Problems from the Ground, Up.
There have been numerous studies tying in the relationship between low back pain and the development of neck pain, thus, demonstrating how a chain reaction can occur through the spine. There is also a direct relationship between the stability of the pelvis and spine and the movement of the lower body. Proper spinal function, therefore, can be affected by simple gait problems, such as over pronation, leg length differences, or uncoordinated patterns of movement. With this being said, it is important to look at possible issues in the lower body to properly treat issues in the spine, such as sciatica. In the nervous system, the brain records patterns of frequently occurring positions and movements that it then stores as a “normal” position or movement. This is why people can have reoccurring problems; even after getting a small amount of treatment to help improve movement or posture, the issue could simply reoccur because the brain hasn’t overwritten the previous storage with a new storage of posture or movement. The answer for this is that more consistent re-education needs to occur in order for the brain to understand what the “new” normal is in position or movement (whichever you are trying to educate it on). Here is a simple example: if someone crosses their legs often, this could put a strain on the ligaments of the sacroiliac joint (the spine and pelvis junction). The patient may undergo a short amount of treatment and symptoms may be reduced. However, a couple weeks go by and the patient has the same amount of pain again in the buttock area during sitting and walking. If the patient continued sitting down while crossing their legs, the brain continues to understand this as a normal position and it requires the ligaments of the SIJ to strain to adapt to this position. During gait, abnormal motion initiated by excessive or restricted joint interactions of the feet and lower extremities will eventually interfere with normal spinal-pelvic motions and can lead to pain syndromes. A common dysfunctional lower-extremity pattern is hyper-pronation, producing excessive internal rotation of the entire lower extremity (this knock-kneed). The increased rotational forces are transmitted into the pelvis and hip region where the primary antagonist is the piriformis muscle…. simply put, the muscle in the buttock region becomes really agitated and can produce sciatica-like symptoms. This article was written to give some basic demonstrations to how a chain reaction of problems can occur from the ground, up. Also, to give insight to how the nervous system not only plays a key role in attributing to orthopedic dysfunction, but also plays a key role in the rehabilitation of these problems.