Pain down the legs

[Sunil]

 I have a client who when on her feet for long periods of time gets a painful sensation from her ASIS area all the way down the front of her leg to her foot.  When she sits she notes the pain more so in just the bottom portion of the leg cheifly in the peroneals.  I have noted that her Left ASIS was higher than her right.  Her left QL was also short.  I have achieved a more normal resting length for the QL, and got her ASIS's more level by lengthening her deep six and giving her a more normal balnce between adductors and abductors.( her adductors were exceptionally strong)  Any other ideas as to what this may have stemmed from??Thanks for the future posts!! ;D

 

[Old Thrusty]

Have you looked into the existing tone of the low back muscles, not limited to but including the erector spinae?  The reason I ask is because if she has shortening of one side QL, I wonder what other back structures are shortened as well possibly causing some sort of impingement in the lumbosacral plexus:  such as the lateral femoral cutaneous nerve which the skin of the thigh.  Also, have you done any deep palpation of the external rotators, or did you just lengthen them?  Palpation of piriformis specifically might recreate the pain she is experiencing since the sciatic nerve later divides into a peroneal nerve at the popliteal fossa.  These are just thoughts but nerve problems (at least it's been my experience) can often either be overlooked or misjudged as simple muscular imbalances.  Let me know if this was of any help!

 

[Moonlights]

Very interesting!  I did not check existing low back tonicity, or do any palpation of the external rotators, but I definately will.  I find it very intriguing that the the sciatic nerver later becomes the peroneal nerve.. Thats strange, because the pain that she was having went right down the peroneals.  Hmmmmm.  Yep  I need to palpate the piriformis, and see if that recreates a similar pain pattern ;.  Thank you very much!  

 

[littlemoomaid]

Pain down the legs

You mentioned that the Left ASIS is noticeably higher than the right side. I'll assume leg length is also unequal. Have you assessed the Pubic Symphysis? A higher Left ASIS can usually tell one of two things...1.) Anterior Innominate Rotation on the Right2.) Posterior Innominate Rotation on the LeftTherefore, one scenario the tight QL On the left was due to an overstretching caused by the Posterior Rotation. Check the hamstrings/glutes on the Left side.Another Scenario is the Anterior Innominate Rotation on the right. Check the QL and Iliocostalis on the Right. If this is the case, does your client have the pain down their Left or Right leg? Let me know!Jay