Case Study: Treating Chronic Pain In A Middle-Aged Distance Runner

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Author(s): 
Bruce Williams, DPM

   The patient returned to the office two weeks after the gait analysis and stated that he was doing great. He said his knee, hip and back felt better. He said his feet felt great as well. Finally, he was able to start running again for the first time in years.

   Dr. Williams is in private practice at Breakthrough Podiatry in Merrillville, Ind. He is a Diplomate of the American Board of Podiatric Surgery. Dr. Williams is also a Past President and Fellow of the American Academy of Podiatric Sports Medicine.

References

1. Olson W. Overuse knee injuries: evaluation and management. Available at http://aapsm.org/ct1100.htm .
2. Milner C. Is gait normal after total knee arthroplasty? Systematic review of the literature. J Orthop Sci. 2009; 14, 114-120.
3. Milner C. Bilateral frontal plane mechanics after unilateral total knee arthroplasty. Arch Phys Med Rehab. 2008; 89(10):1965-69.
4. Butler RJ, Minick KI, Ferber R. Gait mechanics after ACL reconstruction: implications for the early onset of knee osteoarthritis. Br J Sports Med. 2009; 43(5):366-70
5. Gurney B. Leg length discrepancy. Gait Posture. 2002; 15(2):195-206.
6. Walsh M, Connolly P, Jenkinson A, O’Brien T. Leg length discrepancy – an experimental study of compensatory changes in three dimensions using gait analysis. Gait Posture. 2000; 12(2):156-61.

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Drsilversays: August 11, 2011 at 9:02 am

I often make orthotics for patients with knee pain.

I explain to them the closed kinetic chain such that pronation causes abnormal forces at the knee and more proximal joints. I explain the compensation of the proximal joint biomechanics due to foot pain and problems. I also explain the cushioning effect to reduce forces at the proximal joints.

I am often surprised how well patients with knee pain do with orthotics. My results truly exceed my expectations. With that said, I usually set their expectations low. I tell them that orthotics are only one part of the multispecialty treatment for knee pain. I describe how their medical treatment along with physical therapy and orthotics all work together.

Most of these patients are referred to me from orthopedic surgeons and physical therapists. I make an effort to reach out to orthopedists and PTs in my neighborhood to tell them how orthotics can help their patients. I offered them a free pair for themselves and their staff to try them out.

This turned out to be excellent marketing.

I hope this helps you as well.

Lawrence Silverberg, DPM
Blog: www.bestpodiatristnyc.com

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