"Felt Need" Patient Testing Procedures

These tests are beneficial for your client to not only see but - more importantly - feel how improper foot mechanics affects them. These tools are valuable in educating and helping individuals understand the importance of proper biomechanics of the foot.

 

Talus Neutral

Palpate with moderate pressure along the plantar fascia band with client standing and bearing weight as normal. Reposition the talus into neutral in accordance with the Achilles tendon becoming straight. Have those patients with excessive pronation and pes planus watch carefully as repositioning enforces the amount of torquing (internal rotation) happening in the hip, knee and corresponding tendons, ligaments and muscles and how that affects the low back and affected areas. Allow the ankle to roll back, and reposition it a few times to maximize effectiveness.

Fascia Palpation

Palpate with moderate pressure along the plantar fascia with patient standing and bearing weight as normal. You will most likely feel fascia strain, or more importantly, significant discomfort/pain (plantar fasciitis). Keep finger on the strain/pain point and reposition the talus in accordance to the Achilles tendon straightening. Re-palpate and the fascia strain/pain will decrease substantially if not disappear completely. (On occasion you may need to exaggerate pronation, as it would occur in dynamic.)

Knee Palpation

While the patient stands in his/her normal weight-bearing stance, palpate over the medial/lateral collateral ligament and surrounding area. If discomfort is noted, reposition talus into neutral in accordance with the Achilles tendon becoming straight, and re-palpate. If discomfort decreases, chances are foot positioning is creating the knee discomfort. However, if no change in the knee discomfort is noted, it is likely that there is more of a functional knee problem not correlated with the foot.

Metatarsal Palpation

While the patient stands in a normal, weight-bearing position, palpate over the top of each metatarsal. If you find one that is moderately tender (the operator can usually tell, as the met. head is anterior), keep your finger on that point. With your free hand take four quarters and place them just behind the tender metatarsal. Placement of the quarters is crucial; if they are placed too far forward or backward, the test doesn't work. Re-palpate with moderate pressure, and tenderness/pain will likely decrease significantly if not completely.

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