QuestionHi 4yrs ago I had extended foot surgery and was not put into rehab and was in a cast for 6 weeks and than a inflated cast another 4 weeks while needless to say I totally depended on my left leg since than i forgot how to walk normally and now walk with a limp and my muscles are so tight that standing to long is very painful. I was going to a Chiropractor and deep massage therapist and they have help me with my gait and pain. Do you have any suggestions to help me because at this point I certainly don't want surgery ever again. This was suppose to be a simple bunion surgery and turned out to be a totally reconstructed foot. Hope you can help thanks Kim
Answerback pain, gait, limp, massage, bunion, foot reconstruction,
Hello Kim,
Sorry to hear of your 4 year loooooooooong history of pain and complication.
Often patients come to my Staten Island Chiropractic Office after treatment by other disciplines. Often the culprit is a lack of appropriate rehabilitation. Different disciplines have different strengths and weaknesses.
Doctors of Chiropractic are often criticized for being to structurally oriented. Surgeons view every problem as correctable by surgical intervention. Medical Doctors 'give a pill' for everything. Nutritionists have a vitamin for everything. These are the perspectives of many patients,,,, and unfortunately, often correct!
You have learned, unfortunately, that everything in the body is connected to everything else. A simple bunion dominoes into foot reconstruction which dominoes into a cast, muscle atrophy, altered gait, muscle weakness, knee, hip, back dysfunction and pain.
Not trying to cast stones, but it certainly would have been easier on you IF adequate explanation and description of the surgical procedure and it's possible complications were given to you prior to surgery. It would have been easier on you if after surgery adequate, appropriate rehabilitation were given to you. Unfortunately many of us professionals view a health condition through a tunnel and sometimes forget the 'big picture', the whole picture.
I will admit my bias, as a Staten Island Chiropractor, I do TRY to look at the whole picture of the patient and give a more comprehensive 'holistic' health approach. Chiropractic is GREAT for the structural/ neurological components of a problem. Nutrition can change the chemistry of a problem. Physiotherapeutic modalities can ameliorate pain, help joints/ muscles/ tendons/ ligament restore and return to function. Exercise, range of motion, strengthening at the correct progress point in a problem is important. -- -- there are many aspects to even the simplest of conditions and a multifactoral approach to the problem is usually best.
Rehab should have been started even while still in the cast. Only your surgeon could really comment on this, but perhaps after a couple of weeks of total immobilization and rest,,, then perhaps you could have started to just 'wiggle your toes'; perhaps after that, lifting your foot up and 'painting the alphabet' in the air may have been helpful. Maybe you should have been totally OFF that foot for two weeks, three, four, six weeks- THEN followed by a progressive rehab.
Anyway, that is spilt milk,,,, no use crying over spilt milk and hindsight is 20/20.
What to do now is the question.
It is NEVER TO LATE to start, continue with rehabilitation.
The body is alive and dynamic and able to change and adapt.
You are doing the correct thing going to a Doctor of Chiropractic and a massage therapist. Stay there. Be patient. Your problem is chronic. Deterioration/ degeneration has a headstart and momentum. It takes a while to catch up with the problem (progressive degeneration), slow it, stop it, and reverse it.
Most Doctors of Chiropractic now utilize Adjustment of the spine and manipulation of the extremity joints to restore movement, function, strength. The spinal adjustment is paramount in your return to more full function. Adjunctive physiotherapy: ultrasound, infrasound, electrical muscle stimulation, interferential, vibration, massage can all be utilized in the Doctor's office. Many Chiropractors are now using nutrition to complement the structural work: proteolytic enzymes, omega 3 essential fatty acids are probably going to help you
(anti-inflammatory- help with pain)- perhaps your DC can help you with more suggestions. Appropriate range of motion and strengthening exercises under the direction of a Doctor such as your Chiropractor, or perhaps your massage therapist, physical therapist, or a certified physical trainer.
Rehabilitation, restoration/ recovery from any health condition takes time and patience. Recovery takes a plan- appropriate steps at appropriate times as progress is made. Your Doctor of Chiropractic is a good choice for this- either to perform in his(her) office, or appropriate referral.
I utilize informational handouts in my Staten Island Chiropractic office, these may be somewhat helpful to you:
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P.R.I.C.E. =
P protection. R rest. I ice. C compression. E elevation.
Hurt yourself ?? injury/ trauma/ bruise/ not even sure - - a broken bone ??
You should certainly get to the Doctor or trained health professional to be examined if you think it is bad enough. BUT in the meantime, some simple steps may help.
PRICE.
The PRICE protocol will usually help just about any musculoskeletal injury.
P = Protection; protect the area from further injury- stop what you are doing, can you pad or bandage the area ? Tape the area? Do something to protect the area !
R = Rest; rest the area as much as possible, if a part is damaged, give the body time to repair the area
I = Ice; ice is a potent anti-inflammatory; it will slow swelling, help with pain control (ice is analgesic), place ice over cloth over the injured area for 5, 10 minutes, off the injured area for 30 minutes; then back on again
C = Compression; to help prevent swelling compression may be helpful- for example if it is an ankle, wrap the ankle with an ace bandage and ice the area. Many body parts may not be applicable to compression.
E = Elevation; again to fight swelling and pain, raising the injured body part above the heart may be helpful- ie raise an ankle or knee, you lay down, raise the injured part
PRICE may help : Sprains, Strains, musculo-skeletal injury, bruise, contusion
Sometimes a slip, trip, fall, heavy lift, athletic injury, or a motor vehicle accident can cause a bump or bruise, sprain or strain. Sometimes also involved with the injury is a vertebral subluxation (or other joint subluxation) (subluxation is a mechanical problem- of any joint- and requires a mechanical correction). In the spine, a sprain/strain is a misalignment, a 慿ink?in the joint, a stretch of the muscles, tendons and/ or ligaments:- more properly termed a Vertebral Subluxation. Sometimes symptoms can come immediately, sometimes days, weeks or even months later!- Well after the actual trauma !!!
Spinal = Vertebral Subluxation Complex (a.k.a. 憇ubluxation? ; ( subluxation COULD be any joint )
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.
This is a serious condition identified by its five parts:
Spinal Kinesiopathology:
This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
Neuropathophysiology:
Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
Myopathology:
Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
Histopathology:
A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.
Pathophysiology:
Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.
The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.
Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
Vertebral Subluxation cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.
Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction- - - a manipulation, best performed with the chiropractic adjustment. For good health- Treat the Cause, not just the Symptoms. Sprain/ strain/ bump/ bruise?= may result in subluxation of the nearby joint.
CORRECT the subluxation !!!!
Dr. Victor E. Dolan, Doctor of Chiropractic; Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST Chief of Chiropractic in a Hospital in New York State (DHSI); As Seen in PREVENTION Magazine
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BE PATIENT:
What ? ! , I have to brush my teeth!?,,, after EVERY meal ! ? ,,, For the REST of my life ! ? ! ... I don抰 want to. period. I won抰. To heck with it ! If I get a hole (cavity), THEN I抣l take care of it. Maybe I won抰 get any cavities anyway?...
It took the American Dental Association YEARS to educate people that they should brush frequently to avoid dental disease. It has taken YEARS to educate patients that visits to the Dentist for hygiene, cleanings, flossing, coatings, etc. are necessary to PREVENT dental problems. Some people still do not floss after every meal, some do not even brush often enough (yyyuuukkkk), so some people still have severe dental problems despite all the knowledge about PREVENTION and dental health maintenance that is out there. Can you believe it ?? !!
Some people have the same problem with PREVENTATIVE Spinal Health
that used to exist with preventative dental health. Some people come to the Doctor of Chiropractic and say, ?..do not adjust me, just give me therapy...? some people say,
?..What ? ! , I have to practice SPINAL HYGIENE !?!, (practice proper postures, proper movement patterns, and see the Chiropractor periodically !?!), Naahh, ... I don抰
want to. period. I won抰. To heck with it! When I get PAIN, then I抣l take care of it.
( pain is often the LAST symptom to appear- whether a cavity or a heart attack ! )
Vertebral Subluxation Complex (a.k.a. 憇ubluxation?
The vertebral subluxation complex can be the underlying cause of many healthcare problems. A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.
This (Subluxation) is a serious condition identified by its five parts:
Spinal Kinesiopathology, Neuropathophysiology, Myopathology, Histopathology, Pathophysiology.
The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.
Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
Vertebral Subluxation cannot be corrected through chemicals (medicine), stretching, yoga, massage, vitamins or physical therapy alone. Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction- - - a manipulation, best performed with the chiropractic adjustment. For good health- Treat the Cause, not just the Symptoms.
Chiropractic corrects the Vertebral Subluxation Complex.
ONLY a Doctor of Chiropractic evaluates for a Vertebral Subluxation.
You cannot be 慼ealthy?if you have a Subluxation. You MAY feel it, with a pain, stiffness, or a 慿ink?in your neck/ back. You may NOT even feel it-
just as people often do not feel the cavity growing in their tooth,,,, until it hits the nerve; or you may not feel it at all, like people do not feel high blood pressure or diabetes until AFTER damage has been done!! PREVENTION- Visit the Doctor of Chiropractic REGULARLY,,, just like your dentist! (practice spinal hygiene as you do dental hygiene -PREVENTION!-
Dr. Victor E. Dolan, Doctor of Chiropractic; Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST Chief of Chiropractic in a Hospital in New York State (DHSI); As Seen in PREVENTION Magazine
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Your Doctor of Chiropractic is a good choice for your rehabilitaion path. If you are happy with your local Doctor and he(she) seems to offer the 'comprehensive' 'holistic' package I have described above; stay there. If your massage therapist seems to be doing a good job, stay there. Again, be patient, and PROGRESS weekly, monthly, in the correct direction with appropriate changes in therapy, exercise, etc.
Many patients do not realize that Doctors of Chiropractic also have specialties - - - similar to MDs. I have a specialy in Sports Chiropractic (DACBSP - see www.ACBSP.com ), and there are specialties in Rehab (perhaps exactly what you need !), orthopedics, neurology, radiology, nutrition. If you are happy with your DC- stay there! If your DC offers the 'comprehensive' 'holistic' package - stay there. If you like the chiropractic approach, and want a little more than what your DC is giving, look for a DC with additional credentials, such as those cited above.
I wish you Good Luck and Good Health NATURALLY,
Your Staten Island Chiropractor Friend,
Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com (email newsletter)
