My sister asked me to take a look at my 12 year old niece Grace at the weekend, as she was worried about a lump on her shoulder (she also has left knee pain).
The lump turned out to be her collar bone, which was more pronounced on the left due to compensations occurring through her body because of an unstable left foot. The photo below shows the position of the foot, though it is really how the foot is functioning that is the problem.
The foot has also caused limitation of her left hip as the big muscles of the hip attempt to control it. Her knee, caught in the middle, is taking the hit.
“She’s all wonky” exclaimed my sister before instructing her daughter to stand up straight and roll her foot out. “I think that’s what Katie has” said my mum “She’s getting insoles”.
I was struck by how little my family know about my professional beliefs and the principles by which I am guided – drawing on success; highlighting the positive; the body’s immense intelligence and ability to adapt and take a different path; the subconscious nature of movement and need to re-pattern movement without too much conscious thought on the part of the patient.
As soon as Grace takes a step, gravity, ground reaction force, and the mass and momentum of the body will drive the foot and conscious attempts at controlling the motion will at best fail and at worst cause a problem elsewhere.
So we have commenced functional exercises directed at stabilising the foot and reversing the compensations in the hip and trunk.
No conscious holding of a position, no insoles (unless we find we need them), just the use of the principles of movement to direct the body to take a new path.