- Lian Yun-Perng, Physiotherapist
Peripheral Vascular Deficiency
50+ yo, Male
C/o: Sluggish right foot movts after walking for around 100 m around 3-4/12 ago. Did a LL nerve conduction test: NAD.
PMH: No issues with heart, DM,CES or ca. Was admitted into hosp for Pneumonia but he's healthy otherwise.
SH: Ex soldier turned businessman, sedentary lifestyle
LL MMT: 4/5
Hip ROM: Mod
DTR for Ankle and Knee: Bil normal
X-rays: NAD, had quite a healthy spine for someone his age
I treated this client as having adverse neural tension on his LLs so I did some soft tissue work with his right calves, sciatic nerve mobs and LL strengthening exercises. I did not see a problem with my treatment programme or his symptoms. I told myself that even if I couldn't give him symptomatic relief instantly; I would still be helping him physically.
His condition did not change so he visited an osteopath and he was told that he had some issues with his blood circulation on his right leg. I only realised then that I had a wrong impression of his condition. This could have been a pretty straight forward case if I thought through his history thoroughly. So, the message I got from this case was to assess and re-assess if my client has min to no improvements.
PS: He has seen a vascular specialist for further investigations and has started medical management.
Take home message: Foot drop after walking for a while is a RED flag!
Always, always consider all your patient's symptoms and do not assume that every condition has the same clinical presentation.
Things to also pay attention : Calf pain/ cramp aka Intermittent Claudication