Oct 31, 2018
Over the past month, I had a few amazing cases come into my office. These cases were classic, in that I’ve seen a lot of them, but they’re often times odd for the patient to understand. The correction was not even remotely close to the area of pain.
These three cases made me wish I had more content to assist the public in their understanding of other possible reasons why their son or daughter’s foot, knee or groin pain is not going away with standard physical therapy, why their MRIs are negative despite continued disability and why their sports doctor has no idea what to do with them. (Sorry guys… nothing against any profession, but that’s just the story they tell me.)
These athletes stories all had something in common… off-loading of their symptomatic limb during a squat test.
In other words, they had crooked squats.
In all of these cases, the first correction I made was to “even out” their squat. Low and behold, they felt better within a matter of minutes and this reduction remained for days to follow! I picked the “low hanging fruit” found within their examination. The key was not getting caught up in solely investigating in the region of pain or where the patient was pointing to.
Each person was very different in their presentation, which is interesting in itself, because their regions of pain (the diagnoses) would be very different by definition.
- Groin Pain
- Knee Pain
- Foot/ Arch Pain
After we made the needed correction, they all had questions about WHY this worked.
Why did improving their squats yield 50-75% reduction of symptoms within one session?
Great question! As I explained the theory of WHY the correction working in their case, I started to wish I had something I could share with them, hence this podcast.
So here we are!
General Rules Of My Examinations In These Cases
- Listen
- Don’t beat the same therapy to death
- Rule out spinal considerations
- Rule out local instability
- Look at the other side
- Pick the low hanging fruit
- Pick a movement based trigger (not a stretch)
- Recommend exercise dose
- Retest
Young Adult Female Soccer Player With Knee Pain
- “Patellar tendonitis?”
- MRI negative
- Multiple professionals examined
- Months out of soccer
- Squat patterning - she off-loaded the symptomatic knee
Youth Male Soccer Player With Groin Pain
- “Sports hernia?”
- Years of past groin pain
- Reoccurring
- Negative advanced imaging
- Pick a movement test
- Normalize the squat
- Explain to patient what is exacted of them asap
- Squat patterning - he off-loaded the symptomatic thigh
50+ Year Old Golfer With Arch Pain
- “Posterior Tibial Tendon Dysfunction?”
- Podiatrist and orthopedic evaluation
- MRI found PTTD possibility
- Noticeable medial lower arch of the foot
- Can’t walk or golf without pain
- Current recommendation was bracing for 6 weeks
- Squat patterning - he off-loaded the symptomatic foot
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Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don’t get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.