I want to describe a session I recently had with you.
Client’s complaint was hip and pelvic pain that “floated” into the lower back once in awhile.
I started at the feet. I checked the plantar flexion and dorsiflexion in each ankle. The right ankle moved easier into plantar flexion with limited dorsiflexion. The left ankle was exactly opposite.
The talus on the right had limited posterior glide (which means limited dorsiflexion). The talus on the left had almost no anterior glide (which means extremely limited plantar flexion). The left ankle was collapsing medial. This means the lateral calcaneus and the cuboid shifted toward the plantar surface of the foot, and that the distal fibula was moving inferior.
Now, here’s where it gets interesting: the anterior talus was pushing into the tibial dome (think inferior lateral and middle aspect of the tibia). So, the medial malleolus was moving easier inferior while the lateral tibia was moving superior due to the position of the talus.
This meant the lateral aspect of the tibia was moving superior and the medial aspect of the tibia was moving inferior. The lateral aspect of her knee had decreased space while the space on the medial aspect was expanded.
This pattern played right into the inferior shift of the lateral aspect of the femur (leading to a lack of tone in the gluteal muscles) and the superior shift of the medial femur (leading to tension in the adductors and an inferiorly shifted pubic bone)
Wow, complicated! So, with all of this in mind, I used the concept of SMRT to follow this pattern as well as I could with only 2 hands. My focus was on the connective tissue and the bones. Continued assessment led me through the pattern and she left saying, “I feel like I have someone else’s legs. It’s good, really good, but really weird.”
Join me from June 28-30, 2019 for the Advanced SMRT Lower Extremities course and enhance your SMRT and assessment skills. Prerequisite: basic SMRT: Lower Extremities live or by video. Class will be in Aurora, CO. Register here.