? Posterior Tibial nerve compression/entrapment
I am a PT working inthe Boston area. I have been seeing a patient who is 4 months s/p calcaneal fracture and ORIF after a 30-40 foot fall from a mountain. We have addressed edema, joint mobs, ROM, and strength all which have improved and are improving. He has an incision from the fracture site at the medial malleoli that has decreased mobility. This incision has increase sensitivity and palpation reproduces significant pain along the medial plantar fascia. His primary compliants of pain at this site, increased plantar fascia pain, and cramping are limiting return to function. I have been addressing tissue mobility as well as the patient in his home setting. My concern is that he has a posterior tibial nerve compression/entrapment. There is positive Tinel's sign and reproduction of pain as well as increased pain with traction (increased tension on the nerve). Are there any treatment strategies that may help mobilize the nerve and or other tests for further confirmation of the entrapment?
Thanks
Re: ? Posterior Tibial nerve compression/entrapment
Well try Active release techniques though you will need to attend a seminar for that. From the already known perhaps slump test or SLR for mibilise and or testing the entrapment. Testing would suggest direct palpation of the area for possible scar tissue presence.
Re: ? Posterior Tibial nerve compression/entrapment
Butler and Shacklock are the information go-tos for neurodynamic know how.