As a specific patient example, we had an eager middle aged woman come in with an old history of lower lumbar fusion, as well as anterior hip impingement release. She had been treated by numerous practitioners from different backgrounds and was “at her wits end” because of her low back/SI/hip pain. At her Initial Examination, the patient ambulated with a single Lofstrand crutch, demonstrating very poor control of her right hip and pelvis (in both swing and stance phase). She had been told she would need to use this for safe ambulation and balance issues for the rest of her life. Some of her previous treatment, which consisted of electric modalities, hip flexor and knee extensor exercises, as well as “core exercises,” did not yield the results she expected. Upon our manual assessment, this patient exhibited poor mobility and dissociation of the femur, innominate, and lumbar spine in very specific patterns of compensations. Extensive soft tissue mobilization, joint mobilization, and visceral/neural mobilization lead to great gains in mobility and function, to the point she no longer needed the assistive device.
We then used researched techniques to alter her proprioception for pelvic alignment and facilitated appropriate pelvicfemoral and lumbopelvic initiation to alter her static standing alignment. A few sessions focused on re-training the brain/body connection automatically while maintaining an efficient posture in sitting and standing. The next session, not only did the patient have reportedly less symptoms but also exhibited significant carry over in seated and standing posture. “I had a friend tell me she hasn’t seen me walking this great in the past 10 years!” These drastic improvements in gait mechanics have led to improved resting muscle tone, increased automatic core activation, and balance efficiency.