I’ve been  working on an upcoming book, Fixing You: Foot & Ankle Pain, and have been experimenting with a new approach to fixing foot problems. The interesting thing is, since I’ve been trying this new approach to walking, my pelvis has not become rotated,  resulting in no back pain. Before, I’ve always been able to prevent or fix my back pain with the techniques from my book, Fixing You: Back Pain. But one thing I hadn’t been able to do is identify the habit that is continually causing my pelvis to become rotated, contributing to recurrence of my back pain. Now I think I’m on to it! This is an unexpected benefit I hadn’t counted on. Of course, we all know that everything in the body is connected but we don’t know yet, the best way to use these connections to reduce pain. I think, in the course of applying a new understanding of our foot and lower leg anatomy, that I’ve figured out a way to reduce chronic pelvic rotation which is often at the root of pelvic pain, sciatica, SI joint, and back pain.

This was reinforced when I asked one of my clients with a perpetually rotated pelvis and a history of back and sciatic pain to try this new walking technique. He also has hip pain due to arthritis that has gradually become worse over the years of his pounding sports. Additionally he has knee pain on the same side. We’ve been able to fix all these aches and pains but I have not been able to get him to fix his walking pattern which is contributing to the recurrence of these problems. Immediately upon fixing his gait (walking) pattern his leg and pelvis corrected themselves without his even thinking about it! He also reported his hip pain had vanished! We both looked at each other stunned.

I’m still experimenting with this and working out the nuances for different foot types but I’m excited at what I’m finding. Finally, I think I might be getting to the bottom of a more complete approach to fixing ailments from head to toes, beginning with the toes!

It’s funny how I treat problems of the body but don’t think about the grand scheme of movement. Recently I stepped back and thought about many of the knee pain cases I’ve been treating and realized one common factor in all of them. Although the knee flexes and extends, it is rotation of the knee joint that causes most of the problems I see. The morphology of the end of the femur dictates that  rotation must occur at the knee joint when it bends and straightens. But where are the muscles that control the rotation?

The quadriceps, hamstrings and calf muscles control the bending and straightening of the knee and may assist in controlling rotation but they are not primarily rotation muscles. The pelvic muscles control rotation at the knee because they control the femur.

From the other end, foot pronation and supination affect rotation at the knee as well. But I rarely find that treating issues here translates directly to alleviating knee pain. 90-100% of the time it is working with the hip musculature, which controls femoral rotation, that fixes knee pain.

I have been writing a book detailing some very powerful self-treatment techniques I use to treat patients with chronic pain. It’s been an interesting venture because, in the process of writing the book, I now understand how my subconscious or intuition has been working to guide my treatments. This understanding, in turn, has helped guide my treatments.

Each chapter of the book addressed a different area of the body. For instance neck pain & headaches, shoulder pain, elbow pain, back pain, hip pain, knee pain, foot & ankle pain and back pain & sciatica during pregnancy. The feedback I’ve received is that the information was too technical for laypeople (who happen to be my audience). In the process of breaking the information down even more, each chapter has expanded to become its own book.

The title of the series will be Fixing You. The first book out will be Fixing You: Back Pain and will be followed by seven other books all to be published this year. It will be a busy year for me! My sincerest hope is that these books help the thousands of people out there living with chronic pain. So often with just a little attention to the right areas, pain will vanish. I hope the Fixing You series can guide people to pain-free lives.

I just began working with a man scheduled for right knee replacement surgery. He wanted to know what pre-surgical strengthening he might do to help him recover from his surgery. When I examined his right knee, he was unable to extend it fully–lacking approximately 10 degrees. It was swollen and painful. During the course of my examinating I found several things wrong with his left hip, namely poor gluteal function and hamstring dominance. My initial thoughts were he was compensating for deficient strength of his left leg.

Then I decided to try and alleviate his right knee pain through a few alignment tests I like to perform. None of these had any effect. That is until I distracted the knee. Immediately he felt pain relief so we stayed with it for a few minutes. I asked him to stand up and he could almost fully extend the knee! I educated him about activating the gluteals while walking and we practiced that. Within 15 minutes his knee began to flex again so  we tried the distraction again, this time lying on his stomach so I could anchor a small weight on his ankle to assist the knee into extension while I provided the traction. The result was dramatic. He could fully extend the knee and walk correctly without pain.

We’ve since had two treatments (1x/wk) and he is now calling off the surgery and contemplating skiing this season. Again, my thoughts return to the fact that by improving his biomechanics by both fully extending the knee and correcting his gait dynamics we are able to improve pain free function. I do not doubt that his cartilage is still missing but it begs the question once more that just because we see an alteration in the structure of a joint or soft tissue, it doesn’t mean that is where the pain is coming from. To me it is an indication that something is wrong biomechanically. If we correct the mechanics, pain eases and function returns.