Iliotibial Band Syndrome (ITBS), hip bursitis, plantar fasciitis, and knee pain; One problem or four different ones?
Our patients have often heard me say that where we hurt is not necessarily why we hurt. Many had similar stories of visiting their primary doctor who sent them to an orthopedic who referred them for weeks or months of physical therapy. They then visited me after this approach to care did little to offer long-lasting relief after their problem either failed to improve or the symptoms worsened after returning to their former activities.
The idea that foot, hip, knee, and even lower back problems are separate is at best a medical construct and at worst a series of myths people have been believing for years. Since the body is a system, of organs, joints, muscles, ligaments, fascia, and muscles designed to work as a unit, breaking it down to the joints or areas as if they don’t communicate with each other is folly at best and ignorance at worst.
While the answer is obvious, people will often visit a specialist who will look and treat the part, while ignoring everything affecting it. Try that while building the foundation of a house and see how that works out. Science and engineers as well as chiropractors understand how movement works, so why don’t most medical doctors?
While we are designed to move, the feet are our foundation and our structure above it including the hips, back, knees and even the feet are affected by our unique structure that has evolved oveer thousands of years and continues to do so.
We are all different, coming from different backgrounds and different gene pools. We not only look like our parents but are likely to look and walk like them too. This is why one size fits all protocols to lower back, knee, hip and even plantar fasiitis often fail to offer relief; you are not a protocol and people often require a unique personalized approach to help them solve their unique problems.
I have often heard “oh dad had back and knee problems too”. Genetics, you can run but cannot hide.
Movement is holistic meaning it is a series of things that happen mechanically in our bodies from step to step. Movement is like a slinky; graceful, smoothe in theory. The truth is, we all adapt to walking, crawling, growth, aging, injuries and other things as we age. An unfortunate truth is that we do not always adapt well.
When we dont adapt well or have structural inherited problems, the result is stiffness and then pain. Your normal stiffness may be a precursor for pain but you find out you have a problem while reaching for your keys, or lifting up a box or going to the gym.
What is normal?
There is no normal but most people understand there is a normal for them. I explain the idea of normal in my book Cheating Mother Nature, what you need to know to beat chronic pain. Physicians should evealuate function. Often they are evaluating damage to an area they believe caused the pain. Often this fails because the area of pain is often a symptom, while the problem is elsewhere. There is no normal however, when someone is in pain that does not go away, that is suddenly not normal and we need help.
Chiropractors are physicians who specialize in joints, movement and holistic evaluation and treatment of the musculoskeletal system. They are usually a one stop shop for everything you need to diagnose and treat your hip pain, plantar fasciitis, lower back pain and even your IT band problems.
You may find out they are not problems, but symptoms of a greater issue that when treated properly, resolves or markedly improves all of these problems.
Chiropractors are primary care for the musculoskeletal system, a role that has not been fulfulled by the medical system very well.
Chiropractic is not a therapy but a profession that uses manipulation of the extremity, spine, soft tissues as well as exercises, active evaluation and treatment to resolve conditions. A chiropractic sports physician has additional training for on the field injuries to help resolve problems that occur while playing sports. These physicians also are excellent at gait issues and understanding how to improve the way you move and impact the ground. This is why for problems such as it band symdrome, knee pain, hip pain, bursitis, etc, you will rarely see a chiropractor sending you to multiple people. It results in disjointed care and over complicates what can be a simple problem to successfully treat.
In our office, we like the KISS principle (keep it simple). The more complicated the care, often the worse and more costly the care is.
What to expect during your first visit.
Your first visit will include a holistic history where we ask about your prevous problems and look for a holistic pattern which will help us during our evaluation. Recently, a patient visited us for shoulder pain from a fall two months prior. Further questioning revealed chronic lower back problems and neck problems. The patient had visited urgent care two months ago and had x rays that were negative. He was told to not use the shoulder for two weeks. The problem worsend over time. Our evaluation showed that his lower back was restricting his shoulder and his shoulder range of motion and pain improved after treating the lower back and leg problem causing it. This is the value of holistic thinking.
A throrough evaluation of movement, neurological and orthopedic function will be performed and the doctor will explain what they see when they see it. In most cases, you will be treated and the doctor will try to reduce your pain as quickly as possible by improving the way you function and move.
Treatment will consist of manipulation, myofascial release treatment and you may require foot orthotics if the imbalance causing the problem occurs from the ground up. You are likely to walk out of the office having a much better understanding of why you hurt.
The chiropractors goals are aligned with yours.
Treatment is designed to improve function, strengthen and retrain a dysfunctional area causing the problem. The other goal is to give you tools to help yourself.
Once you are feeling better, the doctor will continue to treat the malfunction which often takes time as it has likely been there long before the pain. Patients want relief and fast so they can get on with their busy lives. Chiropractors want you out of pain fast too, however they also want you functioning well enough so the next time you reach for your keys, pick up your child or go to the gym, you recover quicly and avoid further painful episodes.
When it comes to plantar fasciitis, knee pain, hip pain, bursitis and other diagnoses, often the diagnosis is the symptom, but the ability to do simple things like get out of a chair or lift your child require functional integrity. Then things work poorly, conditions like plantar fasciitis, hip, knee pain and back problems result.
Chiropractors treat the mechanism, resulting in pain free function, improved flexibility and reduced risk of future injury.
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