Posts Tagged ‘C1’

Dwight Freeney of the Indiana Colts is using chiropractic to heal his ankle

Friday, February 19th, 2010

I know, I know, it’s all over now but this caught my eye:

Dwight Freeney’s ankle injury was a major story in the run-up to the Superbowl. The Colts kept their cards close to the chest on the whole matter though some details have leaked as to what they did to treat the issue.

They are very active with their treatments and Freeney is using some methods that have helped him in the past. The main one is Dr. Leon Mellman, Freeney’s Chiropractor, who was making sure not only his ankle is getting the proper care, but is also monitoring how his newly guarded walk is effecting the rest of his body. Most notably how his lower back could be adversely affected due to his newly acquired limp.

Freeney’s injury was being treated as any other low ankle sprain would be in the NFL with some minor tweaks. Although he was seen in a supporting boot very recently, he spoke openly about keeping the motion in the ankle joint to promote healing. This became common place in joint surgeries; where immediately following the surgery, the joint are put into passive motion to prevent adhesion build-up and promote a quicker recovery. Freeney was spotted walking the beach without his boot on, most likely advised by team doctors for the same reason: a quicker recovery.

Can chiropractic help with leg-length inequality?

Thursday, September 17th, 2009

We’ve been having a run on patients presenting with “hip pain” at C1 which turns out to be leg-length inequality (LLI) rather than true hip joint pain.

Leg length inequality is common, with a staggering 90% of us having some inequality and 23% of the general population having a discrepancy of 1 cm or more – which is a fair discrepancy. Treatment aims for LLI must include obtaining leg length equality, producing a level pelvis, and improving function.

Guidelines set out by James J. McCarthy, MD, and G. Dean MacEwen, MD for treatment of leg length inequality are: <2 cm — no treatment or a lift in the shoe; 2 to 6 cm — an epiphysiodesis or shortening procedure is considered; 6 to 15 cm — a lengthening procedure is considered. A leg length inequality of 15 to 20 cm — may require a staged lengthening, lengthening combined with epiphysiodesis, or amputation. Numerous complications of limb lengthening procedures occur frequently, even in experienced hands.

Management of Leg Length Inequality
from Journal of the Southern Orthopaedic Association
James J. McCarthy, MD, and G. Dean MacEwen, MD

Now, few and far between, are those who have a LLI of 2 – 6 cm and rare as hen’s teeth are those who have greater but the less than 2 cm are pretty common.

What causes LLI – well it is is uncommon for your limbs just to grow to different lenghts so an anatomical LLI is usually something to do with trauma – breaking a leg or ankle being the most likely cause. If this hasn’t happened that we’d look at the arch of the foot and see if they are symetrical as a collapsed arch can lower a hip height. However, the most common cause of LLI we have seen at the clinic is caused by pelvic rotation at the sacroiliac joint. This is usually treatable depending just on how much movement you can back into the joint and they have a tendency to resolve well if they can be moved.

I’d resist a heel lift as they are a real pain, since they have to be moved between shoes and, on philisophical grounds, as they treat a sign and not a cause in many cases.