A fair while since my last blog post but I have been so busy it has fallen a little by the wayside!! A couple of recent highlights have been training one of my Pro boxers Phil Gill for his 11th pro fight on the 30th of April and Olympia, and also a great day with a bunch of Osteopaths going through the functional assessment process down in Brighton. I am also really looking forward to the upcoming functional assessment course in London on the 16/17th of April which has had a great response but require lots of prep!
The topic of this blog post is about a client I have been seeing recently who had lower back pain. When I assessed him I discovered a minor short leg (2-3mm) but was so small and short leg assessments so unreliable in terms of actual measurement that I payed less attention to it than I normally would a short leg. Short legs can be hugely destructive on the system and create a myriad of compensatory patterns.
The upshot was we created much better motion in the sessions but this reduced when he went off and did stuff on his own. Something else in the system was shutting it down. Very frustrating for me, but I think I may now know the reason why!
A usual compensation pattern that I see in the feet is that the long leg pronates to become shorter and short leg stays inverted or supinated to remain longer. With this individual however the long leg also had a large uncompensated Rearfoot Varus. This means that it cannot pronate and takes away this compensation mechanism and actually makes the short leg shorter in comparison (or the long leg longer!!) and therefore more significant and destructive on the system. The uncompensated rearfoot varus will create a lack of shock absorption in the chain and the inability to compensate for the short leg will create an obliquity in the system which can also cause it to shut down motion in favour of stability.
I have addressed this temporarily with a small heel riser, although a full length lift is always better because we do not create so much plantar flexion and shorten the calf. Watch this space for an update on the progress of this interesting case.
This definitely shows that when more than one structural deformity presents itself then things do not follow a set pattern. We must always remember the principle of individuality when helping our clients. A + B does not = C!!! We cannot simply have solutions without a thorough assessment process that takes many things into account.
This is something I will be teaching the guys on the upcoming functional assessment course!!!