Outpatient Physical Therapy Management of a Patient with Left Medial Plantar Myofascial Pain

Background and Purpose: This article describes a 6-week outpatient physical therapy management of a 62 year old female who had a posterior tibial tendon Repair with flexor digitorum longus transfer surgery in 2013 on the left foot following foot pain that worsened over the years. The patient presented with decreased left ankle range of motion, strength, activity tolerance, endurance, marked swelling and sharp pain on the medial and plantar surface of left foot. The purpose of this article is to describe the interventions used for this patient and the results from the physical therapy interventions provided. Description. The treatment of this patient involved range of motion, stretching, joint mobilization, manual therapy, strengthening, neuromuscular re-education, soft tissue massage, pain management treatment progression. Outcomes. Following ongoing PT intervention, the patient achieved normal limits of ROM of the left ankle, normal strength, eliminated pain and swelling, decreased scar tissue adhesions, increased activity tolerance and endurance. Discussion. The rationale for the client’s treatment is based on evidence-based practice and clinical protocols following the diagnosis of left medial plantar myofascial pain and subsequent posterior tibial tendon repair. Treatment was adjusted to the patient’s signs and symptoms (ROM, strength limitation, pain, swelling, activity tolerance etc.) Outcomes were evaluated using standard clinical assessments