Case of the Week 9-9-13: Radiating Leg Pain: Online Consult | Modern Manual Therapy Blog

Case of the Week 9-9-13: Radiating Leg Pain: Online Consult


The case of the week is rather interesting. He does not improve with standard loading/unloading MDT strategies, neurodynamics, Mulligan techniques, IASTM, compression wrapping, etc... Sx have been peripheralizing... read on for more info!

The COTW is me! I sought help from two of my online colleagues in social media, first up is Dr. Zac Cupples who is also rather eclectic, reads a ton and takes a fair share of con-ed as well. Here is the vid from last night's google+ session. I sought Zac's help because of his experience with PRI thanks to Bill Hartman, one of his mentors.


Part 2


The vids are over an hour in total, just like a live eval! However, the recap is that I have a pathologic left hip, so it's lax, and a capsular pattern or slow responding (possibly) right hip with high extensor tone limiting my upper quarter motion. The weakness of my left adductors, combined with my right hip limitations is what is limiting my ability to hold the "repositioning" that was previously helping.

Zac's homework was to

  • stand and sit in a right AIC pattern
  • perform the 90-90 hip shift - emphasis on left hamstring
  • left adductor
  • left glut med
  • the above two under PRI terms act as "ligamentous muscles" a concept that if used enough, can restore stability to a lax joint by increasing tone
  • after "losing" some mobility in my left Thomas Test, then go to the right glut max (which I was doing previously but was not helping)
Of course you know I'll be compliant, and I'll update on the case, and big thanks again to Dr. Zac Cupples!

Morning update: Less paraesthesia last night, will keep up with homework today and periodically update the blog with my progress.

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