Case Study
50-Year-Old Female presented with Neuropathy of Right Foot

A 50 year-old housewife presented with pain in right foot and ankle.  She could not move her toes and was in constant pain due to an accident in February, 1999, when she fell down steps and broke her leg above the ankle, a severe break, almost compound fracture.  She had surgery with fixation using pins, screws, and plates.  She got a staph infection that resulted in a loss of tissue and a 9-day hospital stay.  She had a skin graft two weeks later.  In 2001, the pins were removed.

She had standard physical therapy (exercise and modalities), with minimal effect.  She was discharged home and told that nothing further could be done.  She would have to get use to the pain and lack of function.

She was referred to us by her husband, who had received help from us for his shoulder.  When she came in she walked with a significant limp. She had swelling in her foot that she said had been present since the injury.  There was no movement in the toes.  The big toe was flexed down and over the next two toes at a 40 degree angle lateral drift toward the small toe.  She had pain and numbness in the foot radiating up to her knee.  She had minimal active movement in her ankle. She was beginning to complain of hip pain, due to postural distortions due to the poor mobility in her foot and ankle and how she had to walk.  She was unable to sleep and could not tolerate the weight of a blanket on her foot. 

At the first treatment, we did an evaluation and released the fascial restriction in the joint at the great toe.  We used a toe pull with a lateralization and allowed the joint to unwind.  We went into the surgical sites and found significant scar adhesions.  We released the scar adhesions and did a leg pull to allow her ankle to unwind with some hip distraction to ease the pain in her hip.  When she got up she said it was the first time she had seen the whole nail of the great toe since the accident.  She was able to wiggle her toes for the first time since the accident.

On the second visit, she reported that since the week before she had been able to sleep through the night for the first time since the accident.  She said the pain in her hip was gone and that most of the pain was gone out of her foot. 

She continued weekly treatments for approx. one month and then moved to every other week.  She no longer limps and has no pain in the foot and ankle.  She has 50% more mobility in her toes.  She also can spread her toes and was able to have a pedicure with polish for the first time since the accident.  The manicurist has no trouble separating or polishing her toes.  She has active movement in her ankle and sleeps through the night.  She can tolerate the weight of the blanket and shoes on the foot.  She was actually able to wear a small low-heeled shoe to a church function for the first time since the accident.  She still has a slight amount of numbness at the site of the infection but it has improved approx. 50%.  She reports that she hardly notices the bit of numbness that remains.

This website last updated on 31 July 2010

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