The Application of Mechanical Diagnosis and Therapy to the Ankle-Foot Complex: A Case Series

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

THE POWER TO CONTROL PAIN