So, I thought I would break from the norm today and discus a case study. Our client has given full approval to use this and he has also read the blog and approved it. He was keen to share his experience to help others out there who have his condition.
This client is a 74 year old male, he was diagnosed with Multiple Sclerosis (MS) in his 20's but has always refused to let it dictate his life. He regularly exercises and works out in the gym. Last year he had a number of falls resulting in him having the posture shown on the right of the picture. This is not only painful, it makes it incredibly hard for him to balance and walk. Now we do treat a few MS clients in our clinic and like all patients with chronic conditions of this nature, our first priority is to try to sort their biomechanics out. If someone isn't aligned, they won't be able to function, so where do you start with this?
Well, if you are using this for CPD grab a pen and paper and note the position he started in and then take a think about all the structures that may be causing him to be in this position, what is overworking, what is underworking.....
The picture on the left was taken after about 6 months worth of work, and we achieved this change in one session, but an awful lot of pre-work proceeded this. Initially his spine and pelvis were rigidly held in the position shown in the right picture, no amount of loosening would affect this. So we started with an x-ray to ensure he hadn't fractured his spine in any way on his fall. The x-ray showed a narrowing of the spinal canal with the vertebrae rubbing and causing osteoarthritis....great we thought, we can treat that. 😃
So again, if using this for CPD, what can you do about this, what structures can you strengthen to give the vertebrae space to move?
The answer is the deep spinal stabilisers, not sure what these are or how to strengthen them? Take a look at our short video on this. So we started to strengthen these along with his core muscles. Remember he has MS, so balance is a big issue. In order to strengthen the core an stabilisers we have to put him off balance!🤔 So we worked with the trainers at his gym to create him a program he could access with their help. The ball was the main tool we used and he began to get strength into the core and stabiliser muscles this way and used a 4 point kneeling exercise alongside this. There were lots of compensatory muscle firing issues we had to address, using our hands on work and lots of other muscles we had to address strength wise, but the core and stabiliser work allowed his body to accept being realigned.
Over several months, as the muscles are getting stronger, he is holding the alignment shown on the left in the picture. We can now easily reposition him with hands on work and he is able to hold this position for weeks rather than hours.
The take home message from this, is that even though something may look extreme, if you break it down and start with the deep structures, you will start to be able to realign even the most complex person.
So , if using this for CPD, write up a treatment plan for this client. Where will you start, how will you progress? Do you need to collaborate with any other professionals to get your client the best outcome? Then write it all up in your CPD log.
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