Appropriateness of therapy?

[CityGal]

I'm recently returned to PT to treat scar tissue that resulted from a fractured & displaced talus in an auto accident in 6/06 which required ORIF surgery and a long recuperation. The scar tissue was giving me bumpy feelings on the foot bottom and might have been entrapping nerves.

As part of the therapy 2 paddles are applied, 1 to top of foot and 1 to bottom. The foot is then wrapped to hold the paddles in place and the machine is turned on until I feel a pulsing feeling which I assume is a current to stimulate something - what I'm not sure. This treatment lasts for 15 minutes.

Lately, I've been having discomfort in a tendon (think that's what's bothering me) behind the medial ankle, and stiffness in dorsiflexing which I haven't had in over a year.

Can somebody explain what this treatment is about and whether it can cause any negative side affects? Could it be the cause of the symptoms I described?

Thanks for any replies!

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[Physio Dace]

CityGal,

From your description I assume your therapist is using a single channel TENS (transcutaneous electrical nerve stimulation) or other e-stim device - for what reason I am unsure. If you have pain and swelling in the midfoot then I would deem it an appropriate symptomatic modality; if not then I don't see the point.

As for whether this treatment could account for the new medial ankle pain I think it would be unlikely to be a direct cause and effect. Perhaps they have given you some other exercises/stretches for the ankle/foot that may be more relevant to this pain e.g. heel raises, ankle pumps in hamstring stretch position etc. A number of structures can generate pain in that area - more symptom and therapy information is needed to answer your question more thoroughly.

Hope this helps a little.

[CityGal]

Thanks Dace. It does help a bit. I know the ankle is so complicated it's often hard to deduce what's causing the problems.

I once asked if the machine was a tens unit and was told it's more than that. Guess because they can hook 2 patients to it simultaneously. Yesterday I overheard one of the other therapists saying he didn't want to hook one of his patients up to it as he didn't want something (muscle??) overstimulated. That's what precipitated my concern. Should've asked the therapist directly, but didn't see her again for the rest of the session. I will have a discussion on my next visit as I'm also not sure why this 'treatment' is being given. Her mission is to break up the scar tissue in my foot.

[Fyzzio]

Hi Citygal,
I guess it is really difficult to comment on your situation, as we don't exactly know what kind of machine is used, what the machine actually does and the rational behind the treatment.
Which is sort of exactly my point.
Under the Patient Code of Rights for any country, you need to give informed consent to any treatment applied to you.
This includes full information (verbal and or written)and explanation about the treatment you receive and any available treatment alternatives.
Please ask your Therapist what the treatment consists of and why she/ he believes this is the best treatment option.
We know that there is a psychological component to recovery and if you cannot fully commit to the treatment, because you don't understand what is happening and you have fears or doubts in regards to the treatment you receive, the success of the treament is likely to be less than optimal.
Again, talk to your therapist (she/he might not even be aware that you don't know what's going on...) and you'll be much happier.
Regards,
Fyzzio