funkyfemur-blog

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Today’s adventure

Somehow I pulled my calf muscle on my good leg. Wtf?

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This is Cleo, the love of my life. We met at Operation Kindness in Carrollton, TX on August 22, 2016. It was during one of the darkest times in my life. Her happy, sweet, sassy little self has helped me through so much. She gives me so much joy even on terrible days.

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Sciatica symptoms can be caused by piriformis syndrome or a herniated disc. Here are some easy ways to help narrow it down, and some treatments for each. More sciatic nerve stretches & exercises: https://www.youtube.com/watch?v=pX-QI4wRpiE&list=PLPS8D21t0eO8bRyNBvm5NULZeCKPsnP3Q&t=0s&index=15

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Gait, Running or Biomechanical problems ? Today we talk of Torsions and Versions….

(excerpted from the forthcoming second edition of our book)

We’ve all heard of, and probably have used, the terms torsion or version especially in the vernacular of antetorsion or anteversion and retrotorsion and retroversion. We (including authors and researchers) often like to use these terms interchangeably. Technically speaking, we have all been wrong.

Believe it or not, there was actually a group of folks in 1979 called the Subcommittee on Torsional Deformity and Pediatric Orthopedic Society whose mission was to set people straight on the differences between torsion and version. Version is actually the normal difference in angulation of the proximal and distal portions of a long bone. Torsion is said to be present when this measurement falls outside 2 standard deviations of the normal version.

Versions are present in utero and are considered part of the developmental process. For example, the femur has approximately 30 degrees of anteversion at birth (ie the femoral condyles are rotated 30 degrees medial to the plane of the femur head). During the normal developmental process, the femur “untwists” at a rate as slow as 1-3 degrees per year to approximately a 20 degree by age 6, leading to a “normal” angle of 8-12 degrees of anteversion. Of course this can occur slower or faster or to a greater or lesser degree as well resulting in a torsion, which may or may not have symptomatic sequela later in life. Regardless, these torsions are very important transverse plane deformities from a gait biomechanists point of view in regards to resultant compensations which occur in the lower kinetic chain and more proximally.

These versions and torsions can affect any long bone, but most important to us, the femur and tibia. Of interesting note, there is a 2:1 preponderance of left sided deformities believed to be due to most babies being carried on their backs on the left side of the mother in utero, causing the left leg to overlie the right in an externally rotated and abducted position.

Now maybe you will think twice about the position of the feet of a newborn when placing them on their stomach, as this posturing will effect their development over time and potentially contribute to adult torsional deformity! How’s the sleeping position of your child? Do they consistently sleep on one side? Is their thigh drawn up and internally rotated with a compensatory external rotation of the foot relative to the tibia? Wow, and you thought as long as you fed them well and didn’t let them watch too much TV that all would be OK!

Torsions and Versions…. They are not just for breakfast anymore…

Yes, we ARE a little twisted……Ivo and Shawn

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My life as an episode of Mystery Diagnosis

I have had pain for five years. Ever since my hip popped in a dance class, nothing has been the same. 

It started as pain in the back of my leg, consistent with a pulled hamstring. Treated it as such (orders of Dr. No. 1) and it never really got better. I had already been accepted into Southern Methodist University as a Dance Major. The “muscle” wasn’t healing at the rate I expected, but I figured by the time I started college (5 months after the injury took place) I’d be good as new. I flew off to New York to train for six weeks so I’d be in top shape when I started my new program.

I got to New York, and things didn’t get better. I saw a doctor (No. 2) who worked with the Harkness Center for Dance Injury. He did an exam and an X-Ray to make sure I didn’t break off part of my ischial tuberosity (sit bone) when I pulled the muscle. Tests showed that everything was fine. He suggested physical therapy. I limped back to Lincoln Center and stumbled through an agonizing afternoon of rehearsal. I could barely dance. My teachers could tell how upsetting this was for me, and their kind (Russian, translated) words comforted me. I was sad. I started gaining weight, which made me sadder. 

I got to Dallas in August and pushed through every pain I had for about a month. I wanted to impress my new professors, but within a month the pain had gotten so bad I couldn’t finish all of my classes. I was angry about it. My professors could tell I was angry because of the way I acted in class. Unfortunately, my peers had to experience my anger through mean words and actions. I felt like an injured animal on the side of the road, forgotten, and left to suffer. I finished the year with a few incomplete courses, and went home to do PT over the summer.

At home, scared and hopeless, I started therapy for sciatic nerve pain (Orders of Dr. No. 3). It seemed miraculous. By the end of the summer, I was ready to go back to school and make up for lost time. I had intermittent pain, but it usually subsided if I did my exercises. By the end of the year, my pain was back and it brought even more emotional turmoil with it. I was determined to push through it, so I went to New York again to train for six weeks.

I made it through the six weeks with no pain. I thought that perhaps I had finally cracked the sciatic nerve code. Lo and behold, when I returned to school my pain returned, only in a slightly different area. I started having painful spasms and pain in my back instead of my leg. I saw yet another doctor (No. 4), and the exam (once again) showed that nothing was wrong. PT didn’t help this time.

I thought maybe I was crazy, and I started acting like it.

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“The Most Famous Physical Therapists on the Internet”

The self-proclaimed “Most Famous Physical Therapists on the Internet” try to explain Retroversion, and some of its possible causes

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The beginning

I was born in a time and place. (You know if you need to know the deets, y’all.)

I was a cool, cute little kid. Really cute. I swear.

I wanted to be an archaeologist, a museum curator, an eye doctor, an artist, and a ballerina. But mostly a ballerina.

So I took some ballet lessons. It was great. Really great. I was four, and on the way to being a full fledged ballerina. I had it all, or so the grownups said. My feet pointed, I could understand and count the music, and--most coolest of all--my feet were wayyyy turned out! It was the dream! I got good at it. Really good.

Flash forward about 14 years. I was 18. If you asked me, I’d have told you I was probably going to join the Martha Graham Dance Company one day. It was a solid plan. And then.... POP! During a dance class my hip popped VERY loudly, so loudly that a friend across the room turned to me and asked if it was my hip. It was. At that moment, I knew for sure that I had pulled my hamstring. It hurt badly. I rested it, but I pulled through and kept on dancing. My leg was weak, but I was in PT so I thought it would get stronger. It didn’t. Something wasn’t right. Little did I know, that was the beginning of a sequence of events that would challenge everything I ever believed about myself.