Orthopedic pain syndrome tracer assessment:  A process in which the center of mass (com) creates a tracer pattern over the base of support (feet and assistive device as applicable) of a person’s walking or running using two insoles feedback device. The pattern is analyzed for asymmetry to assist with identifying imbalance or dysfunction of the spine and legs including: leg length, muscle weakness, muscle imbalance, postural or alignment imbalance and/or movement behavioral dysfunction. The results of the baseline analysis are used to provide correction of the dysfunction as indicated.  The pattern is then reassessed for restoration of symmetry. Once restored, the pain syndrome (back pain, leg pain, knee pain, hip pain, foot pain or other pain syndrome) may be mitigated or resolve completely. A result of symmetry  of the mechanics of the body.  

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The series of images below, was from a patient case back in 2018 when Therapy in Motion was exploring ways to use the tracer pattern in helping to assess and treat orthopedic problems.  This patient was in her mid-thirties and healthy.  She was trying to train for a marathon.  She reported that consistently between 3 - 6 miles she would develop anterior right knee pain.  She attempted new shoes, orthotics, consulted PT, Orthopedic specialists, and so forth with no resolution.  They could not find anything to explain the anterior knee pain.  This patient asked if the technology I was working on would be able to help.  I did not know, but I said lets do a full physical exam and then test you walking and running and see if we find something.  As per all the other clinicians, a physical exam yielded no imbalances or problems.  The walking image looked to be within normal parameters. 

     The technology was rudimentary compared to today's imaging, but at the time the walking tracer pattern was symmetrical and she had no complaints while walking (Figure 1).  The second image is that of the patient running while on the treadmill(Figure 2).  There was a consistent lack of right heel strike vs the  left side.  The asymmetry was very subtle. but distinct and consistent.  Visually and with  careful measuring procedure this PT like so many others could not consistently measure a leg length difference.  This PT suggested that the difference is so small that the tracer pattern was the only thing that may have picked up the leg length  difference.  We tried a 3 millimeter lift and retested ( Figure 3).  The patient reported no pain.  She even picked up the pace, but there was symmetry.  

     I suggested she train this weekend.  9 - 12 miles as was on her training schedule.  The next meeting, three days later, she reported no pain for 11 miles(she ran 11 miles).  She went on to train for and complete the marathon in the autumn of 2018 without any complaints of pain or limitation.  To this day she stills has a 3 millimeter lift in her shoe for running.

    

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