Case study- It’s All Connected!

I had a patient in last week and she had a referral for low back pain. After getting to know her true problems and goals, it was apparent to me that she had way more going on than low back pain.

So I evaluated her low back, but in this process I took a look at her standing posture. Her posture suggested upper back and neck pain as well as low back pain. So I asked her to tell me about her neck and upper back pain?

She looked at me and said, “How do you know?” and immediately followed up with “my old PT would only look at one thing at a time!”

I then explained to her what her posture told me: First, she was tight (locked short) in the front of her body, particularly the hip flexors, chest, and the front of the neck. This led to weak muscles (locked long) in her deep spinal muscles, her core and her upper back/shoulder blade area. Her head stuck out forward, her pelvis also stuck out and she presented as she had a moderate lean forward.

With a few simple verbal and tactile cues, she was standing tall and both her low back pain and neck pain decreased. However, she could not find this position or hold it on her own at all.

Then I explained how the spinal and shoulder blade posture was creating poor mechanics for the entire spine and that I treat the entire body as needed to solve the problem(s) that got them to me.

I also noticed how she was very anxious and nervous about everything. This led to a discussion about the fight or flight response, which led to a cranial-sacral manual treatment session.

After the treatment, which was focused to just her skull this day, she stood tall on her own and was out of pain, both the upper back pain and lower back pain. She relaxed for the first time in who knows how long and had a great response to the session. Now, she still does not have the strength to hold this posture for very long, so on the next session we initiated core stabilization exercises and progressed to Pilates and Gyrotonic exercises for mind body awareness training.

Adjusting a small bone called the sphenoid can have effects on the entire body.

IT’S ALL CONNECTED!

Are you unable to relax? always stressed? worried about everything? feel fatigued all the time?

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Stephen Dunn

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