The Application of Mechanical Diagnosis and Therapy to
the Ankle-Foot Complex: A Case Series
Lindsay Carlton, Joseph R. Maccio, Joseph G. Maccio,
Andrew Braga, Elizabeth Tomanio and Anastasia Belikov
Maccio Physical
Therapy, Troy, NY, USA
Background:
Pain at the ankle-foot complex is a common musculoskeletal condition that can
lead to dysfunction. Mechanical Diagnosis and Therapy [MDT] is an orthopedic
classification and treatment system based on mechanical and symptomatic
response to repeated and sustained movement. There has been no investigation of
the association between MDT and patients diagnosed with ankle-foot complex
pain.
Case Description: This report presents four patients with a primary complaint of pain in
the ankle-foot complex. Three patients had a medical diagnosis while the other
was self-referred through direct access. All received classification and
treatment by clinicians trained in MDT solely utilizing MDT principles.
Outcomes:
Short- and long-term (4-12 months) outcomes were excellent, demonstrating rapid
abolishment of symptoms and return to prior levels of function in an average of
6 visits over 21 days (4-8 visits over 14-33 days) without the use of
modalities, strength, or proprioceptive training. The patients demonstrated the
ability to prevent and manage re-occurrence of symptoms independently without
seeking further healthcare at long-term follow-up.
Discussion:
The rapid speed of recovery and return to functional activities demonstrated in
this case series, raises questions about whether or not the pathologies
traditionally associated with the etiology of the ankle-foot complex are
actually at fault or understood. Moreover, it demonstrates that specific
movements can rapidly worsen or improve symptoms challenging the current
generalized rehabilitation protocols. This report provides preliminary evidence
that MDT may be capable of providing more effective short-term outcomes in the
management of ankle-foot complex injuries. Level of Evidence: 4.
*Keywords:
Mechanical Diagnosis and Therapy; McKenzie; Classification; Ankle Sprain;
Derangement; Lumbar Spine; Posterior Tibialis Tendonitis; Plantar Fasciitis
Maccio Physical Therapy, PLLC
The Capital Regions ONLY Certified
McKenzie Spine and Extremity Clinic
1 New Hampshire Ave, Troy, NY 12180
(518) 273-2121 www.macciophysicaltherapy.com
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