When patients come in with a local problem such as leg pain, the first question is where is the source of the pain; is it from the leg itself or the the low back. The other important question is what “set up” the problem. Without answering this question,the problem is not really resolved; the patient will come back with the problem again; you will be just “chasing pain*.”
The answer to the second but more important question may be in the global muscles or core stabilization muscles, these muscles are the Rectus Abdominus, the Transverus Abdominus, the Internal & External Obliques, the Quadratus Lumborum, the Erector Spinae and the Multifidus.
Recently new patient came in complaining of feeling “unbalanced on her right side” siting specifically her right leg and hip.
The lower extremities were a quick fix: a Rectus Femoris – major muscles in the front of the thigh -compensating for a weak Gluteus Maximus. Also the patella and the rotation of the femur (thigh bone) on the tibia (lower leg bone) needed to be adjusted and the Popliteus ( a muscle that rotates the tibia) released.
But during the examination, on lateral flexion of her truck, I noted that her rt shoulder was rotating. I asked her to try to not rotate her shoulder but she was unable; in fact she was unaware of doing it.
I tested her Oblique muscles and they were weak on the right side. Touching (therapy localizing) her Quadratus Lumborum strengthened her Obliques when retested. So I released the QL and the Oblique were strong.
A Category One pelvis which involves rotation was found and fixed.
When she stood back up, the rt. leg felt balanced and the rotation of her shoulder on lateral flexion was gone.
It was a great illustration of how sometimes part of the problem you have to look above the area of complaint to truly fix the problem; a local problem with a global part.
Stretches and exercises were given as homework.
In my practice, I Iisten, observe and test during the examination and use a combination of NKT, Applied Kinesiology and Chiropractic to help my patients; it’s a strong combination.
© 2017-Dr. Vittoria Repetto
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*I thank Dr Perry Nickelston for his phrase “Stop Chasing Pain.”