Case Study: When Feet Can't Find Solid Ground
Patient: "Taylor" (name changed)
Bio: 33 year old female, On disability for chronic pain
Primary Complaint: Chronic bilateral foot pain beginning at age 9
History
Taylor first began experiencing significant foot pain at approximately nine years of age.
Her feet were profoundly pronated, to the point where the lateral borders of her feet had minimal contact with the ground. Over the years, the pain progressively worsened and significantly impacted her quality of life.
In 2012 (at age 19), she underwent a HyProCure procedure, a surgical intervention designed to improve foot mechanics by placing an implant within the sinus tarsi to support the arch.
Unfortunately, within a relatively short period of time, the implant became symptomatic and began protruding enough to be palpable beneath the skin.
A second surgery was performed in 2014 using a larger implant in an attempt to maintain correction.
This was also unsuccessful.
By the time Taylor arrived in my office in 2017, she had recently withdrawn from her post-secondary education due to chronic pain and had been placed on disability support because her symptoms were significantly limiting her ability to function.
She was chronically exhausted from the pain. Even grocery shopping would lead her to needing several days to recover at home.
Several years later, after consulting numerous specialists and exhausting conservative options, she underwent extensive reconstructive surgery on both feet. These surgeries involved removal of the previous hardware and substantial alterations to the mechanics of the feet, including modifications to surrounding soft tissues, bone and tendon structures.
Despite all of these interventions, pain remained a significant feature of her life.
The Curious Beginning
One detail that always stood out to me was that before the foot pain began, Taylor experienced an earache that persisted for nearly eleven months prior to any pain in her feet evolving.
While we cannot definitively connect the two events, I have often found it valuable to pay attention to what was happening in the body before a major symptom pattern emerged.
And as you know - the body rarely speaks in a single chapter of our lives...
The Person Behind the Pain
Taylor is one of the kindest people I have ever met.
She is thoughtful, conscientious, and deeply caring.
In fact, one of her most consistent patterns was concern for everyone else's wellbeing.
She would routinely check in on me before discussing herself, always asking how I was doing or if I had any challenges in my life because she wanted to "help".
Over the years, another pattern became apparent:
She consistently put herself last.
As our therapeutic relationship developed, I learned more about her upbringing.
Around the time her symptoms first emerged, there was significant turmoil within the home. Relationships were unstable and emotionally difficult.There was considerable tension between her parents, and many of the adults around her were struggling themselves. Her home life became very hostile and given her age and size, she had no control over the situation or her daily life.
Because of the pain she was experiencing she had to stop dancing (one of the few things she enjoyed at that time) and was relegated to a fruitless quest for medical answers to her mysterious foot pain.
Interestingly, both Taylor and her mother shared a similar pattern:
Being highly attuned to everyone else's needs while largely ignoring their own.
The Osteopathic Journey
I've now worked with Taylor for almost a decade (9 years to be exact).
During her first appointment I remember feeling really perplexed. Everything I did created pain in her body - even my gentlest approaches such as cranial or even a fascial glide assessment caused her to respond with pain.
At first I wasn't sure I could provide much support.
But the reality is, Taylor had seen everyone. There weren't many modalities or practices that were left.
And after a few treatments, there were some notable improvements, albeit small. But for someone like Taylor who had felt like she'd been shuffled around from clinician to clinician it was a massive shift.
Having someone listen to her and be willing to patient and understanding of her pain even when it didn't make sense mechanically did more for Taylor than any surgery could have.
Many visits focused on helping her manage pain and improve function.
At the same time, our conversations gradually expanded beyond the mechanics of the feet.
We began exploring:
- How much responsibility she carried for other people.
- How often she pushed through exhaustion.
- How frequently she overextended herself.
- How difficult it was for her to disappoint others.
- How uncomfortable it felt to establish boundaries.
One of the most interesting observations was that symptom flares often followed periods where she ignored her own limits.
She would commit to activities she did not have the energy for.
Push through discomfort out of a sense of obligation to others.
Override what her body was asking for.
And then spend days and sometimes weeks recovering afterward.
Over time, we started treating those moments as information rather than bad luck.
The Emotional Anatomy Perspective
From an Emotional Anatomy lens, the feet often represent our relationship with support, stability, direction, and our ability to stand our ground.
I don't view this as a literal cause-and-effect relationship.
Rather, it is a lens through which we can ask better questions.
For Taylor, those questions became increasingly relevant.
Could she trust herself?
Could she stand her ground?
Could she say no?
Could she stop carrying responsibilities that didn't belong to her?
Could she create safety without constantly earning approval?
As these conversations evolved, something interesting happened.
Her relationship with her body began to change.
Instead of seeing herself as broken and a medical anamoly, she began seeing herself as someone whose body had been communicating for a very long time.
What Changed?
The most significant changes did not come from another surgery.
They did not come from finding the perfect diagnosis.
They came from gradually shifting how she lived.
Over the years she:
- Developed healthier boundaries.
- Reduced people-pleasing behaviours.
- Learned to listen to early warning signs from her body.
- Challenged the belief that she was fragile or broken.
- Began making decisions based on what felt sustainable rather than what pleased others.
As these changes accumulated, her pain levels gradually decreased.
And what's exciting to see now for Taylor is that she has developed a new baseline for herself.
Although she still deals with pain it has become far less of a driving factor in every decision that she makes.
She is finding new ways to interact in her relationships where she values her own time and energy.
Recently, she cancelled an appointment because she was feeling so well - something we've been striving towards for a long time.
For many practitioners, that might seem insignificant.
For Taylor, it was monumental.
Lessons for Practitioners
One of the reasons I wanted to share this case is because I think many practitioners feel pressure to have the answer.
We want the diagnosis.
The technique.
The protocol.
The breakthrough moment.
But some cases don't unfold that way.
I've worked with Taylor for nine years.
And looking back, I don't think my role was simply to treat her feet.
My role was to provide a consistent space where her body could be listened to differently.
Where symptoms could be explored rather than fought.
Where she could gradually develop trust in herself and in her body's capacity to heal.
Sometimes the treatment is the solution.
Sometimes the relationship is part of the treatment.
Sometimes helping someone understand the language of their body becomes the most important intervention of all.
Reflection Question
Taylor spent years asking:
"What's wrong with my feet?"
The question that ultimately created the greatest change was:
"What has my body been trying to teach me about support, boundaries, and standing my ground?"
What patient in your practice might benefit from a different question rather than a different technique?
šGeneviĆØve
PS. I'm trying new formats for these case studies - let me know which ones are easiest for you to follow! (ie laid out formally like above or more like a story? More or less emojis š? )
PPS. Please feel free to share your thoughts/comments below or bring it to the community. The community space is like a lab- a place where we can share these kinds of observations and get feedback on your real cases! And if you don't quite get how the community piece works just reply to this email - I'm happy to help!
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