As someone who has a special interest in foot and ankle biomechanics, I have long seen many podiatric colleagues of mine getting great results from the inclusion of mobilisations within their care plans. In fact, it was the departure of one of the podiatrists in my clinic who used mobilisations that spurred me on to doing it
The course that I attended was called “Foot Mobilisation” run by Inifigo via Algeos Academy. (As they say in TV, other course are available). However, I have known the leader of the course, Ian Linane, for some years now and his courses are always very well received. To boot, Ian is a really good bloke with a relaxed teaching manner and the food was great! This course is one of several courses dealing with different aspects of mobilisations at different levels.
Over 2 days, participants learn about the history of mobilising and how the development of the techniques has been influenced by different professions and different paradigms. Many of the techniques covered within the course are based upon solid, evidence based physiotherapy principles but perhaps with a slightly greater emphasis on the much smaller and more numerous anatomical structures of the foot and ankle.
The largest part of the course, however, is spent doing practical work mobilising many different feet. Over the two days, I was amazed how much more sensitive I (and my hands) were to feeling very subtle movements that can be critical in managing tissue stress
The real winners (with my Orthotist hat on) were improving talo crural joint range of motion by mobilising the fibula and the talus and mobilising the sub talar joint. It is important to be very careful about the terminology here. This is mobilisations at very low levels of force and speed with only small oscillatory movements. This is NOT manipulation.
In my practice, all of the areas covered in this course will have influence on my outcomes because of the patient demographic that I see. For many in regular orthotic practice it may well be that the only thing they take from it is how to improve sub talar movement and how to increase dorsiflexion available at the ankle joint. But just those two small things can have a profound effect on how you prescribe and how good your outcomes are instantly without even having issued any orthoses.
Is it a panacea? No. What is the mechanism of pain relief? We don’t know. Does it work? Yes, but not for everyone
All these questions are answered in exactly the same way when we talk about foot orthoses. Mobilisations are not something that we need to shift to in order get results with our patients. We already do OK quite well on that count. BUT, it is another arrow in the quiver for managing our patients to the best of our ability. Will I return to a life where I do not use mobilisation as part of my care plan? I find it unlikely and I look forward to using these new found skills.
If anyone has any questions about the course and the suitability of the content, I would be happy to discuss. Email me on [email protected]