Sam Thompson
Background
Sam, an elite trail runner, was battling ongoing arch pain and ankle instability during long technical races. The pain was intermittent initially, but became more constant, ultimately causing him to pull out of an ultramarathon.
He reported:
- Swelling to the inside of the right ankle
- Pain during weight bearing activity
- Difficulty standing on tiptoes
Sam had tried resting, as well as using ice and basic painkillers. He saw his physiotherapist who started him on a course of rehab exercises and referred him to Foot Factor for further assessment.
Case Study Disclaimer: The case studies presented are based on real patients from Foot Factor. All names and identifying details have been changed to protect patient confidentiality.
Assessment
A full gait analysis and biomechanics assessment suggested:
- Bilateral pronated foot postures, worse on the right side
- An antalgic or limping gait pattern
- Weakness of the right tibialis posterior muscle and difficulty raising onto tiptoes
An ultrasound scan was arranged which confirmed tendinopathy of the tibialis posterior tendon.
Orthotic Intervention
Sam was prescribed full length bespoke orthotics to:
- Offload the painful tendon
- Manage foot pronation
- Stabilise the foot within his shoes and on uneven terrain
He was also shown ankle taping techniques and the team at Foot Factor liaised with his physiotherapist to optimise his rehab plan and return to running.
Results (after 6 weeks)
- Significant reduction in pain and swelling
- Good improvements in strength and stability
- Gradual return to training with minimal flare in symptoms
Conclusion
This case highlights how the team at Foot Factor can utilise foot orthotics and work with our clinical partners to reach a diagnosis and implement a plan to get Sam back to running and later in the season he was able to return to competition.