Cath Lab Digest

   To determine the cause of recurrence, Dr. Beekman examined the ligaments and retinaculum, and used applied kinesiology to determine which ligament and/or portion of the retinaculum was involved, and the direction in which to mobilize it. “I found that the equinus reduced without the manipulation and this did not recur on subsequent visits,” says Dr. Beekman.

   Soft tissue massage to the peroneus longus insertion can help this muscle function, according to Dr. Beekman. Additionally, he manipulates the foot using a technique by Kevin Miller, DPM. Dr. Beekman says Dr. Miller’s theory is that the third metatarsal and lateral cuneiform migrate proximally, causing a separation of the navicular and cuboid. As Dr. Beekman explains, this alters the function of the midtarsal and Lisfranc’s joint, which causes a dorsiflexed first and fifth metatarsal. He notes that he confirms this effect by using applied kinesiology testing.

   Dr. Yakel rarely uses steroid injections or physical therapy to treat metatarsalgia. He says biomechanical control often reduces or eliminates symptoms of the condition.

Dr. Williams is a Fellow of the American College of Foot and Ankle Surgeons, and is board certified by the American Board of Podiatric Surgery. He is a member of the American Academy of Podiatric Sports Medicine. Dr. Williams practices in Merrilville, Ind.

Dr. Beekman is a Past Diplomate of the American Board of Podiatric Orthopedics and Primary Podiatric Medicine, and the American Academy of Podiatric Sports Medicine. He is board certified by the American Board of Podiatric Surgery.

Dr. Yakel is a Fellow of the American College of Foot and Ankle Surgeons, and is board certified by the American Board of Podiatric Surgery. He is an Associate of the American Academy of Podiatric Sports Medicine. Dr. Yakel practices in Longmont, Colo.

References:

1. Dananberg HJ, Shearstone J, Guillano M. Manipulation method for the treatment of ankle equinus. J Am Podiatr Med Assoc 2000 90: 385-389.