0:00 “Gloria, tell me what’s going on with
your ankle.”
“I came back from surgery on pain meds, and I rolled my ankle.
That was May 26, and it swelled up and had a lot of pain, very unbearable and since then,
the swelling and the ankle has gone down, and I don’t have any swelling anymore in
my feet.
But I still have pain now, it’s at the ball of my foot and my second toe, so it hurts
me to stand long or walk any length of distance.
It hurts.
I can’t tiptoe, I can’t wear heels, and I have to limp most of the time.”
“So this was not related to your ankle?”
“No.”
“No, okay so that was something else.
And how much pain do you feel there from 0-10, 10 is emergency room, when you walk on it?”
“When it’s really bad, it’s a 7.”
“7 out of 10, okay I want to see how you walk, and tell us how much pain you feel while
you’re walking.”
“Okay.”
“You’re just normal walking back and forth from here to here.
Is that your normal speed?
You’re limping for sure.”
“I am limping because it hurts.”
“Okay, how much pain from 0 to 10?”
“Right now, because I’m limping, it’s probably like a 3, 4.”
“Okay, but if I let you walk a little bit longer, that will increase?”
“Yes, the more walking, the worse.”
“Let’s do it one more time, walking back and forth.”
“Okay.”
“So you’ve been limping like that since May?”
“Pretty much yes.”
“Okay.”
“I was also in a wheel because I couldn’t walk on it for how long, a good couple weeks.”
“Wow, okay when you’re ready, I want you to lie on your back, head over there, so I
can work on the ankle.”
“Okay.”
2:00 “So like I’ve told you, everything should
be pain free, okay?”
“Okay.”
“Make sure to let me know if you feel any pain.”
“So pain is not good?”
“Yeah, pain is not.
Actually if you feel pain that’s damage to the healthy tissue.”
“Okay.”
“Uhm, so pain is like a check engine signal.”
“Yes.”
“So if you ignore it, you’re going to have more damage.
If we can address it, we can fix it.”
“Okay, that’s good to know.”
“That’s why I disagree with the philosophy: no pain no gain.
It actually causes more damage than it benefits.”
“Okay.”
“Hold it up and relax.
So it is all in here, is that painful?
Is that tender here?”
“Oh yeah it was more of the side when you squeezed.”
‘Yeah so it is going to feel cold, let me know if you feel pain with that?”“Okay.”
“Relax, okay do you hear that crunchiness?”“Yeah.”
“That is the scar tissue.
So you have a lot of scar tissue there.”
“Yeah I can feel that.”
“Is it painful or is it okay?”
“Just a tiny bit painful.”
“Okay, relax.
Make be sure to let me know.
I cannot read your mind.
Not today.”
“That would take too long anyway.”
“I am working on it.”
4:25 “Is that too much or is that okay?”
“It is a little painful.”
“So why are you not telling me?”
“Because I am thinking it is the old mentality, if you can break it down and work through
it.”
“Well if you feel pain it that is damage to the healthy tissue and that is going to
cause new scar tissue and we do not want that.”
“Okay.”
“We want everything to be comfortable okay, relax.
You hear that grinding?”
“Yeah.”
“Yeah that is a lot of scar tissue.
Okay, so after that I will have you walk again and tell me how much pain do you feel now?”
“Okay.”
“Okay, put your shoes on and I want to see how you walk here.”
“That feels better.”“Any pain or is it gone?”
“There is a little bit of pain in the toes still, but it is greatly..
oh that feels much better.
Yeah that is smooth.
Wow it is just in the toe now.”
“Where in the toe?”
“In the back, just in the second toe right in here.”
“Okay lets lie on your back.”
“Wow I cannot believe it!”
“Just do not crash your back.”
“Then that would be another injury.”
6:36 “Relax, so this is the area?”
“Uh huh.”
“Relax.
Do you feel the scar there, the crunchiness?”
“Yes.”
“You got a lot of
scar tissue.”
“Would that be from the tendon?”
“Scar tissue is part of the healing process with any injury.
It is essential for our survival.
The problem when we have too much scar tissue it compresses on the nerve and artery, so
we have to manually break it down.
Other wise it is going to cause a lot of issues.
Walk back and forth and tell me how that feels.”
“Okay, oh yeah that does feel better.”
“Is it gone or do you still feel it?”
“Just in the toe still.”
“Okay lets drink some water.
After breaking scar tissue, make sure to drink your water.”
“Okay lets walk back and forth and tell me how that feels?”
“It is better, much better.
Yeah I do not have to limp.”
“Beautiful.”
“I do not have to limp.”
“Thank you so much.”
“No thank you so much.”
0:00 “I have had a herniated cervical disk and
I have had a 2 level disk removal and spinal fusion at C4-5 and 5-6, but I have had quite
a loss of range of motion.
I think especially tilting to the right and to the left.
I have less range of motion looking all the way to the left or right.”
“You have more limitation..?”“I have more limitation looking to the right yeah.
Also looking up, I just feel like I can hardly look up at all.”
“Okay when do you have the surgery?”
“1994.”
“Since then you have been having those limitations or they have been getting worse over time?”
“I have certainly had limitations from then but probably even before the surgery.
Um it may be getting a little bit worse and I do have on more recent MRIs the bulging
disks above and below.”
“So have you had any treatment for neck, what did you do for your neck surgery?”
“So I ended up having a minimal invasive spinal decompression on the next level down
6-7.”
“Okay.
What about your treatment, any physical therapy?”
“Just post op physical therapy.”
“Did you notice your range of motion improved?”
“I would have to say with all the physical therapy I have had has never increased my
range of motion or anything.
It would make my muscles get less spasms.”
“Okay our goal is to get your range of motion.”
“Yeah.”
2:02 “Okay let me see your range of motion again.
Turn to the right.
Okay that is tight here.
Turn to the left, not too bad this way.
Extension/flexion that is really tight.
Okay and side bend left and right.
When you do that how much pain at worse?”
“It just feels like it is stretched to the limit rather than that painful.
It starts to feel uncomfortable but not pain.”
“But it is all tightness?”
“Yes it is tight.”
“Where do you feel the worst area of tightness?”
“I would say it feels the worst looking to my right and looking up.”
“And where do you feel it in the back?”
“Uh just right back there.
Here I feel it more on the right side and then when I do this it is whatever the start
of…”
“Which level do you have intra infused?”
“C4-5, 5-6.
Probably 4 though 6 is one solid bone.”
“Okay lets lie on your back here.”
“Lie on my back, okay.”
“Okay and relax.
Let me know if you feel any discomfort okay.
Do you feel all this tightness here?”
“It feels tight when you are pressing.”“Make sure it is pain free okay.”“Relax, have
you had any head trauma?”
“None to speak of, no significant trauma.”
“Okay, nothing.”
4:00 “Make sure it is pain free.
So we are going to do the same thing, just get it to feel released and we will check
your range of motion.
After that do release and testing to see how far we can go.
Maybe have you do some deep breathing if you are comfortable with that, okay.”
“It does feel tight on the lower circle.”
“Alright, so after the first treatment how does it feel?
“It feels even more..I am now looking at that picture.”
“Okay I think that is a full range of motion on that side.”
“Yeah.
Oh yeah on this one I can now kind of see to that door.”
“That is awesome.”
“How is that?”
“Certainly better I think than before.”
“The first time..compared to the first time.”
“This one is still more limited to me.”
“What about flexion forward?”
“This one I felt I never had a real problem.”
“Yeah this is okay, not too bad.
Yeah so you are getting definitely more on the left side.”
“Yeah.”
“Thank you so much.”