Message

[Guest guest]

Thank you for your reply Greg,

Can you walk me through the mechanism? The patient has had a lot of therapy including deep tissue, ice massage, KSTYM, assisted stretching, and lots of self massage.

What does Fascial Manipulation involve that addresses the mechanism of constant reinjury?

I don’t sense that this young, healthy athlete has muscles which are adhered together with fibrotic scar tissue. I could be wrong as I frequently am.

Enlighten me grandfather,

Signed,

Grasshopper.

(Do NOT tell me that you young people didn’t watch reruns of Kung Fu!!!)

E. Abrahamson, D.C.

Chiropractic physician

Lake Oswego Chiropractic Clinic

315 Second Street

Lake Oswego, OR 97034

503-635-6246

Website: http://www.lakeoswegochiro.com

From: " Dr. Kahn " <gregorykahndc@...>

Date: Tue, 5 Apr 2011 20:21:07 -0700 (PDT)

< >

Subject: Fw: Re: Leg pain info- Suggestions?

From: Abrahamson <drscott@...>

Subject: Leg pain info- Suggestions?

" " < >

Date: Tuesday, April 5, 2011, 7:32 PM

I met a young gal at a boot camp class who had recently been tested for

compartment syndrome. She clearly has tibialis posterior pain so I was

wondering what the current conventional wisdom is regarding this.

One theory holds that pronation causes the tibialis posterior muscle to

attempt to raise the arch and frequently strains the muscle. Lifting the

arches with orthotics cushions the collapse of the arch in mid step thus

protecting the muscle.

It appears in reading ³Born to Run², that shoes and orthotics are making

runner's feet weaker thus ushering in the concept of barefoot running. This

is supposed to allow the intrinsic and extrinsic foot muscles to regain

strength so that we can run well into old age like our meat eating, grain

avoiding, healthy as a pin, celiac-free ancestors! Of course, if the muscles

are already strained there is going to have to be a rehab. period, but

then, look out prey, here come de predator!

Currently, as you can tell from the attached description, this gal is now

experiencing pain from even mild activity. It's certainly interesting to see

how the sports medicine world reveals itself by observing their progression

of care.

Suggestions?

E. Abrahamson, D.C.

Chiropractic physician

Lake Oswego Chiropractic Clinic

315 Second Street

Lake Oswego, OR 97034

503-635-6246

Website: http://www.lakeoswegochiro.com <http://www.lakeoswegochiro.com/>

------ Forwarded Message

>

> Hi !

>

> Sorry I didn't get the chance to shoot this email over yesterday-it was a

> classic crazy Monday. In case you do get the chance to confer with any of your

> friends or present the case about my unsolved leg-pain mystery, here's the

> reader's digest version of the case history:

> -first started feeling consistent pain in March, 2009 when I began to run 3+

> times per week. Pain can be sharp and stabbing around my medial calf muscle or

> throbbing (like a bad bruise constantly being pushed on). If I push through

> the pain, I tend to have residual pain even after stopping the activity. I

> Initially thought the pain was associated with muscle fatigue from starting a

> new exercise regime, but began to suspect shin splints when 2 months passed

> with no improvement.

> -Since beginning of pain, I have tried just about every form of conservative

> pain management with no success: rest (up to 2 months), ice, arch taping, hard

> orthotics (not specifically fitted to me though), massage, etc

> -First saw a sports med Dr. in spring of 2010. He recommended PT with ASTYM to

> treat what he thought was posterior tibial tendon dysfunction and possibly bad

> shin splints (what you and I were talking about at bootcamp-with the hard

> plastic tools that are " massaged " along the painful areas) and I followed

> through with 10 weeks of ASTYM PT. I saw no improvement. At that point I was

> told I most likely had compartment syndrome, since shin splints and tendinitis

> should have improved at least a little with that amount and type of treatment.

> -saw an ortho surgeon to discuss compartment pressure testing and she referred

> me to another ortho who specializes in foot and ankle because she still

> suspected posterior tibial tendon dysfunction. An MRI showed definite

> fluid/inflammation around the tendon, so the tendon dysfunction was confirmed.

> Still, she wanted testing done for compartment syndrome because she thought it

> was extremely odd that tendon inflammation would cause such consistent

> localized pain in the medial calf, and thought I might also have compartment

> syndrome on top of the tendon problem.

> -Compartment pressure testing was done a few weeks ago and showed normal

> pressure in the medial calf.

>

> So now I'm back to square one. We know I have posterior tibial tendon

> dysfunction that presents in an odd way. Unfortunately, I'm not any closer to

> being pain-free when I do any kind of activity that involves the tendon. The

> most recent recommendation was a steroid injection, possibly accompanied by a

> boot to completely " rest " the tendon for ~6 weeks. This would then be followed

> by PT to try to rebuild the muscles around the tendon so they can alleviate

> some of what has caused the tendon to become inflamed in the first place...I

> think. The goal is to get me " better " before I leave for my backpacking trip

> to South America in mid-June.

>

> I'm always open to hearing suggestions about the whole scenario, so thanks for

> all your ideas thus far!!!!!

>

> Let me know if you could use any other info!

>

------ End of Forwarded Message

[Guest guest]

,

What does muscle testing reveal?

Has she been tested for soleus, gastroc and flexor hallicus longus?Also inferior

pubis and adductor issues can refer into the lower leg.

Dr. Todd Turnbull, DC

5223 NE Sandy Blvd

Portland, OR 97213

503-8053865

>

> I met a young gal at a boot camp class who had recently been tested for

> compartment syndrome. She clearly has tibialis posterior pain so I was

> wondering what the current conventional wisdom is regarding this.

>

> One theory holds that pronation causes the tibialis posterior muscle to

> attempt to raise the arch and frequently strains the muscle. Lifting the

> arches with orthotics cushions the collapse of the arch in mid step thus

> protecting the muscle.

>

> It appears in reading ³Born to Run², that shoes and orthotics are making

> runner's feet weaker thus ushering in the concept of barefoot running. This

> is supposed to allow the intrinsic and extrinsic foot muscles to regain

> strength so that we can run well into old age like our meat eating, grain

> avoiding, healthy as a pin, celiac-free ancestors! Of course, if the muscles

> are already strained there is going to have to be a rehab. period, but

> then, look out prey, here come de predator!

>

> Currently, as you can tell from the attached description, this gal is now

> experiencing pain from even mild activity. It's certainly interesting to see

> how the sports medicine world reveals itself by observing their progression

> of care.

>

> Suggestions?

>

> E. Abrahamson, D.C.

> Chiropractic physician

> Lake Oswego Chiropractic Clinic

> 315 Second Street

> Lake Oswego, OR 97034

> 503-635-6246

> Website: http://www.lakeoswegochiro.com

>

> ------ Forwarded Message

>

> >

> > Hi !

> >

> > Sorry I didn't get the chance to shoot this email over yesterday-it was a

> > classic crazy Monday. In case you do get the chance to confer with any of

your

> > friends or present the case about my unsolved leg-pain mystery, here's the

> > reader's digest version of the case history:

> > -first started feeling consistent pain in March, 2009 when I began to run 3+

> > times per week. Pain can be sharp and stabbing around my medial calf muscle

or

> > throbbing (like a bad bruise constantly being pushed on). If I push through

> > the pain, I tend to have residual pain even after stopping the activity. I

> > Initially thought the pain was associated with muscle fatigue from starting

a

> > new exercise regime, but began to suspect shin splints when 2 months passed

> > with no improvement.

> > -Since beginning of pain, I have tried just about every form of conservative

> > pain management with no success: rest (up to 2 months), ice, arch taping,

hard

> > orthotics (not specifically fitted to me though), massage, etc

> > -First saw a sports med Dr. in spring of 2010. He recommended PT with ASTYM

to

> > treat what he thought was posterior tibial tendon dysfunction and possibly

bad

> > shin splints (what you and I were talking about at bootcamp-with the hard

> > plastic tools that are " massaged " along the painful areas) and I followed

> > through with 10 weeks of ASTYM PT. I saw no improvement. At that point I was

> > told I most likely had compartment syndrome, since shin splints and

tendinitis

> > should have improved at least a little with that amount and type of

treatment.

> > -saw an ortho surgeon to discuss compartment pressure testing and she

referred

> > me to another ortho who specializes in foot and ankle because she still

> > suspected posterior tibial tendon dysfunction. An MRI showed definite

> > fluid/inflammation around the tendon, so the tendon dysfunction was

confirmed.

> > Still, she wanted testing done for compartment syndrome because she thought

it

> > was extremely odd that tendon inflammation would cause such consistent

> > localized pain in the medial calf, and thought I might also have compartment

> > syndrome on top of the tendon problem.

> > -Compartment pressure testing was done a few weeks ago and showed normal

> > pressure in the medial calf.

> >

> > So now I'm back to square one. We know I have posterior tibial tendon

> > dysfunction that presents in an odd way. Unfortunately, I'm not any closer

to

> > being pain-free when I do any kind of activity that involves the tendon. The

> > most recent recommendation was a steroid injection, possibly accompanied by

a

> > boot to completely " rest " the tendon for ~6 weeks. This would then be

followed

> > by PT to try to rebuild the muscles around the tendon so they can alleviate

> > some of what has caused the tendon to become inflamed in the first place...I

> > think. The goal is to get me " better " before I leave for my backpacking trip

> > to South America in mid-June.

> >

> > I'm always open to hearing suggestions about the whole scenario, so thanks

for

> > all your ideas thus far!!!!!

> >

> > Let me know if you could use any other info!

> >

> ------ End of Forwarded Message

>

[Guest guest]

,

Perhaps looking to the fascial lines for her would provide some relief. Other than that, microcurrent! Dr. McMakin has provided some excellent relief for comparrtment syndromes and RSDS syndromes.

Sunny

Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com

From: drscott@...Date: Tue, 5 Apr 2011 19:32:23 -0700Subject: Leg pain info- Suggestions?

I met a young gal at a boot camp class who had recently been tested forcompartment syndrome. She clearly has tibialis posterior pain so I waswondering what the current conventional wisdom is regarding this.One theory holds that pronation causes the tibialis posterior muscle toattempt to raise the arch and frequently strains the muscle. Lifting thearches with orthotics cushions the collapse of the arch in mid step thusprotecting the muscle.It appears in reading ³Born to Run², that shoes and orthotics are makingrunner's feet weaker thus ushering in the concept of barefoot running. Thisis supposed to allow the intrinsic and extrinsic foot muscles to regainstrength so that we can run well into old age like our meat eating, grainavoiding, healthy as a pin, celiac-free ancestors! Of course, if the musclesare already strained there is going to have to be a rehab. period, butthen, look out prey, here come de predator!Currently, as you can tell from the attached description, this gal is nowexperiencing pain from even mild activity. It's certainly interesting to seehow the sports medicine world reveals itself by observing their progressionof care.Suggestions? E. Abrahamson, D.C.Chiropractic physicianLake Oswego Chiropractic Clinic315 Second StreetLake Oswego, OR 97034503-635-6246Website: http://www.lakeoswegochiro.com------ Forwarded Message> > Hi !> > Sorry I didn't get the chance to shoot this email over yesterday-it was a> classic crazy Monday. In case you do get the chance to confer with any of your> friends or present the case about my unsolved leg-pain mystery, here's the> reader's digest version of the case history:> -first started feeling consistent pain in March, 2009 when I began to run 3+> times per week. Pain can be sharp and stabbing around my medial calf muscle or> throbbing (like a bad bruise constantly being pushed on). If I push through> the pain, I tend to have residual pain even after stopping the activity. I> Initially thought the pain was associated with muscle fatigue from starting a> new exercise regime, but began to suspect shin splints when 2 months passed> with no improvement.> -Since beginning of pain, I have tried just about every form of conservative> pain management with no success: rest (up to 2 months), ice, arch taping, hard> orthotics (not specifically fitted to me though), massage, etc> -First saw a sports med Dr. in spring of 2010. He recommended PT with ASTYM to> treat what he thought was posterior tibial tendon dysfunction and possibly bad> shin splints (what you and I were talking about at bootcamp-with the hard> plastic tools that are "massaged" along the painful areas) and I followed> through with 10 weeks of ASTYM PT. I saw no improvement. At that point I was> told I most likely had compartment syndrome, since shin splints and tendinitis> should have improved at least a little with that amount and type of treatment.> -saw an ortho surgeon to discuss compartment pressure testing and she referred> me to another ortho who specializes in foot and ankle because she still> suspected posterior tibial tendon dysfunction. An MRI showed definite> fluid/inflammation around the tendon, so the tendon dysfunction was confirmed.> Still, she wanted testing done for compartment syndrome because she thought it> was extremely odd that tendon inflammation would cause such consistent> localized pain in the medial calf, and thought I might also have compartment> syndrome on top of the tendon problem.> -Compartment pressure testing was done a few weeks ago and showed normal> pressure in the medial calf.> > So now I'm back to square one. We know I have posterior tibial tendon> dysfunction that presents in an odd way. Unfortunately, I'm not any closer to> being pain-free when I do any kind of activity that involves the tendon. The> most recent recommendation was a steroid injection, possibly accompanied by a> boot to completely "rest" the tendon for ~6 weeks. This would then be followed> by PT to try to rebuild the muscles around the tendon so they can alleviate> some of what has caused the tendon to become inflamed in the first place...I> think. The goal is to get me "better" before I leave for my backpacking trip> to South America in mid-June.> > I'm always open to hearing suggestions about the whole scenario, so thanks for> all your ideas thus far!!!!!> > Let me know if you could use any other info!> ------ End of Forwarded Message

[Guest guest]

Well, I just met her at a workout class so I wasn’t able to muscle test.

I’m trying to get her in for a series of pelvis adjustments.

I heard somewhere that adjusting the pelvis can affect the foot.

E. Abrahamson, D.C.

Chiropractic physician

Lake Oswego Chiropractic Clinic

315 Second Street

Lake Oswego, OR 97034

503-635-6246

Website: http://www.lakeoswegochiro.com

From: " Dr. Todd Turnbull, DC " <drt@...>

Date: Wed, 06 Apr 2011 06:23:37 -0000

< >

Subject: Re: Leg pain info- Suggestions?

,

What does muscle testing reveal?

Has she been tested for soleus, gastroc and flexor hallicus longus?Also inferior pubis and adductor issues can refer into the lower leg.

Dr. Todd Turnbull, DC

5223 NE Sandy Blvd

Portland, OR 97213

503-8053865

>

> I met a young gal at a boot camp class who had recently been tested for

> compartment syndrome. She clearly has tibialis posterior pain so I was

> wondering what the current conventional wisdom is regarding this.

>

> One theory holds that pronation causes the tibialis posterior muscle to

> attempt to raise the arch and frequently strains the muscle. Lifting the

> arches with orthotics cushions the collapse of the arch in mid step thus

> protecting the muscle.

>

> It appears in reading “Born to Run”, that shoes and orthotics are making

> runner's feet weaker thus ushering in the concept of barefoot running. This

> is supposed to allow the intrinsic and extrinsic foot muscles to regain

> strength so that we can run well into old age like our meat eating, grain

> avoiding, healthy as a pin, celiac-free ancestors! Of course, if the muscles

> are already strained there is going to have to be a rehab. period, but

> then, look out prey, here come de predator!

>

> Currently, as you can tell from the attached description, this gal is now

> experiencing pain from even mild activity. It's certainly interesting to see

> how the sports medicine world reveals itself by observing their progression

> of care.

>

> Suggestions?

>

> E. Abrahamson, D.C.

> Chiropractic physician

> Lake Oswego Chiropractic Clinic

> 315 Second Street

> Lake Oswego, OR 97034

> 503-635-6246

> Website: http://www.lakeoswegochiro.com

>

> ------ Forwarded Message

>

> >

> > Hi !

> >

> > Sorry I didn't get the chance to shoot this email over yesterday-it was a

> > classic crazy Monday. In case you do get the chance to confer with any of your

> > friends or present the case about my unsolved leg-pain mystery, here's the

> > reader's digest version of the case history:

> > -first started feeling consistent pain in March, 2009 when I began to run 3+

> > times per week. Pain can be sharp and stabbing around my medial calf muscle or

> > throbbing (like a bad bruise constantly being pushed on). If I push through

> > the pain, I tend to have residual pain even after stopping the activity. I

> > Initially thought the pain was associated with muscle fatigue from starting a

> > new exercise regime, but began to suspect shin splints when 2 months passed

> > with no improvement.

> > -Since beginning of pain, I have tried just about every form of conservative

> > pain management with no success: rest (up to 2 months), ice, arch taping, hard

> > orthotics (not specifically fitted to me though), massage, etc

> > -First saw a sports med Dr. in spring of 2010. He recommended PT with ASTYM to

> > treat what he thought was posterior tibial tendon dysfunction and possibly bad

> > shin splints (what you and I were talking about at bootcamp-with the hard

> > plastic tools that are " massaged " along the painful areas) and I followed

> > through with 10 weeks of ASTYM PT. I saw no improvement. At that point I was

> > told I most likely had compartment syndrome, since shin splints and tendinitis

> > should have improved at least a little with that amount and type of treatment.

> > -saw an ortho surgeon to discuss compartment pressure testing and she referred

> > me to another ortho who specializes in foot and ankle because she still

> > suspected posterior tibial tendon dysfunction. An MRI showed definite

> > fluid/inflammation around the tendon, so the tendon dysfunction was confirmed.

> > Still, she wanted testing done for compartment syndrome because she thought it

> > was extremely odd that tendon inflammation would cause such consistent

> > localized pain in the medial calf, and thought I might also have compartment

> > syndrome on top of the tendon problem.

> > -Compartment pressure testing was done a few weeks ago and showed normal

> > pressure in the medial calf.

> >

> > So now I'm back to square one. We know I have posterior tibial tendon

> > dysfunction that presents in an odd way. Unfortunately, I'm not any closer to

> > being pain-free when I do any kind of activity that involves the tendon. The

> > most recent recommendation was a steroid injection, possibly accompanied by a

> > boot to completely " rest " the tendon for ~6 weeks. This would then be followed

> > by PT to try to rebuild the muscles around the tendon so they can alleviate

> > some of what has caused the tendon to become inflamed in the first place...I

> > think. The goal is to get me " better " before I leave for my backpacking trip

> > to South America in mid-June.

> >

> > I'm always open to hearing suggestions about the whole scenario, so thanks for

> > all your ideas thus far!!!!!

> >

> > Let me know if you could use any other info!

> >

> ------ End of Forwarded Message

>

[Guest guest]

,

Pelvic adjustments?

Your pulling my leg :-)

Dr. Todd Turnbull, DC

5223 NE Sandy Blvd

Portland, OR 97213

503-8053865

> >

> > I met a young gal at a boot camp class who had recently been tested for

> > compartment syndrome. She clearly has tibialis posterior pain so I was

> > wondering what the current conventional wisdom is regarding this.

> >

> > One theory holds that pronation causes the tibialis posterior muscle to

> > attempt to raise the arch and frequently strains the muscle. Lifting the

> > arches with orthotics cushions the collapse of the arch in mid step thus

> > protecting the muscle.

> >

> > It appears in reading ³Born to Run², that shoes and orthotics are making

> > runner's feet weaker thus ushering in the concept of barefoot running. This

> > is supposed to allow the intrinsic and extrinsic foot muscles to regain

> > strength so that we can run well into old age like our meat eating, grain

> > avoiding, healthy as a pin, celiac-free ancestors! Of course, if the muscles

> > are already strained there is going to have to be a rehab. period, but

> > then, look out prey, here come de predator!

> >

> > Currently, as you can tell from the attached description, this gal is now

> > experiencing pain from even mild activity. It's certainly interesting to see

> > how the sports medicine world reveals itself by observing their progression

> > of care.

> >

> > Suggestions?

> >

> > E. Abrahamson, D.C.

> > Chiropractic physician

> > Lake Oswego Chiropractic Clinic

> > 315 Second Street

> > Lake Oswego, OR 97034

> > 503-635-6246

> > Website: http://www.lakeoswegochiro.com

> >

> > ------ Forwarded Message

> >

> > >

> > > Hi !

> > >

> > > Sorry I didn't get the chance to shoot this email over yesterday-it was a

> > > classic crazy Monday. In case you do get the chance to confer with any of

> your

> > > friends or present the case about my unsolved leg-pain mystery, here's the

> > > reader's digest version of the case history:

> > > -first started feeling consistent pain in March, 2009 when I began to run

3+

> > > times per week. Pain can be sharp and stabbing around my medial calf

muscle

> or

> > > throbbing (like a bad bruise constantly being pushed on). If I push

through

> > > the pain, I tend to have residual pain even after stopping the activity. I

> > > Initially thought the pain was associated with muscle fatigue from

starting

> a

> > > new exercise regime, but began to suspect shin splints when 2 months

passed

> > > with no improvement.

> > > -Since beginning of pain, I have tried just about every form of

conservative

> > > pain management with no success: rest (up to 2 months), ice, arch taping,

> hard

> > > orthotics (not specifically fitted to me though), massage, etc

> > > -First saw a sports med Dr. in spring of 2010. He recommended PT with

ASTYM

> to

> > > treat what he thought was posterior tibial tendon dysfunction and possibly

> bad

> > > shin splints (what you and I were talking about at bootcamp-with the hard

> > > plastic tools that are " massaged " along the painful areas) and I followed

> > > through with 10 weeks of ASTYM PT. I saw no improvement. At that point I

was

> > > told I most likely had compartment syndrome, since shin splints and

> tendinitis

> > > should have improved at least a little with that amount and type of

> treatment.

> > > -saw an ortho surgeon to discuss compartment pressure testing and she

> referred

> > > me to another ortho who specializes in foot and ankle because she still

> > > suspected posterior tibial tendon dysfunction. An MRI showed definite

> > > fluid/inflammation around the tendon, so the tendon dysfunction was

> confirmed.

> > > Still, she wanted testing done for compartment syndrome because she

thought

> it

> > > was extremely odd that tendon inflammation would cause such consistent

> > > localized pain in the medial calf, and thought I might also have

compartment

> > > syndrome on top of the tendon problem.

> > > -Compartment pressure testing was done a few weeks ago and showed normal

> > > pressure in the medial calf.

> > >

> > > So now I'm back to square one. We know I have posterior tibial tendon

> > > dysfunction that presents in an odd way. Unfortunately, I'm not any closer

> to

> > > being pain-free when I do any kind of activity that involves the tendon.

The

> > > most recent recommendation was a steroid injection, possibly accompanied

by

> a

> > > boot to completely " rest " the tendon for ~6 weeks. This would then be

> followed

> > > by PT to try to rebuild the muscles around the tendon so they can

alleviate

> > > some of what has caused the tendon to become inflamed in the first

place...I

> > > think. The goal is to get me " better " before I leave for my backpacking

trip

> > > to South America in mid-June.

> > >

> > > I'm always open to hearing suggestions about the whole scenario, so thanks

> for

> > > all your ideas thus far!!!!!

> > >

> > > Let me know if you could use any other info!

> > >

> > ------ End of Forwarded Message

> >

>