One of the remits of Mark's NHS commitments at the University Hospital Birmingham was to develop the musculoskeletal and trauma service from a podiatry perspective.
As part of this development over the last decade and beyond Mark has been heavily involved in the management of musculoskeletal lower limb injury.
Mark has been fortunate to work with experts from other professions such as physiotherapy and orthopaedics in regard to musculoskeletal management and this has allowed an holistic approach to lower limb problems.
Orthotic management provides a baseline mechanical input in regard to overuse problems in the lower limb. Orthotic intervention in isolation rarely will address either the acute or more commonly chronic problems presenting in general musculoskeletal clinics. The role of orthotic intervention is to provide an appropriate mechanical environment to allow injured or overused structures to repair.
This approach utilises tissue proliferation as an instrumental theme behind tissue repair. This alongside appropriate soft tissue work in terms of length and strength plus proprioceptive work often are the binding and defining factors for sports people to return to their activities.
Mark also works with a number of professional sports clubs around the region. The involvement covers rugby, cricket and football clubs where the team approach to management is at its strongest. It is from working within this field where Mark is convinced that effective management of the sports population is in being able to identify and address the multifactorial reasons as to why people are either injured or whose injuries fail to resolve following trauma.
Effective management for musculoskeletal complaints covers orthotic provision, footwear, soft tissue length and strength and proprioceptive work. Alongside these interventions are techniques to stimulate tissue repair.
The role and the commitment of the injured patient is also instrumental in returning to sport and therefore compliance to the management plan is essential in effective management. Running injuries make up the largest percentage of Mark's caseload of sports population.
Given the volume of information from various sources there are competing theories to the most appropriate way of managing this group. Mark's experience of working with this group has provided a framework of management options this covers mechanical predisposition, footwear selection and running program as an adjunct to the additional interventions described above.