In the second situation I would check out his full lower limb soft tissue
profile, strength and length of all muscle groups. Often people can have
tight calf muscles and weak eccentric dorsiflexors, and some hip tightness
and weakness.
If it recurs and fails to resolve to stretching and specific strengthening
it may be worth getting pressure studies done to see if he has either a
compartment syndrome or medial tibial syndrome
Hope this helps. Alot of our patients used to end up having ops for this but
are now responding to thorough soft tissue assessment and podiatry.
Alison
-----Original Message-----
From: PHYSIO - for physiotherapists in education and practice
[mailto:[log in to unmask]]On Behalf Of nabil keshavjee
Sent: 15 April 2001 20:35
To: [log in to unmask]
Subject: Two stiuations.
Have been working for a year now in private practice.
This week I have come across two situations in which I
do not have the slighest clue what to do.
1. First patient: history: getting out from trunk
and fell. Lost consciousness but doesn't remember for
how long. No neck pain. Currently has constant
headaches, ear ringing in the left ear and occasional
dizziness. He was cleared by the neurospecialist. I
think he is suffering post-concussion syptoms. Can I
refer him to anyone who could help? Can I do anything
to help?
2. Second patient: Marathon runner, gets pain medial
along tibia after running short period. Pain on
palpation. No pain on AROM, PROM or reisisted. Pain
is located 1/3 of the way down the tibia. Also has a
pain 2/3 way down the tibia along the tibia. This is
resolving with ultraound. Previously (1 year ago) had
stress fracture. Weird thing is this pain was
radiating in a circular fashion around the calf.
Anyone seen something like this? Any ideas on Rx for
his his first pain?
All help would be greatly appreciated.
Nabil K.
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