Malleolar Fracture

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What does a post lateral malleolar fracture patient look like?

Can you say loss of proprioception? Can you say loss of triceps surae strength? Can you say loss of hip abductor strength?


Whenever we have a fracture and that segment is subsequently immobilized, we usually have damage to joint and muscle Mechanoreceptors as well as some atrophy of the receptors because of the immobilization. Lucky for us, and this patient in particular, those changes are rapidly reversed due largely to initially neural adaptation which is responsible for most of the early strength changes and then later, after a few weeks, muscular hypertrophy.

A simple test for motor programming

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Marching, a rudimentary motion, is a great screening for people with motor programming difficulties. This gal has left lower extremity dystonia and we were looking to see if it was more peripheral or central in origin.


You can see how her movement breaks down after a few simple steps of attempted coordinated movement. Use this simple marching screen next time you suspect a central programming issue in your patients :-) 

Appropriate Placement of Metatarsal Pads

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In a follow-up to our last IGTV video, here we look at appropriate place in metatarsal pads. Metatarsal pads can do a great job to lift and separate the individual metatarsal heads and create space for things like neuromas and alter the forefoot mechanics. They are not a substitute for appropriate exercise and strengthening.

This individual had right “sixth toe“ disease and the metatarsal pad was being used by a podiatrist to alter for foot mechanics. It was clearly too far back on the right side. 

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