Chris and his foot pain

(Plantar Fasciitis with Bunion)

Chris, a 38 year old, self-employed builder, came in with a six-week history of right foot trouble that was giving him sharp pain every morning when he stood up out of bed. As he is constantly up and down ladders all day it was starting to affect his work. On further questioning he also mentioned playing Sunday league football and that he had been plagued with knee and hamstring trouble over the last year.

On examination Chris was a healthy individual who kept himself trim with gym and football. He had no obvious postural problems and had good, even muscle tone. Examining the foot revealed tender points along the arch with the beginnings of a bunion forming. His right foot arch had fallen slightly compared with his left, which was still adequately supportive. His right knee dropped inwards giving him the appearance of being ‘knock-kneed’, and the right side of his pelvis was slightly higher than the left.

With further discussion it was decided that Chris had probably injured his pelvis some time ago playing football and this had caused it to become displaced. This was causing the hamstring muscle to be put under tension, accounting for the recurrent thigh strains. The ‘pelvic imbalance’ had the knock-on affect of forcing the knee inwards and causing the foot to roll in. This was causing his arch to flatten and forcing the big toe outwards.

With five sessions to help balance his pelvis and some home strengthening exercises Chris has been without injury for six months. Treatment was also directed at improving mobility in the joints of his foot and reducing the pull of the small muscles which can make a bunion worse. After treatment his big toe looked much straighter and his foot pain had almost disappeared. With advice on suitable footwear and occasional treatment we hope to prevent a bunion forming, although Chris appreciates that he may need to use orthotics at a later date.

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