Ask a PT in Maple Grove & Vadnais Heights

Bone spurs do change your movement at a joint as you are experiencing. We can change the movement at your forefoot to make up a bit of the difference. You have 23 bones and joints in your foot. We can also look at the movement of your big toe and see how much we can change and what is left over. Get you back to more walking.

You are correct we can hit our limit of control and get a bit mechanically vulnerable. We have 23 bones and joints in our feet. When we hit our limit of running and we cannot control the movement at our joints we get a secondary muscle spasm, our protective reflex kicks in. All those muscles that attach at the edge of your heel run along the bottom of your foot and attach at your toes. As that muscle spasm pulls at your heel you get pain. This is very fixable by fixing the movement which then resolves the secondary spasm. The tissue then settles over 2 or 3 days (10,000 repetitions of movement through the new end range). Yes, you can also inflame that fat pad on your heel by heel striking on concrete. If this is the case, then ice for a few days post the injury and a cushion under your heel to let the tissue settle will resolve the issue. If the pain has not fully resolve in a few days, we can always fix the movement and secondary spasm and pain quite quickly- get you back to running.

Heel pain can be quite intense. Mornings can be significant because our tissue tightens up anyway when we sleep, and when we have a significant movement dysfunction, the secondary spasm is exacerbated. The movement at your feet can be assessed and addressed. You have 33 bones and joints in your ankles and feet that all have to be able to move to have full, pain-free foot movement. When a joint can not fully move in its preferred path, a secondary muscle spasm occurs. This is then exacerbated in the morning when our tissue is already tight. You can use heat in the morning to loosen up the tissue and make up a bit of the difference. When the movement dysfunction is resolved, you should have no foot pain, full movement.

Yes. We can assess and address your movement. You have 26 bones and joints in your ankle and foot. The tibialis tendon crosses over these joints. When we are unable to move fully at a joint we get irritation, a secondary muscle spasm and a secondary inhibition, a false weakness. Muscles are reactors to joint movement. As the mechanical joint dysfunction continues, the tendon becomes quite irritated as it lacks movement and pliability resulting in tendonitis, an inflammatory process. We can fix the joint movement to resolve the secondary spasm and the inflammatory process will settle with a bit of time. The inhibition will resolve when the movement and full muscle contraction is restored. You can then build back the ankle control and power we just loose when we cannot move. Full activity level will follow the resolution of movement dysfunction.

The numbness under your right foot and little toe can correlate with the narrowing at the S1 nerve root. Your reflexes and muscle strength correlated with the S1 nerve root can be assessed to give you a full picture of the neurological dysfunction. We can not change the degenerated disc itself but we can assess and address the movement at the joint level. Fixing the mechanical joint dysfunction does change how we move and has the potential to take the pressure off that S1 nerve root. If the joint mechanics are addressed but you still have numbness and neural signs, then you would look at interventions to take pressure off the nerve root- a visit to the neurosurgeon would be recommended. The quicker a neurological dysfunction is resolved, the better the outcome.

I would have a few questions for you. Do you have numbness? Can you walk on your toes? Can you walk on your heels? Did the cortisone shot help?

What we can do is dissociate the difference between mechanical joint dysfunction and true neurological dysfunction. Neurological dysfunction leads to three specific signs - numbness, decreased strength and decrease reflex. We can also look at your movement and fix the joint dysfunction that leads to pain, a secondary muscle spasm and inhibition (false weakness). The sciatic nerve does cross through the Piriformis muscle ten percent of the time. When this muscle, that crosses over the Sacraliliac joint, is in spasm it can squeeze the nerve and cause secondary neurological complications and irritation radiating into the calf. We can assess your neurological signs and fix the mechanical dysfunction gently. Yes, if you have neurological signs and the mechanics are correct, taking the pressure off the nerve is important to do sooner than later. We would be happy to assess and address this for you.

I would ask you a few follow-up questions. What was fixed at your SI joint in 2010? Was it fused? Was it 'cleaned out?" Do you have pain at right side? I think your reaction of being skeptical about a second surgery when the first one sounds like it was not help is a healthy one. You do have the option of evaluating your movement and treating the movement dysfunction and related spasm and pain. You can then monitor change and see if anything is left over. Your SI joint moves about 47 different ways. It is where all your movement begins. To move at your trunk and your limbs you have to first move through your pelvis. Treatment of an SI joint dysfunction needs to be precise. It can also be very gentle. Tissue is a reactor to joint movement. So, when you have full SI joint movement, then you will have full tissue pliablity and no pain. Pain is a perseption from your brain. It is very real and can be very intense when it is a joint dysfunction because all your pain receptors are at your joint capsules and your blood vessels.

We have 33 bones and joints in our wrists. All those joints have to be able to roll, in what you would read called their preferred path, for you to be able to fully extend your wrist in order to balance on your hand. (That is very impressive by the way.) When the joints can’t roll we get pain and a secondary spasm. The tendons that attach at the end of your thumb, and all your fingers, attach into your forearm muscles and up at your elbow. That secondary spasm limits the wrist motion too. We can assess your wrist and elbow movement, fix the mechanical dysfunction and make sure you can get back to hand balancing. Any of us would be delighted to meet you and fix your wrist movement.

Yes, we can look at her wrist and elbow movement, fix the mechanical dysfunction and the secondary spasm. This will allow the tendon to calm. Sometimes we need cortisone if the inflammatory process as been there quite a while, but fixing the mechanics first is very appropriate. Usually we can avoid the cortisone but if it is needed when the mechanics are resolved, then the results are positive.

We can definitely look at your movement. There are 26 bones and joints in the wrist. All these joints need to be moving fulling to have full wrist pronation. Wrist movement is also influenced by the elbow. The Ulnar-humeral joint is shaped like a saddle and the radial head needs to be able to fully rotate to have full forearm pronation and wrist movement. When joint movement is limited, a secondary muscle spasm kicks in, the Arthokinetic reflex. We can change the joint movement very gently, resolve the secondary muscle spasm and pain and assure full, pain-free wrist pronation.

We can look at the mechanics and fix the movement at the joint level to give you relief. When we have Osteoarthritic changes the surfaces of our joints begin to change and therefore we move differently at that joint and are then vulnerable for a mechanical dysfunction. Our thumbs have the most movement in our body, minus our shoulders, and therefore are vulnerable for a mechanical dysfunction anyway. We can fix the mechanical dysfunction. You state that you have bilateral tendonitis. Because it is bilateral, both hands, I would wonder about your history of inflammatory disease. Did you get an MRI or ultrasound? Has tenosynovitis and synovitis been ruled out? Tenosynovitis and synovitis, when bilateral and when the gut inflammatory diseases are ruled out, are symptoms of Rheumatoid Arthritis, another inflammatory disease. Rheumatoid Arthritis can be seronegative. If there is evidence of tenosynovitis or synovitis I would recommend a second rheumatology opinion to make sure your Sjogren's is being treated fully and to make sure that other autoimmune diseases are ruled in or out so that nothing is missed. One autoimmune disease can lead to a second. If there is no tenosynovitis or synovitis evident, then fixing the mechanics will take away the secondary spasm and allow the tendons to move and heal. We are good at fixing this. Hope this helps. We would be delighted to meet you.

Wonderful to hear that you are encouraged. Give yourself enough time for recovery. Tissue takes about 10,000 repetitions to change. This is as simple as your daily activity and your walking at this new end range of movement. I suggest a week or two between appointments to begin. You will see frequency decreases over time. You will not need us for long as you build your movement control and your power. You will get to keep the results.

Yes, abdominal surgery can be a slow recovery. I would suggest starting with rolling out your abs with a soft ball, a Skyball is a good one, starting up at your rib cage and rolling side to side to make sure nothing adheres down. I would then do a light isometric, laying on your back and pulling your belly button in and your rib cage down to your pelvis as you blow all your air out. As this gets easier you can add in a small roll up. This can progress to a bridge and then a squat. If you find that progression continues to be difficult we can always look at the mechanics post surgery and take care of the secondary muscle spasm and make sure you have a full muscle contraction. Getting back to a cardio and strength routine will limit the chances of this happening again in the future.

Yes. We can take a look at your lower quadrant movement, right and left, and fix the joint dysfunction and related spasm and irritation. Our tissue tightens up anyway at night so we can get quite an exacerbation of a secondary muscle spasm. This can exacerbate the restless leg symptoms that are already quite irritating. I can not fix the true neurological dysfunction leading to the neurological restless leg syndrome, but I can fix the secondary movement dysfunction.