Memories from DC

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Do you have a city that holds an emotional place in your heart? They may be positive emotions:

  • where you got married!
  • where your first child was born!
  • where you ran your first marathon!

Or they may be negative:

  • where you got your first speeding ticket
  • where you broke your leg
  • where your parent died

Sometimes, you have a city that just triggers you.  There is a memory or a time that was spent in that place that was either so positive or so negative that you constantly place that emotion on that particular city.

Every time I think of Paris I remember waking my 3 year old up at 11 pm to watch the pretty lights sparkle on the Eiffel Tower.  It is no surprise she dreams of living in Paris to this day.

I should have expected the trigger when I landed in DC after a red eye flight.  But, in my sleepless haze, I found my way to the Metro and figured out which direction I needed to go to reach my destination.  I stood on the platform and enjoyed the sunshine.  When the Metro arrived and I sat down, all the memories came flooding back.

Lorelei and I were medevac’d from Germany to Walter Reed Medical Center 12 years ago.  Since Lorelei was not a big fan of sleeping we arrived in DC pretty groggy.  I remember searching for the shuttle I had arranged to take us to the base while carrying enough suitcases to last us who knew how long.  We had a return ticket for 2 weeks later but there was no guarantee we would be going home then.

The shuttle was only able to drop us off at the gate for the base.  This was post 9-11 and there were civilians on the shuttle.  I had to carry my baby and all our stuff up the ¼ mile long driveway to the hospital.  But it was okay.  I was finding answers for my baby.  We would be fine.

You see, Lorelei was very sick as a baby.  She cried constantly whenever she wasn’t being held.  She didn’t eat very well because she couldn’t poop.  Lorelei had become a ‘failure to thrive baby’.  They had sent us to a specialist in Germany who ran all the big, scary tests.  No, she didn’t have any life threatening disease. Yes, she did have muscles to push things out from that end.  No, we don’t know what’s wrong with her.

Lorelei was so sick that they had pulled Matt out of Iraq to come home and care for Ainsley so Lorelei and I could go to DC.  Okay, let’s be honest, first they told me to leave my 3 years old with friends in Germany while my husband was in Iraq and I took Lorelei to the US.  When I explained (read: yelled) about how I wouldn’t do that, they brought Matt home from Iraq.

I finally found the place in the hospital where we were supposed to check in and get our lodging assignment for our time in DC.  When I explained that Lorelei was the patient and not my husband the lady at the office said those fate filled words “Then I cannot help you”.  This was during the height of the war and this office was focused on helping families of soldiers who had been injured in Iraq and medevac’d to Walter Reed.  My baby didn’t count.

I was alone in DC with a very sick baby and no clue where I would sleep that night.  No clue what answers we would find in this place.  No clue what the next step was.  As I got back on the elevator to go back downstairs my luggage literally exploded all over the place and I started bawling while trying to grab all my luggage and pull it into the elevator.

Luckily an intern walked by and took pity on the crazy woman crying with a baby strapped to her chest and luggage that was all over the place.  He finally got the story out of me and figured out what needed to be done.  He marched me downstairs and had the information desk get me a hotel room for the night with a shuttle to come pick me up.  I continue to offer up thanks to that intern. I was, and am, so grateful for his help.

As it turned out the trip was non-productive.  They ran the same tests they had already run in Germany which led to the same diagnosis that we had received in Germany.  Which was “we have no idea why your kid can’t poop but she needs to be on medication for the rest of her life”.  It would be 5 years before we found the naturopath and nutritionist who would finally give us the diagnosis of celiac disease.  This would allow all the pieces of the puzzle to come together and allow for the healthy teenager we now have.

Therefore, I should not have been surprised when 12 years later the Metro brings about all those fears, anxieties, and tears.  But I was surprised.  I had difficulty breathing.  I became nearly paralyzed with fear.  And I had to figure out how to put one foot in front of the other.

I started with gratitude for how much our lives have changed in 12 years.  That fussy, failure to thrive baby has turned into a beautiful dancer/8th grade President/super fun teenager.  And I was in the DC area for a conference to help me with business development.  Because I own my own business.  Which is so very awesome.

I was honest with myself and the people around me about what was going on.  I texted Matt to get some support and I also told my group what was going on.  I acknowledged that these were old memories surfacing which decreased their power.

I moved forward with what I was in DC to do in the first place.  I did let the memories have their time while I went for a walk before the conference started.  But, once the conference started, I let go of those memories and focused on what I was there to do.

Grateful, honest, and moving forward.

Maybe you find yourself in a place filled with fear, anxiety, pain, or overwhelm.  I encourage you to remain grateful for all the good you have in your life.  Be honest about where you are with people you can trust to vault that information.  And then figure out how to move forward.  You are not meant to live in this place.

Movement is Life

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You need to be able to bend over to work in your garden, pick up your grandchild, or do yoga.

You need to be able to squat to give a child a hug at their level, to do home renovation projects, or tie your shoelace on the side of the trail while you are out running.

You need to have foot flexibility to walk so you can go hiking with your friends, take the dog out for a potty walk, or keep up with the kids while they are riding their bikes.

You need to have shoulder motion to play basketball, do Pilates, or paint a wall in your house.

You need to have neck motion so you can check your blind spot while you are driving, lay on your stomach while you are sun bathing, or use your “third eye” to watch the children.

Movement is required for life.  Movement is required to be able to do the things we want to do every day.  They may not feel like amazing things but they are the things that you want to do.  The activities that make up your life.

Perhaps you are a stay at home mom who spends your day reaching down for little ones, picking up their toys, standing while preparing meals, or hauling all of their stuff everywhere.  Those are all movements and they are required for your life.

You may work in an office which requires you to drive to work where you are walking between meetings, standing for discussions, typing to communicate with your team.  Those are all movements and they are required for your life.

Retirement brings a whole new set of movements depending on what that looks like for you.  It may be renovating your forever home, outfitting a boat for sailing around the world, or loading up the fifth wheeler to travel the US.  Those are all movements and they are required for your life.

The tissues in our body need movement to get stronger, to become more flexible, and also to heal.  Muscles need heavy weight applied in order to grow and become stronger.  Bones need the muscles pulling on them to regenerate and avoid osteoporosis.  Spinal discs require rotation to bring in fresh nutrients to remain healthy.

Just as you need motion to live your life, your body needs motion to maintain your life.  If you stop moving then you stop living.  Your body has a harder time healing itself as it becomes more difficult to get the proper nutrition to the proper locations.

Movement is life.  Movement allows you to live the life you love.  Movement teaches your body to adapt thereby allowing you to do the things you love.

If you are not moving, you are not living your life to the fullest.  If you are not moving, you are not helping your body to heal itself.

When a muscle is tight it holds on to all the extra stuff that is meant to be pumped out on a regular basis.  This makes it harder to bring in fresh nutrition for the muscle to feed on.  As you challenge that muscle with your daily activities, it starts to hold on for dear life.  No amount of ice or heat will cause it to release.  It simply can’t because it has gotten into this holding pattern.

That muscle may be compressing a joint.  The joint needs movement in order for the cartilage to get its nutrition.  When cartilage becomes dry it leads to arthritis.  Arthritis leads to pain and decreased movement.

Or that muscle may be compressing a disc.  Spinal discs are like sponges that absorb nutrition when the pressure is released.  If they are constantly compressed they cannot receive the needed nutrition.  This causes degenerative disc disease.  It comes down to a lack of movement.

Movement is life.  Movement allows the tissues in our body to heal. Movement allows us to do all the things we value doing in life.

How is your movement?  How is your life?

If you are having difficulty with movement please reach out to us.  We are movement experts that love seeing you achieve the movement you need for your best life.

Where headaches are born

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Have you ever had a headache that started at the base of your skull and wrapped itself over your head finally lodging behind your eyeballs?  Those headaches really hurt.  And, it seems like they can last forever.

But where do they come from?  Headaches that start at the base of the skull actually start in the upper neck.  You see, there are two special vertebrae in your upper neck that are different from all the other vertebra.

First you have C1.  AKA: The Atlas because it holds up the entire world.  Well, it holds up your head which feels like the entire world.  C1 is special because it is shaped like a ring which allows it to move more than the other vertebra.

Next you have C2.  AKA: The Axis.  The entire world (or head) spins around C2.  That’s why it’s called the axis. C2 has a part that sticks up so that C1 can rotate around it.

This intricate design can get out of place, causing increased pain that translates into headaches.  Specifically, headaches that go up over the top of your head and lodged behind your eyeballs.

The good news is that there is help for these types of headaches.  You can finally stop having to deal with the pain and frustration of never knowing when the next headache is going to strike.

Now, you might be thinking to yourself, I don’t have neck pain.  I know.  These headaches usually do not have neck pain associated with them.  In fact, when we start working on the source of my problem my patients often tell me that they didn’t know there was pain there.

As we get C1 and C2 playing nice with the rest of the spine, the headaches can clear up for good.  No more need to take pain medication on a regular basis.  No more missing out on activities because of your neck pain.  No more wondering why you keep getting these headaches.

Are you ready to put an end to your headaches and get on with your life?  Please feel free to contact us and find out more about how we can help eliminate your headaches.

Chewing on another cause of headaches

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Have you ever had a headache that started in your jaw?  Maybe you have noticed that you wake up with a headache the morning after eating a big meal.  Perhaps you grind your teeth at night and wake up every morning with a headache.  Some people chew gum all day long, causing jaw and head pain.

Have you ever wondered how jaw pain is related to headaches?

First, let’s do a brief demonstration.  I want you to take your pinky fingers and place them inside your ears with your pinkies facing forward.  You don’t have to shove them all the way in just enough that the pads of your fingers are inside.  Next I want you to open and close your jaw.  Do you notice that when you close your jaw a bony part butts into your pinky finger?  That is the TMJ (TemperoMandibular Joint)!

Congratulate yourself on finding your TMJ!

Now, the part that moves is your jaw bone also known as the mandible.  This is the “mandibular” in temporomandibular.  The part that stays still is the temporal bone.  You put the two together and you have the temporomandibular joint.  See, they really didn’t get that fancy when they named this stuff.

The part that stays still is connected to your skull.  This is one way that TMJ pain can radiate into a headache.  Often this pain will be described as “temple pain”.  People will point to one or both sides of their temples and say “it always hurts here”.  This is a common sign of TMJ pain.

There is also a big muscle called the temporalis muscle.  It helps you to do things like close your jaw and chew your food.  This muscle can be found by placing your hands flat on the sides of your head.  Open and close your jaw and you will feel this muscle activating.

This muscle covers the side of your head and can cause pain to travel up the side of your head.  People with this type of pain often point along the sides of their faces, up to the top of their head.  They describe the pain as going behind their eyeballs.  People with this type of TMJ pain often say their pain increases after eating.

What if you have pain that starts in the back of your neck and comes up over your head to the front?  This type of pain often starts from the upper neck.

Is it still related to the TMJ?

Often, yes.  You see, there are many small muscles that cross from the TMJ to the upper neck.  They are coordinated to work together to allow for very small motions in your upper neck and jaw.  So when the jaw starts becoming a problem, the upper neck will feel the effects too.  And the upper neck will send it’s pain up the back of the head, over the top, and down into the front.

So there you have it.  The TMJ can cause headaches along the temples of up the side of the head.  Further, the TMJ communicates with the upper neck which tends to send it’s headaches up the back of the head, along the top, and down into the forehead.

Do you suffer regularly from the headaches types described above?  Are you ready to find the real reason behind your pain and get rid of it once and for all?  Please contact us and we will get you scheduled for an absolutely free 20 minute consultation to see if we are a good fit for each other.

What not to wear

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Recently, I had a memorial service to attend right after treating patients.  So I wore my dress and flats while I was treating.  That afternoon, while I was standing at the memorial service, I felt my back tighten up.  “Oh well, it will be fine” I though like every other person does.

That evening I tried to avoid my low back pain by walking around the house and getting some things done.  I went and ran an errand at the mall to get more steps in.  My thought was – “move more and my low back pain will settle down”.  What I did NOT do was take off those flats.

The next morning I rolled out of bed and tried to stand up straight.  As I hobbled on my aching feet, holding my back and trying to stand up straight, I was reminded that it was not fine.  There are consequences for improper footwear and low back pain is at the top of the list.

Here’s the thing – I usually wear very supportive shoes all the time.  Especially when I am going to be working with patients.  I thought that I could get away with one day of wearing improper footwear and not have it bother my back.  I thought that doing it wrong, just this once, would not cause increased low back pain.  I thought these shoes were good enough to get me through my day.

What I am learning is that since I have hit the big 4-0, my body has less tolerance for these deviations.  My body requires me to work out daily.  My body requires regular stretching to maintain its performance.  My body requires me to not sit for more than 60 minutes while I am working on the computer.  And my body requires me to wear supportive shoes.

I have many people ask me what brand of shoes they should wear for work.  That is a complicated question as everyone has a different foot structure.  Also, your daily work requirements are different than your neighbors.  But I would be happy to discuss what works for me.  Feel free to send me an E-mail at amy@physicaltherapyforeverybody.com

One key way to decrease your low back pain?  Wear supportive shoes!  I have an order for new ones on the way as we speak.

 

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Snow Shoveling 101

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Snowpocalypse hit the Pacific Northwest and left behind snow, sleet, hail, slush, and ice.  Last I heard, the groundhog was awaiting extradition from the Bahamas for his poor forecast this year.  As we move forward to finally getting out of the house, here are some key tips to remember while you are shoveling all that snow.

#1 – Use the shovel to push the snow – Walk with the shovel in front of you to push the snow out of your way.  Kind of like your very own snow plow.  This puts the snow in a nice pile ready to be lifted.

#2 – Bend your knees – do a squat to pick up the snow with the shovel.  Bend your knees and keep your back straight.  This is critical when the snow is heavy as it is now.  Make sure you have two hands on the shovel to distribute the weight.

#3 – Pivot your feet – when you are getting ready to throw the snow make sure you pivot your feet.  This allows your back to stay in a neutral position.  Twisting of the spine with a weighted load (like snow!) is the most common cause of injury to the low back.

#4 – Make sure to breathe – keep your breathing regular.  Holding your breath while you are lifting increases the pressure on your back.  Breathing also helps to improve your endurance.

#5 – Take a break – we’ve gotten a lot of snow this year and clearing it away will take some time.  Make sure you take regular breaks to head inside, warm up, and drink some water.

Snow shoveling is a great workout when you can’t get to the gym, yoga studio, or Crossfit box.  If you need more of a workout, offer to clear your neighbor’s driveway too!  Be careful with your body if you are not used to performing heavy lifting or endurance type activities.  Give yourself lots of breaks and keep an even pace.

If you have any questions regarding proper snow shoveling technique or if you hurt yourself in the snow, please reach out to us at PT4EB.

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So, you have a herniated disc

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There are few things in life as painful as a herniated disc.  But it’s not just the pain that is difficult to deal with – it’s also the fear.  What is going on in my spine and am I going to live?  That may sound extreme but herniated discs are extreme.  They can cause extreme fear, extreme panic, extreme frustration, and extreme pain.

The first time I herniated my disc was in college.  I was in Air Force ROTC (don’t ask, long story) and we were doing physical training.  All of a sudden, I felt a ball of glass explode in my lower right spine.  Okay, I know that a ball of glass didn’t explode in my spine but that is absolutely what it felt like.

Of course, training must go on so I got up and went for a 3 mile run.  Each step caused a mini explosion of the glass shards in my right spine.  And I was one of the lucky ones.  My pain never touched my sciatic nerve and went down into my leg.

For many people, the disc herniates and then it irritates the nerves in the area.  The nerves are located close to the spine and right next to the disc.  When the disc herniates, the material inside the disc leaves the fibers of the disc and is hanging out right next to the disc.  This can cause increased pressure on the nerve which responds by sending pain down into your leg.

What are your initial steps when you have a herniated disc?

  1.  Breathe – Easy for me to say when the glass shards aren’t flying around my spine, right?  I know.  But it’s really important to breathe slow and steady.  Holding your breath increases the pressure on your spine which is not what you want right now.  I now it is incredibly painful right now but I promise it’s going to get better.
  2. Grab an ice pack and your favorite chair, floor, or bed.  You need to rest for the first 24-48 hours.  Find a comfortable position (as comfortable as possible) and an ice pack.  You might want to grab some magazines or the remote control.  You are going to be there for a day or two.
  3. Small movements matter. During the first 24-48 hours it is important to keep the area moving in small PAIN FREE ways.  This can mean trying to stand up straight while you walk to and from the bathroom.  Rolling your shoulders to get some movement in your upper spine.  Sitting and rotating your spine from side to side.  Don’t go crazy right now but keep those small movements.
  4. Get help. Once you can walk to and from the bathroom pain free you are ready to get some help.  A Physical Therapist will help you get back to moving pain free.  Yes, you will get back to all those activities you loved doing before.

Yes, the pain will go away.

Yes, we can help you figure out your path on this journey of healing.  Please fill out this simple form and we can get you started healing and back to living life on your terms.

Why more people are choosing to pay cash to eliminate their pain

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We are all familiar with the usual course of treatment when we are dealing with an injury or chronic
pain. First, we go see our Primary Care Physician (PCP) who recommends pain medication and muscle
relaxers. We take those for 4-6 weeks and go back to the PCP when the pain is not any better. The PCP
then orders an X-ray which doesn’t show anything and we are referred to a specialist. It takes a couple
of weeks to get in to see the specialist. Meanwhile, the pain medication is not eliminating the pain and
is upsetting our stomachs. The specialist recommends either surgery or avoiding the activities that
cause pain. This is the assembly line of the modern medical system that leaves many people feeling
frustrated or hopeless.

Did you know that you could bypass this system?

In Washington State, you can see a Physical Therapist directly to deal with your pain issues. You do not
need a prescription. You may even be able to go in for a free consultation to get all your questions
answered and see if PT is right for you.

Don’t I need an MRI?

What if you could avoid the cost, hassle, and exposure of having an MRI? Research has proven that
what shows up on MRI’s is often not correlated to what is causing your pain. Often the pain is caused by
a movement dysfunction that an MRI cannot see. Physical therapists are experts on movement
dysfunctions. They are able to “see” areas that are not moving correctly and help to get them moving
pain free.

How do I know if Physical Therapy will even work?

Often the art and science of Physical Therapy does work, it is the mode of delivery that doesn’t work.
Traditional PT’s in an insurance based model are forced to see more patients in less time. They are
compensated for using things like ultrasound, E-stim, and ice/heat. In this system, the insurance
companies decide how much treatment you get instead of you and your therapist deciding on the best
plan for you. Insurance companies often dictate the schedule you are seen on which may not be the
optimum for your body or for your lifestyle. Having 2-3 PT treatments per week can be a strain on your
already busy schedule.

All of this restraint has caused Physical Therapy to get a bad reputation.

What other options are available to you if you don’t want to take medication, you don’t want surgery, or
you have had a bad experience with Physical Therapy before? You can take matter into your own hands
and pay out of pocket for an experience that is custom tailored to your unique needs.

You want me to pay for Physical Therapy?

Yep.

Here’s why – people will see a chiropractor, massage therapist, and personal trainer in an effort to
manage their pain and move forward with their lives. Physical Therapists are specialist in movement
disorders and have training to move stuck joints, release tight muscles, and teach you specific exercises
to help your body heal. We will also offer you loads of education on how to keep yourself healthy and
pain free in the future.

Here’s how – at PT4EB we spend more time with you. Most sessions are one hour. You are given our
complete attention for that one hour. We usually only see people once per week for 6 sessions and
then we spread sessions out. Often people require a total of 10-12 sessions. During and after your
treatment, we can check in over E-mail if you have any questions. Traditional PT clinics blow through
your 12 visits in 4-6 weeks. This is long enough to get you feeling better but not long enough to make
real changes in your body. The real changes you need for long term results. This costs you more in the
long run as the problem comes back.

Since the insurance companies do not decide on your course of treatment, we are able to spread your
visits out. We are able to give you undivided attention. You have time to get all your questions
answered. You have complete access to us both during and after your treatment for any questions that
come up.

Many times sessions can be paid for by submitting your claims to your insurance company. Please let us
know and we will provide you with a superbill – the paperwork needed to submit your claims. We also
accept Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA)

People often come to our clinic as a “last resort” after exhausting their other options. They refuse to
have surgery which is the only medical option provided to them. People are tired of taking medication
because they realize that it only masks the symptoms. They are frustrated, disheartened, and
sometimes depressed over their lack of activity. The biggest question I hear is – how come I didn’t find
you earlier?

Are you curious if this model is right for you?

If you are local to the Maple Valley area, please feel free to give us a call. We are happy to answer all
your questions or have you come in for a free Discovery Visit to see if we are a good fit for your needs.
Please click here to fill out a brief contact form (link to contact form).
If you are not local please feel free to give us a call. We have a network of other providers throughout
the US that we can connect you with who hold these same values.

Your health is at least worth a conversation, right?

Traveling to Kenya

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I recently returned from a two week teaching trip in Kenya. I volunteer with a program that teaches Physiotherapists in Kenya hands on skills and clinical problem solving.

So, what was I doing there? This trip I was able to go into the clinic with the Physiotherapists and treat patients. This is a great opportunity for the wheels to hit the pavement with everything the students have learned in class. And, it gives us a chance to really check out their skills in a clinical environment.

Many people have asked me why I travel so far away to help a group of people that I had no direct connection with before I started traveling there. I have boiled it down to two reasons.

Reason #1 I travel to Kenya to teach – I WAS ASKED!

About 5 years ago, this program had a teacher drop out at the last minute. They threw the net wide trying to find someone who could go to Kenya for two weeks at the last minute. I happened to be transitioning to a new job and could take the time off work. So I volunteered.

How many times in our lives are we stuck, frustrated, overwhelmed, in pain, unsure of how to move forward in a situation? And, how many times do we ask for help? Our society prides itself on being independent and not needing help from anyone else. But, a beautiful thing happens when we open ourselves up to help from others. Not only are we blessed with their assistance, they are blessed to assist us.

I encourage you to think about any situations where you feel stuck and may need to ask for help. It may be in preparing for the holidays, it may be in getting through the holidays, or it may be a need you have had for a while. Find the person that can unstick you!

Reason #2 – I AM UNIQUELY QUALIFIED TO SERVE

The program I teach with requires an OCS or FAAOMPT. I have both. I also have my PhD which is kind of like an advanced teaching certificate. There are very few people who have all three of these qualifications so I fit their unique profile of instructors.

I enjoy traveling – especially when I get to meet new people. I lived in Germany for 3 years with the US Air Force and I realized that I LOVE to travel. But, I prefer it when I get to meet the local people and spend time with them. The trip becomes way more meaningful when you are able to break bread and have true discussion.

I love being a Physical Therapist and want to see the quality of PT improved worldwide. I believe that Physical Therapists offer a unique perspective as movement specialists. We understand how things are supposed to move and what can happen to the body when things aren’t moving correctly. PT’s are qualified to work on joints, muscles, ligaments, fascia -the entire body.

I am uniquely suited with these aspects of my personality and education to serve the Physiotherapists of Kenya. You are uniquely suited with aspects of your personality and education to serve a certain group of people. It may be your neighbors, it may be at the school your child attends, it may be at the home where your parent is living because they are no longer safe alone. Your people are out there and they need you.

I encourage you to take some time to think about all the people you serve in your life. And, think if there is anyone else you might be uniquely gifted to serve.

 

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It’s All Connected!

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Have you ever been to see a Physical Therapist with complaints of low back pain and they are watching you walk or talking to you about your foot?  Have you ever questioned (to yourself or out loud!) why they are discussing your knee movement or hip strength when you came in because you can’t sleep because of back pain?  Have you ever wondered what is going through their minds?  I am here to tell you –

It’s all connected! There are two bones, the tibia and fibula, that run between the ankle and the knee.  As we age, all bones become stronger and less flexible.  By the time we are adults, the bones have very little “give” or movement in them.  So, any movement that occurs through the ankle is transferred through these bones up to the knee.

Helping to move the foot and knee through daily activity are several muscles.  Many of these muscles start just below the knee and cross the ankle joint to insert into the foot.  These are the muscles that help your foot move up, down, and side to side.  The big muscles in your calf even cross above the knee joint!

On top of all this you have fascia.

Have you ever tried to pull fat off a raw steak?  You know that silvery white stuff that firmly holds the fat onto the steak – THAT is fascia!

The fascia is what holds everything together under our skin. There is fascia throughout our body and there are thick sheets of fascia that help to keep the lower leg connected – to each other and to the rest of the body.

Moving on up the leg, we have the largest and strongest bone in our bodies – the femur!  The weird thing about the femur is that it has a ball at one end and a straight edge at the other end.  Also, it doesn’t run completely up and down.  Instead, it runs at an angle which makes the hips wider than the knees.  So, any force that is coming up through the ankles and into the knees has to take a turn before it heads into the hips.  This has the potential to be a turn for the worse!

Between the hip and the knee we find many big, strapping muscles – the quadriceps (in the front) and the hamstrings (in the back).  These big muscles help to get the hip and knee moving which allows the foot to be in the optimum position to walk, jump, run, or play.  If these muscles are having any problems then the foot has difficulty connecting to the ground.  The reverse is also true – if the foot has any restriction that limits motion then the knee/hip will not receive the required motion they need.  The problem that starts in one area can easily lead up (or down) the chain!

Remember that fascia?  Well, along the outside of our leg we have the largest single piece of fascia in our bodies – the iliotibial band (or ITB for short).  The ITB is a thick, fibrous band that starts from the gluteus medius on the side of the hip and inserts into the fibular head.  The ITB directly transfers force from the lateral hip into the knee joint – and vice versa!  This band can particularly be a problem for women as our hips are wider than our knees.  Pro tip – pain in the ITB may be due to weakness in the gluteus medius!

Moving up the chain and headed towards the low back, we cross the pelvis. The pelvis is made of 3 bones.  One ilium on each side and a sacrum in the middle.  The spinal column stacks up onto the sacrum.  So, the 5 lumbar vertebrae stack up onto the sacrum which is attached to an ilium on either side.

What holds all that together? There are muscles that help to connect the lumbar spine to the sacrum, the ilium, and the femur.  There are muscles to connect the ilium and the sacrum (this is often called your pelvic floor).  And, of course, the silvery/white fascia helps to hold all these bones, muscles, tendons, and ligaments together.

Now, I don’t mean to get controversial here but I am just going to say it – the ilium move on the sacrum!  If that makes sense to you – HOORAY!  This is a huge discussion among health care practitioners that has received endless debate.  You see, the ilium and sacrum are connected by very thick, fibrous ligaments that allow for very little movement in the pelvis.  This helps to provide stability for the pelvis while you are performing daily activities.  However, too much movement can be a big problem.

Back to our foot-low back connection.  If your foot doesn’t interact with the ground the way it should, this can cause an immediate pain (as in our example of stepping off the curb above) or cause a wearing of the joints over time in your low back.  If you challenge your muscles to work harder by walking in the sand, this can actually improve the muscle control through the foot that decreases the stress on the joints in your low back.

As you can see, the bio-mechanics through our legs are complicated. Each bone, muscle, and joint interacts with other bones, muscles, and joints to allow us to move through our environments.  This is why your body deserves a full, comprehensive evaluation of the pain or dysfunction you are experiencing.  And why Physical Therapists look at your foot, knee, hip, and pelvis while talking about your low back pain.