Case Study

This post is less about the case study than it is about the person that it was with.  Nice title for the post, right?

The thing is that the person I worked with was my Clinical Instructor for Pediatrics about 11 years ago.  At the time I wasn’t well thought of by my PT school faculty, but there wasn’t much they could do to someone going MCL or SCL every semester.
When I got to Trish for pediatrics, I suppose I made the right impression, and her voice back to the jerks at my PT school kept them off my back for the rest of the time.  I’m sure they were shocked, but it all worked out.

So being able to come back over a decade later and work some magic with Trish was a special moment for me.  She was thanking me, but it is I that should be thanking her.
I’m finding I am doing a lot of thanking recently, specifically to 2 of my current mentors, Gray and Coach Boyle.  Things must not be so bad I guess.

Anyway, Trish did some kind of twisting torquing fall down and go boom thing with her left knee like 2 weeks ago.   So she’s been icing and hobbling around, and maybe a few days ago, she felt at least she was getting on top of the swelling.
Pain in terminal flexion and extension.  Everything smells like meniscus.

I poo’d a full eval and just confirmed a quick Cyriax impression of the knee if for no other reason to go back for test-retest.

Gua Sha to anterior thigh and posterior capsule.  Rectus Femoris lit up like a Christmas Tress.
Walking with verbal cues of long steps, pull your hip through, push off with the toes.  The brain likes the words push and pull.  Try it.

Mulligan tape to the ankle.  Would have liked to have tried to the knee to see if it was better, but the lotion from the Gua Sha would have made the tape worthless.
Walking w/med ball overhead. Improved.
Full lunge with med ball squeeze.  Abolished.
(You notice the McKenzie terms?)

No time to address breathing in an effort to get at the DNs of Extension and Rotation, but it was very interesting that this is her right knee, and it’s her right hip that always “goes out,” AND she can’t do right-leg back Warrior progressions in yoga.
I don’t know enough about the variants available for Warrior, but I did suggest to her, and she understood what I mean, that she didn’t have the right to explore those excursions of hip extension when the basic movement was not functional by a lesser standard.

Well, this morning (about 15 hrs after treatment), the puppy attacks her in bed, and if I understood her correctly, she was uninhibited in chasing after her.  This is after 2 weeks of life-affecting pain.

Look, nothing we did will change what her meniscus looks like on MRI or if a surgeon will be warranted to do something surgically.  What we did do is normalize the local and regional systems and remind the brain that things aren’t so bad.  Then we fix the interregional systems, and like the most of us, we can play the odds that the meniscal tear may be non-impactful.

Folks, be blessed that your children not need someone like Dr. Trish West-Low for pediatric physical therapy.
But if they do, she has the passion and intensity that I am not too humble to recognize in myself.   Maybe I learned it from her.

She thanked me.
I’m still thanking her.

  • June 12, 2010

Leave a Reply 3 comments

Jeff Cubos Reply

Charlie, Gua sha with traumeel GEL. Wipes off easy. If not, use some alcohol wipes. Then you’d be able to apply the tape no problemo.

Just make sure its the gel not the ointment

Trish West-Low Reply

I once and still do consider Charlie Weingroff most brilliant student. From the get-go I knew he would be a force in our field. Academics are often not as clear sighted when it comes to revolutionaries. Yesterday the student became the teacher and patient. Chralie confirmed for me that although I have some wicked movement aberations, an age does not mean that activity levels have to abate. What he did, hurt, I won’t dance around that, BUT for the first time in 2 weeks I am walking pain free with only slight tweaks with lateral movement or tibial roation, and as he mentioned I was able to chase my 4 month old pup down the hall and catch her. Weather or not I will need this knee scoped I will continue to work on the movement asymmetries he found, so that I can continue running, biking and yoga which not only keep me healthy but keep my mind sound. At some point I will have a right to do the warrior series i teach every saturday morning! Thanks again Charlie, keep on teaching! Someday you wil replace all the jerks AND make people better!

Michael Reply

Great case presentation with interesting findings. Always good to find a positive outcome in what otherwise might have been MD…MRI…Surgery…and so on

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