Correcting Severe Antalgic Posture & Gait

The purpose in sharing this Sports Medicine Acupuncture® case study on correcting severe antalgic posture and gait is threefold:

  1. To show you that people with severe debilitating conditions can reclaim back their health and life.
  2. To introduce you to effective treatment approach with Sports Medicine Acupuncture®.
  3. To initiate a dialogue between you and people you care about, who might be suffering from limiting pain conditions.

Clinical Presentation

Mr. Harris came to our clinic in mid-December, a week before Christmas of 2018. He was seeking relief for a very debilitating back condition. He had a pronounced antalgic posture and gait with severe spasms along his left erector spinae muscles.

In fact, when he came in, his body literally looked like a disfigured question-mark.

Patient’s Background

Mr. Harris is a 36-year-old gentleman, 5’10”, who looks well nourished and is in overall good shape. He is an avid traveler and holds himself to a rather active lifestyle. He has been traveling around the world with his girlfriend for many months out of the year, when his back injury took place.

Up until that point, and for the past 10 years, Mr. Harris, has had issues with his back, but it would come and go, or sometimes just irritate him while doing a workout. During the last six months, Mr. Harris has been noticing frequent episodes of severe sciatica (pain shooting down his leg) along with a reduced ability to work out.

The Incident

In June 2018, during his stay in Bali, Indonesia, while performing a sudden abrupt motion, or more precisely, while trying to smack-down a cockroach holding a shoe in his hand, Mr. Harris felt a severe shooting pain in his right lower back. Initially, he thought he had just thrown-out his lower back. However, the pain was so incredibly severe that he had no choice but to get urgent medical attention.

He ultimately was sent over to a hospital in Bangkok, Thailand for further medical care. The severity was not found out until he had an MRI scan. The surgeon then asked him how he was even walking. An MRI showed significant degeneration at both L4/5 and L5/S1 disc segments in his low back, which required performing an urgent micro-discectomy surgery.

His surgery was performed in the beginning of July 2018, and overall went well. Three months later, around October of 2018, he felt good enough to start hiking, swimming and cycling again. He was already back in San Diego with his girlfriend’s family.

However, the day after Thanksgiving 2018, following several days hiking, he woke up and realized he wasn’t able to stand up straight and was in pain. Sitting became extremely uncomfortable. Within three to four days, he realized that this condition was not going away.

Standing straight was impossible and to walk or stand was taking so much effort he had to kneel or lie down out of breath. First, he tried to resolve this issue with chiropractic care. He had 10 chiropractic sessions, which he found to be painful and non-helpful.

Being an athlete, and having a good past experience with traditional acupuncture, Mr. Harris was recommended to our clinic in December 2018.

Orthopedic Assessment & Diagnosis

As shown in his initial assessment photos, Mr. Harris’ body had a notable antalgic posture.

His body was severely hunched over to the right. As a result, and in an attempt to compensate for this excessive right lean, his left back muscles had to go into constant spasm as they were struggling to keep his shoulders and head upright. He also had a notable forward lean. Interestingly, when measuring his hips, he had no elevated ilium, however, both his hips had been significantly tilted posteriorly (over 20˚off of normal).

Mr. Harris was totally limited on activities that required standing and walking for more than a few minutes. Attempting to turn his body in bed or lifting up his leg while laying down, would cause a severe debilitating pain in his lower back and down his left hip.

Treatment Guidelines

  • Restore integrity to the lumbar-sacrum junction by reducing local inflammation and muscle guarding in the lumbo-pelvic tissues and increasing proprioception.
  • Relax muscle spasms in the lumbar region.
  • Restore shortened muscles to their normal length, focusing on right abdominal wall muscles and bilateral hip flexors.
  • Perform postural exercises to correct hip disparity & muscle imbalance to improve antalgic posture and gait.
  • Treat Mr. Harris’ TCM constitution.

Antalgic Posture Treatment

The following two steps comprised the acupuncture treatment plan for Mr. Harris’ severe antalgic posture and gait:

  • Step 1: 5 weeks plan of acupuncture at 2x/week
    Results were significant! Mr. Harris’ gait has been greatly improved along with a fantastic increase in his ability to carry out activities of daily living. Regular acupuncture sessions with daily corrective exercises have greatly increased his ability to heal and recover.
  • Step 2: 5 weeks of acupuncture at 1 x / week along with introducing him to Foundation Training® exercise program (a self-paced online program for strengthening the postural muscles, developed by Dr. Erik Goodman)

Consistent acupuncture care along with systematic strengthening of the body postural muscles have contributed greatly to his healing process and to correcting his antalgic posture and gait.

Obstacles

The following were obstacles surrounding the treatment of Mr. Harris’ severe antalgic posture and gait:

  • Notable muscle soreness and general fatigue following the early acupuncture sessions, as his body adapted to the therapeutic needling stimulation and activated healing processes.
  • Frustration and depression from daily struggle with pain and disability.
  • Frustration with alternating pain patterns (pain moving from left to right and then switching back to left again).
  • Dealing with other stressful “life” events.

Results at Six Weeks

The results after six weeks of acupuncture treatment of Mr. Harris’ severe antalgic posture and gait were excellent.

Mr. Harris antalgic gait is minimally visible. He is no longer having spasms in his left low back muscles. His pain levels are minimal and he feels completely functional. He is now able to keep up with his normal daily routine.

Results After Total of 12 Weeks of Treatment

After 12 weeks of acupuncture treatment of Mr. Harris’ severe antalgic posture and gait, he is now able to walk and drive for hours with no limitations of time or distance. His posture looks normal and his ability to carry full schedule days is now a reality. He is now swimming half a mile and doing a 100 push-ups, 40 pull-ups and 100 abs exercises. He is looking forward to getting back to running again.

Here are images of Mr. Harris’ posture after an additional six weeks of care (one visit per week):

Mr. Harris’ Comments

“I have been dealing with back issues on and off for almost 10 years. …At the beginning of 2018 I knew I needed to start taking care of the situation. …Then the incident with the cockroach happened and I immediately knew I had done some serious damage. There would be times after that that I would be lying on the floor in absolute agony. …MRI confirmed severe disc degeneration at L4-5 and L5-S1.  …3 days later I was on the operating table.

The surgery was a huge success. …Everything seemed great and the next 4 months I didn’t really have pain. …Then after about 4 weeks of doing the first set of exercises since the operation, like indoor cycling, swimming and hiking I woke up one morning and couldn’t stand up straight. At first, I thought it would be temporary. But very quickly I realized that this was a real problem and the pain and now inability to stand up become a great concern. …At first, I went to a chiropractor which didn’t fix the problem and at times almost made it worse. I then was recommended to see Uzi by a friend.

…The first thing Uzi did was to change my mindset from fear to building confidence in the practice of acupuncture and myself to get back on track. The sessions were intense. My left side of my back’s muscles were like concrete and relaxing those took weeks alone. Even with the back muscles relaxed I was still leaning to the right although now I was standing more upright. However, walking was becoming easier and Uzi had given me some exercises to work on my hip alignment. The real breakthrough was after a difficult time over the holiday period. …I still remember how exhausted I felt afterwards but it also seemed to be the turning point. After this session my mobility and back alignment was starting to progress forward more rapidly.

…Uzi, along with all the fantastic treatment and knowledge he gave me, made sure I stayed mentally healthy and positive.”