What is the presenting case?
Simon presented to the clinic having injured his foot while playing football. Assessment revealed a significant deficit with his foot function. Simon was referred for an MRI.
The MRI revealed a LisFranc ligament injury- this required surgery.
After 3 months of non-weight bearing and wearing a moon boot, Simon started his rehabilitation process at Elite Physiotherapy.
Clinical findings
- Muscle wasting and weakness of the foot, calf, quad, hamstring and gluts
- Poor single leg balance
- Tightness in his foot and lower limb muscles, including the Windlass mechanism
- Hypomobile Subtalar joint, Talocrural joint and 1st metatarsal phalangeal joint
- Antalgic gait pattern
Clinical Diagnosis
- Lis Franc rupture and surgical repair
What was the end Goal? Return to running and full physical fitness
Intervention
Comprehensive intervention following the principles of mechanotherapy to optimally load Simon comprising of the following:
- Soft tissue therapy- focusing on the calf and intrinsic foot muscles
- Joint mobilization- ankle and foot joints
- Home: daily thera-band strength exercises. Targeting his intrinsic foot muscles, combined with stretching through his calf and plantar surface of his foot.
- Gym: targeted exercises to improve the strength of the identified weak muscles, progressing to plyometric based exercises and functional movements.
Outcome
- Simon was able to return to running and managed to complete the Rottnest Swim/Run covering 32km.
