In our clinic, we often see clients who have literally seen everyone, they have gone round various therapies in search of a solution to their pain.
So when they arrive with us we know the problem isn't a simple one, if it was they would have been fixed ages ago. We start by looking at the subtleties, a protracted shoulder here, a pronated foot there... and usually by the end of our first assessment we know exactly why they are in pain. 😀 Because we look for the little problems, the ones people have ignored. Little problems, left, lead to big ones. Let's look at a few examples.
Our feet are so, so important, they are our main contact point with the floor, so a problem in the foot will spiral up the body. How many clients do you know who have a mildly weak arch, leading to a pronated foot? That weak arch has an effect up the body.
A foot that pronates will lead to the knee dropping in...
A knee dropping in will lead to the glutes overworking on the effected site to try to rectify the knee position... they may even be doing this so well in the early days that the knee isn't dropping medially yet.
An overworking glute will eventually cause a rotated pelvis.
As the glute weakens, the hamstring will try to assist it, then over time, the hamstring will also get tired due to overwork and the calf will try to assist, hypertrophying, until the affected calf is now several cm larger than the opposite side....
A calf that overworks that much, is likely to cause symptoms of plantar fasciitis or knee pain.
See how it can spiral out of control. 🙈
Going back to that pelvis that was starting to rotate, think of all the muscles that attach to the pelvis that are now being put under excess strain..... the issue spirals all the way up to the neck if you allow it to.
How about that hugely common presentation, an anterior pelvic tilt..... now a slight anterior tilt is normal, but only a slight tilt, anything more and this is something not to ignore. So as muscles can only pull, they can't push and anterior tilt is caused by one of two things, the muscles of the anterior leg, pulling the pelvis downwards or the muscles of the back pulling the pelvis upwards.... now most people we see are actually very weak in their backs, so usually the issue is in the anterior leg muscles and often Rectus Femoris is a good starting point, now think of the effect of a tight Rectus Femoris muscle on the knee....... also take a think of the effect of an anterior pelvic tilt on the posterior muscles of the leg.... we are back to that plantar fasciitis again!! How many clients come in saying my hamstrings feel so tight... you loosen them but it still feels tight... check the pelvis, you may be loosening the wrong muscles.🤔
So the take home message is that the subtleties are really important, ignore them at your peril. 😀 If you are a PT or a massage therapist you are perfectly placed to notice these small imbalances before they become bigger problems.
If you are using this for CPD think of this:
Mentioned in the article is : "Going back to that pelvis that was starting to rotate, think of all the muscles that attach to the pelvis that are now being put under excess strain..... the issue spirals all the way up to the neck if you allow it to." follow the muscular chain through and work out how a rotated pelvis can cause pain in the neck, then work out a treatment / training / massage plan to rectify it.. Then write it all up in your CPD log. For our FREE CPD logbook, click here and subscribe to our newsletter.
We have a course all about the Biomechanics of the Knee coming up that covers this exact thinking, 😀 so take a look here if interested.