New patient case - Morton's neuroma

Replies to This Discussion

Permalink Reply by Jody Jakob on June 9, 2008 at 4:52pm

Check the longitudinal arch...if that is collapsed or ending to Pes Planus can lead to inversion of the foot and extra weight on the metatarsal heads irritating the nerve.....very often there is no neuroma yet and by correcting the foot mechanics can cure or at least help the body compensate better. If the body cannot compensate it may be time for an arch support or a insole to correct the inversion

▶ Reply to This

Permalink Reply by Clement Rhein on June 9, 2008 at 10:18pm

She usually gets R knee pain in morning as going down the stairs, but since treatment its ok. No more foot pain. Lets see how it holds up...
I didn't think bout arch dude - I'll take a look next time. Cheers

▶ Reply to This

Permalink Reply by Clement Rhein on July 4, 2008 at 10:34am

I find this orthotic business interesting. You don't think that an orthotic can be useful in treating a chronic foot restriction (compensating or else)? Once its treated then take it out... Do you think there is any therapeutic use to orthotics?


For me, I cannot tell someone to look at this joint or look at this specific area when treating this particular condition... like you say "You won't change this by treating the foot or the knee alone".

I say this because I feel every patient is different and with all the biomechanical relationships, I find it impossible to have a set route for a presentation. In this example, I felt the cause came from the knee, so i treated the knee. If I felt it came form the occiput then I would I have treated that.

To this date, she has no more knee stiffness in AM and no MN symptoms.


I think as osteopaths we us a combination of logic and palpation for our diagnosis. PErsonally, I use mostly if not all palpation for diagnosis and treatment (logic for safety purposes of-course), therefore, use what my hands feel needs to be done, not what I what to do or what the patient want's me to do. I then use logic to explain to the patient. "It's painful there because here is tight and this joint cannot move properly so this one is overworked and becomes painful now..."

I think osteopaths who use primarily logic will say things like, "ok MN, treat the tarsals, the interosseous membrane, the knee, hip and SI and take a look at the iliotibial band and adductors...". By all means I'm not saying is a crapy way of treating, just different. What do you think?

▶ Reply to This

Permalink Reply by Clement Rhein on July 10, 2008 at 10:34am

:-) Howard
My question to you is how can you say that, even-though you have not laid your hands on this patient? Are you saying that, for you, MN can never originate due to a knee SD?
From where you are seating, are you able to tell me where the problem has started from then?

Who's taking about lots of structural techniques to the knee anyway? Not me.

▶ Reply to This