Anterolateral Lower Leg Pain &/or Foot Drop – Peroneal Nerve Entrapment – A NYC Chiropractor /Applied Kinesiologist /NeuroKinetic Therapist Explains

Occasionally a patient comes in with pain along the anterior lateral part of their lower leg and they may also have difficulty lifting the top of their foot upward at the ankle (dorsiflexion) or moving the foot outward at the ankle (eversion). This also affects the patient’s gait (ability to walk properly)

movements-of-foot

They may have been told that their problem is sciatica since branches of the sciatic nerve goes all way down the leg and into the toes. They may have been to a physical therapist or another chiropractor who worked on the low back where the sciatic nerve originates without any relief.

How a NYC Chiropractor /Applied Kinesiologist /NeuroKinetic Therapist Treats Sciatica

But the problem is the peroneal nerve which branches off the sciatic just below the knee; it goes from the common peroneal nerve which starts at the lateral back of the knee near the inner side of the biceps femoris  (part of the hamstings), goes to the back of the fibula bone and then branches off to the superficial peroneal nerve and the deep peroneal nerve.

The deep peroneal nerve innervates the muscles of the anterior compartment of the leg which are: tibialis anterior, extensor hallucis longus, extensor digitorum longus, and the peroneus tertius. Together these muscles are responsible for dorsiflexion of the foot and extension of the toes.

The superficial peroneal nerve passes between the peroneus muscles and the extensor digitorum longus, and goes into the deep fascia at the lower third of the leg; it supplies the muscles of the lateral compartment of the lower leg : peroneus longus and peroneus brevis. These assist with eversion and plantar flexion of the foot.

The deep peroneal nerve passes inferior and medially, deep to extensor digitorum longus,  and comes into relation with the anterior tibial artery above the middle of the leg; it then descends with the artery to the front of the ankle-joint, where it divides into a lateral and a medial branch. The deep peroneal nerve innervates the muscles of the anterior compartment of the leg which are: tibialis anterior, extensor hallucis longus, extensor digitorum longus, and the peroneus tertius. These muscles are responsible for dorsiflexion of the foot and extension of the toes.

superficial-and-deep-peroneal-nerve-and-muscles

Spasms of muscles along the route of these nerves can cause nerve entrapment and result in loss of muscle function or pain along the route of the nerves. As muscle attaches to bones and joints, spasms can cause misalignments of these structures and this can further complicate the problem.

Sometimes the muscle spasms are complicating for a muscle that is inhibited somewhere along the lateral or posterior kinetic chain such as the gluteus maximus, gluteus medius, the hamstrings and the rectus femoris or the psoas which overwork in order to to lift the leg to clear the dropped foot during walking. Neurokinetic therapy works well answering this question and correcting the problem.

As a applied kinesiologist and neurokinetic therapist I will either place my finger or hand on specific areas and then retests the muscle to see if the weakness is corrected. This is called therapy localization.

If the therapy localization is positive and the area involved is a joint or a muscle, I can move the area in a way to stimulate neuro/mechano receptors in the joint or muscle. This is called a “challenge’ and shows the direction of manipulation needed to improve function of the joint or muscle.

As a chiropractor, I would not only adjust the involved joints but check to see if the change in gait muscles has affected the spine and adjust affected level.

Stretches are given to the previously complicating muscles and exercises given to the previously inhibited muscles in order to break the pattern that caused the problem.

For  more information, please read:

The Use of Applied Kinesiology in a Chiropractic Examination

How a Combination of Applied Kinesiology, NeuroKinetic Therapy and Chiropractic Works

 

 

© 2016-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

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Medical Articles of Interest For September 2016

 The following are from www.medscape.com a site summarizing medical research:

Can a Good Diet Prevent Dementia?

Mediterranean Diet Lowers CVD Risk in Prospective Study

Fungus May Be ‘Key Factor’ in Crohn’s Disease

Chronic Constipation a Warning Sign for GI Disorders

Farm Living Study Confirms the Hygiene Hypothesis

See the following for discussion of the Hygiene Hypothesis – The Hygiene Hypothesis — Redefine, Rename, or Just Clean It Up?

New FDA Watch List Covers 27 Drugs and Drug Classes

Herbal and Dietary Supplements Tied to Liver Damage

This article is one of the reasons why you should use supplements from one of the first companies in the nutritional supplement industry to achieve three independent certifications for Good Manufacturing Practices (GMP) by world-leading arbiters. In many areas, Metagenics exceeds these requirements with additional in-house testing and third-party assays by respected independent laboratories. http://www.metagenics.com/metagenics-difference/unsurpassed-quality

Here’s more information on Metagenics: https://drvittoriarepetto.wordpress.com/2015/08/28/nutritional-supplements-why-metagenics/

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

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Or join me at Twitter: www.twitter.com/DrVRepetto

Looking At Posture As A Clue To Helping Patients – A NYC Chiropractor/Applied Kinesiologist/NKT Practitioner Explains

Two weeks ago, a relatively new patient who has been to other chiropractors paid me a compliment by saying that I was “unlike other chiropractors, I think about what is happening and what I need to do.”

One of the things I look at is posture. How does the patient present as they stand in front of me?

The other question that is relative to their posture is: How did they get that posture? Was there an accident where they were, for example, thrown forward and had to catch themselves when their bus suddenly stopped. What position was their body in? Hands forward? Head turned?

Postural findings may be due to muscular inhibition either as individual muscles or as a group of muscles that work together to do a certain movement

Or they may be due a compensating muscle inhibiting a muscle

Are the involved muscles hypotonic or hypertonic?

Or has a problem with their foot, for example, caused muscles to get inhibited or to compensate up the length of their body causing further joint and spinal pain?

bad-posture-posturepro

Here are some examples of muscles that may be involved in postural findings:

  • High Occiput – upper trapezius, neck flexor/extensor, gluteus medius, SCM, rectus capitus
  • Head rotation – latissimus, gluteus medius, lower trapezius
  • High Shoulder – opposite upper trapezius, quadratus lumborum
  • Low Shoulder – quadratus lumborum, latissimus
  • Elevated Ribs – rectus abdominal, oblique abdominals, quadratus lumborum
  • Lumbar deviation – psoas, lumbar erectors, multifidus, gluteus medius/maximus, tfl
  • High pelvis – sartorious, quadratus lumborum, hamstrings
  • Genu Valgus (Knock Knee) – TFL, gluteus max, adductors
  • Genu Varus (Bowed Knee) –adductor, popliteus, hamstrings

I use manual muscle testing to see if the muscles are hypotonic or hypertonic or inhibited by a compensating muscle.

I also look to see if there is a problem with the alignment of the joint the muscles cross or the vertebrae involved in the spinal innervation of the involved muscles.

For more detailed information, please check out the following blogs:

https://drvittoriarepetto.wordpress.com/2014/08/09/the-use-of-applied-kinesiology-in-a-chiropractic-examination/.

https://drvittoriarepetto.wordpress.com/2010/06/21/muscle-balancing-in-applied-kinesiology/

https://drvittoriarepetto.wordpress.com/2016/03/22/a-nyc-chiropractorapplied-kinesiologist-adds-neurokinetic-therapist-to-her-skill-list/

 

 

© 2016-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

Or join me at Twitter: www.twitter.com/DrVRepetto

 

A NYC Chiropractor/Applied Kinesiologist Adds NeuroKinetic Therapist to Her Skill List

 

On Friday, March 18th I took the exam for certification in Level 1 NeuroKinetic Therapy and passed w/ flying colors. I now can call myself a NeuroKinetic Therapist.

As you know with Applied Kinesiology, I test for the function of individual muscles. For example, we may find the latissimus dorsi muscle weak; that is a muscle that internally rotates, extends and adducts the arm/ shoulder. It also attracts into the lumbar and sacral vertebra and part of the pelvic crest. The weakness may seen either as a higher shoulder on the weak side or a rotation of the lumbar vertebrae. The questions to be asked are: why is the muscle weak? Is the muscle on the other side hypertonic or “too stronger.” 

lat dorsi

Is there a problem with the spinal innervation?,  asks the chiropractor in me.

Is there a problem with the alignment of the joints that the muscles cross? Is there a problem with the vascular or lymphatic drainage of that muscle?

Now I will be adding the question, Is there a dysfunction in the coordination of muscles working in patterns. Is the above mentioned latissimus dorsi inhibited by the muscles that attach to the shoulder like the upper or middle trapezius or the levator scapulae  or is it compensating (facilitating) for weak or inhibited muscles like the gluteus maximus or the quadratus lumborum say involved in low back pain, for example. 

NeuroKinetic Therapy works with that concept that movement is performed in systems or patterns. The human brain has an affinity toward habits.

For example when we sit down , we use a variety of muscles to both lower ourselves,  to keep the upper body straight and to control our balance.  An injury to one of the muscles involved in sitting down can cause a patient to favor a compensating muscle and not use the injured muscle which in time becomes inhibited and the compensating muscle becomes a facilitated muscle which does not allow the inhibited muscle to switch back on.

nkt-logo

NKT identifies muscle imbalances by using muscle testing to determine what muscles are inhibited and what muscles are compensating (facilitating) for them.

I would test the muscles  involved in the problematic movement.  After an inhibited/weak muscle is found, I would muscle test a synergistic (a helper muscle) or an antagonist muscle (an opposing muscle which is strong/facilitated that may be affecting the inhibited muscle. That facilitated muscle would be therapy localized (the muscle is either touched or put in motion) and the inhibited muscle retested. If the TL strengthens the inhibited muscle, then I know that the TLed muscle is affecting the inhibited muscle.

And I can use AK techniques to release the TLed muscle. The inhibited muscle is then retested which should test strong now, the retesting causes a “neural lock” which reprograms the motor control center in the brain.

Stretches are given to the previously facilitated muscles and exercises given to the previously inhibited muscles.

For more detailed information, please click on the following blogs:

http://neurokinetictherapy.com/what-is-neurokinetic-therapy

https://drvittoriarepetto.wordpress.com/2010/06/21/muscle-balancing-in-applied-kinesiology/

https://drvittoriarepetto.wordpress.com/2010/05/06/the-art-and-science-of-muscle-testing-in-applied-kinesiology/

https://drvittoriarepetto.wordpress.com/2014/08/09/the-use-of-applied-kinesiology-in-a-chiropractic-examination/.

https://drvittoriarepetto.wordpress.com/2015/09/20/a-nyc-chiropractorapplied-kinesiologist-starts-adding-neuro-kinetic-therapy-to-the-mix/

 

© 2016-Dr. Vittoria Repetto

 

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

Or join me at Twitter: www.twitter.com/DrVRepetto