The MOST IMPORTANT QUESTION in physical medicine:
WHY DO YOU HAVE PAIN THERE? AND HOW DO WE FIX IT OR MANAGE IT?


Scrolling through Instagram...(yes we all do it)

I came across a great clip demonstrating a complex connection through a basic exercise.  Since my last few posts have had little to do with human movement/anatomy, it is about time I share some knowledge of this topic.  After all, that's the focus of my practice.

Do you know someone with hip, knee, ankle or foot pain?  I'm sure that all of us could think of a friend, family member, co-worker, classmate or colleague that has one of these ailments.  Many patients come into my office and assume that because their knee hurts...their knee is the problem.  Usually, they're wrong.

IN MY WORLD OF HUMAN ANATOMY, THE SITE OF PAIN AND THE CAUSE OF PAIN IS OFTEN NOT THE SAME. ( a previous post of mine on this topic, 
http://dynamicphysicalhealth.com/2/post/2015/07/it-hurts-righthere.html)

Check out the photo below, then I'll explain.
Picture
http://image.slidesharecdn.com/shupe-140306132711-phpapp02/95/pudendal-neuralgia-and-lower-extremity-feet-biomechanics-ics-2011-glasgow-scotland-20-638.jpg?cb=1446317327
Let's look at the image on the LEFT (with posterior at the top).

I am going to attempt to explain this in non-medical terms, as well as  anatomical/medical terms.
Everyday Terms:
START:
Tilt your butt backwards OR tuck it underneath...
-this leads to your hip joint rotating outward slightly
-this leads to torque on the knee joint, force is outward
-this leads to your lower leg rotating outward slightly
-this leads to a slightly higher arch in your foot
Medical Terms:
START:
Posterior pelvic tilt...

-leads to hip external rotation

-leads to external rotation torque at tibiofemoral joint 
-leads to tibial external rotation

-leads to supinated foot position
I tried to coordinate the 2 sides to make it easy for the visual learners reading this post.  Actually try this at home...perform a posterior pelvic tilt (or tuck your butt underneath yourself) and see what happens.

DO YOU FEEL THE MOVEMENTS I DESCRIBED?

If you do...great!  If you do not...you may lack adequate gluteal activation or have other issues along this entire kinetic chain (which also extends well above your hip by the way).  Next time you have pain anywhere along this chain, think of this basic movement and how all of these areas are SYNCHRONOUSLY CONNECTED.  So, if you seek care from a movement professional like myself and they start evaluating a different area of your body, realize this is fairly normal in our world.  By the way, this kinetic chain is just one example of the many bio-mechanical connections throughout the body.  Yes, the shoulder blade not moving properly can effect the wrist...crazy, I know.  Yes, the neck can effect the feet...crazy, I know.  


The reason for this post is 2 fold---- 
1. To demonstrate I actually understand and apply my physical medicine knowledge (other than write about doctor-patient relationships)  

2. To illustrate that although helping people "get out of pain" seems rather straightforward, it's not.  

Clinicians like myself have a whole host of observations to make, questions to ask and tests to perform to answer the most important question in physical medicine...

WHY DO YOU HAVE PAIN THERE? AND HOW DO WE FIX IT OR MANAGE IT?

I have included a brief video demonstrating this movement, hopefully this helps.  Notice the movement at my feet (although minimal).  And please...TRY THIS AT HOME.  As always, I value feedback and look forward to hearing from you.

Be Blessed!
-Dr. K
 


Comments

02/08/2016 8:58pm

good morning and thank you for the information

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    Erik Korzen DC is a chiropractic physician and educator.  He is passionate about re-defining the chiropractic profession and is somewhat of an "Anatomy Geek".

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