Neurological exam and structural treatment following lumbar disc injury, flexion-distraction ASMR.

Our patient Jeneen had a herniated disc a couple of years ago, and after a great deal of thought and advice, opted for a surgical microdiscectomy. As happens in most of these cases, the healing is not rapid or linear, and she still feels some stiffness in the lower back and tingling and cramping in the right leg as the result of the injury.

We discussed her progress and I determined that there was no present tension on the nerve root with a straight-leg raise, Braggard's test, and Valsalva maneuver. She also had full strength of the toe flexors and extensors, the tibialis anterior, peroneus tertius, and tibialis posterior, and peroneals.

She does have some sensory deficit in the right leg consistent with the dermatome of S1, which correlates to the L5 disc, which is the disc she injured. The conclusion was that there was slight compression of the S1 nerve root on the right.

Following the exam and determination that treatment would likely help, we worked prone through the lumbar and sacral regions using myofascial releases and flexion/distraction, as I try to talk through my thought process and what I'm seeing as I work with Jeneen.

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Intro and discussion 0:00
Leg neurological exam 1:15
Discussion of finding and gentle prone work 7:05
Gluteal fascial release 10:10
Initial prone traction 11:47
Full flexion-distraction 12:18
SI releases using flexion-distraction 14:50
Full back myofascial releases 19:00
Neck work 24:25
Cervical adjustments 26:30

Thank you for watching! You are appreciated! :)

Dr. David Russ
Chiropractor
Portland, OR
www.happyspinepdx.com/contact