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? 

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

A patient comes in with a problem, maybe low back pain. Most chiropractors would figure out what vertebrae /spinal nerve is involved and then adjust the segments involved.

However what is missed is why did the problem happen and how can it be fixed so that it does not happen again.

First we need to look at the muscles innervated by the spinal segment

As a Applied Kinesiologist, 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.”

Is there a problem with the vascular or lymphatic drainage of that muscle? Is there a problem with the cranial-sacral system?

Is there a Lovett Brother association where a twisting of the spinal meninges affects an upper vertebrae as well as a low back spinal segment.

As a NKT practitioner, I ask “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 or core muscles, for example.

back muscles

Is the patient using their neck muscles in the movement of their low back?

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

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.

After balance is restored to the muscles, the vertebrae  ( or extremity joint) are adjusted.

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

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

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

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/2015/09/20/a-nyc-chiropractorapplied-kinesiologist-starts-adding-neuro-kinetic-therapy-to-the-mix/

https://drvittoriarepetto.wordpress.com/2016/05/28/why-is-my-neck-problem-causing-low-back-or-leg-pain-a-nyc-chiropractor-applied-kinesiologist-nkt-practitioner-explains-the-lovett-brother-effect-on-the-spine/

https://drvittoriarepetto.wordpress.com/2014/01/01/a-nyc-chiropractorapplied-kinesiologist-talks-about-chiropractic-adjustments/

https://drvittoriarepetto.wordpress.com/2010/05/17/cranial-sacral-therapy-in-applied-kinesiology/

 

© 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? 

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Bursitis: How a NYC Chiropractor/Applied Kinesiologist/NeuroKineticTherapist Treats It.

First, what is a bursa (bursae)? A bursa is any small pouch or sac between tendons, muscles or bony joints at points of friction or stress which contains a very slippery synovial fluid which allows the two sides of the sac to slide freely. http://en.wikipedia.org/wiki/Synovial_bursa

The term “bursitis” is a combination of “bursa” and “itis,” a word termination meaning inflammation of the bursa. Bursitis is an inflammation of the lubricating membrane. The classic signs of inflammation are pain, heat, redness and swelling.

The most common bursae sites involved in bursitis are at the shoulder, elbow, hip joint, knee and heel.

Here’s an image of the shoulder bursa:

bursitis_shoulder

Bursitis can be caused by trauma, infection or crystal deposits. Trauma is the most common type; it usually develops from mechanical stress due to overuse, direct injury or muscle/joint misalignment.

Bursitis caused by trauma is usually what a doctor of chiropractic who uses applied kinesiology and neurokinetic therapy will see so I will confine my discussion to that type.

Repetitive activities as in sports or washing a floor on your knees are examples of overuse. Falling or hitting a joint can cause inflammation to the bursa.

Muscle/joint misalignment is often an overlooked but very common cause of bursitis; joints depend on the contraction of certain muscles that move the joint in the desired direction and the relaxation of opposing muscles.

Improper contraction or using the wrong set of muscles or the joint not being in the correct position to allow the correct contraction can cause a misalignment problem and stress the bursa and cause inflammation.

When a patient comes in with a bursitis problem, one of the first things that I do is test the surrounding muscles for any weaknesses or spasms as a muscle imbalance will affect the joint and the bursa.

In the case of shoulder bursitis, I ask  is there a dysfunction in the coordination of muscles working in patterns. Is the biceps or pectoralis major or trapezius   compensating (facilitating)  for weak or inhibited muscles like the deltoid or rotator cuff muscles , for example. or vice versa. Muscle imbalance can cause uneven pull or  misalignment of the joints that surround the bursa; causing inflammation of the bursa.

Weak muscles are strengthened and muscle spasms or compensating muscles are relaxed via spindle and golgi tendon work. Blood flow to the muscles is improved by working on neuro-vascular points and lymphatic flow.

The joint alignment is checked and any misalignment is corrected by adjustment of the joint.
For information on specific techniques, please read:

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

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

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

Adequate nutrition for repair and health of the bursa is discussed with the patient.

Sometimes chronic systemic inflammation in a patient requires improving the gut digestion as this can affect one’s joint.

Applications of ice decreases swelling and use of wet heat increases blood and lymph flow to promote healing.

Lifestyle changes are recommended; for example if one has to kneel for work, heel pads are suggested. And proper stretching and exercises are recommended to support the joint and the muscles crossing the bursa.

© 2015-Dr. Vittoria Repetto/revised – 2016

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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Are you utilizing your folic acid? The case for metabolically active form of folic acid – L-5-MTHF

Roughly one-third of the general population may have a genetic variation that impairs their ability to properly utilize folic acid.

L-5-methyltetrahydrofolate (L-5-MTHF) is the metabolically active form of folic acid. The folic acid found in food has to be cleaved (digested) from protein carriers in order to be absorbed. This process is inefficient in some individuals. Once absorbed, dietary (and supplemental) folic acid has to then undergo several biochemical conversions in the body to become L-5-MTHF. Roughly one in three Americans have genetically inefficient enzymes that help create L-5-MTHF. By supplementing with L-5-MTHF, one can be assured of getting the benefits of folic acid, regardless of their ability to absorb or convert it to the active form. If you are an individual with impaired ability to utilize regular folic acid, L-5-MTHF supplementation can make a truly dramatic difference in your health.

L-5-MTHF plays a role in DNA synthesis and repair. Inadequate levels of 5-MTHF is linked to childhood leukemia. Cancers of the colon and breast are also associated with suboptimal L-5-MTHF status, as is the precancerous condition called cervical dysplasia. In a study involving smokers, high doses of folic acid and vitamin B12 reversed precancerous cellular changes in the lungs.

Folic acid’s importance to human health has to do in part with its role in a biochemical process called methylation. Methylation refers to the transfer of methyl groups (one carbon bound to three hydrogen atoms). Methylation occurs billions of times in the body each day and is essential for health.

L-5-MTHF is very important to genetic expression. Methyl groups are strategically placed on certain genes to inactivate them. Every cell in the human body has the genetic information to produce every other type of cell. The thing is that most of the genes are not active. Methyl groups (supplied indirectly by L-5-MTHF) silence the genes that should not be active in a given cell at a given time. This is obviously critical for good health. Some of the genes within our cells are tumor promoters. Proper methylation, which requires L-5-MTHF, keeps these genes silenced. The importance of L-5-MTHF involves more than its role in promoting proper genetic expression, DNA synthesis and repair.

L-5-MTHF also plays a role in dopamine and serotonin metabolism.

L-5-MTHF also plays an important role L-5-MTHF also plays an important role in detoxication of a variety of compounds, including environmental toxins (such as mercury, lead, arsenic and tin), medications, and some of the body’s own hormones. Estrogens are detoxified through methylation. Inadequate levels of L-5-MTHF cause potentially toxic build-up of estrogens in the body, which increases risk to breast, prostate and other cancers. Other conditions of estrogen excess, such as uterine fibroids and endometriosis, are also more likely to occur and be more severe. Histamine, epinephrine (adrenaline), and norepinephrine are also detoxified by methylation. Inadequate L-5-MTHF could therefore potentially worsen allergy and stress-related symptoms.

L-5-MTHF is critical for the detoxication of homocysteine. Conditions associated with elevated homocysteine levels include coronary artery disease, heart attack, stroke, deep vein thrombosis, peripheral vascular disease, miscarriage, birth defects, depression, sensorineural hearing loss, osteoporosis, cancer, arthritis, dementia, Alzheimer’s disease, Parkinson’s disease, and complications of diabetes. Do you know what your homocysteine level is?

© 2009-Dr. Vittoria Repetto

Please check out Metagenics for products w/L-5-MTHF at http://www.metagenics.com

Click on Create an Account and use Practitioner Code – DrVittoriaRepetto

Thanks

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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