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Daniel had low back issues as a result of something that happened to him when he was a baby. He had to experience low back pain for over 10 years before understanding this.
When he came to see me he already knew had a herniated disc in his lumbar spine. He said he'd tried every type of treatment but would keep getting these flare-ups in his back.
During his assessment I wanted to see how he moved around in his day-to-day life to give me an idea about how he habitually directed stress through his spine.
So, I drop a pen on the floor and I ask him to pick it up.
He bends forward, flexing through his spine as he grabs it. I notice that his shins are almost vertical as he does so. I ask him if he's aware that he was moving through his spine.
He replies, 'yes, of course, I wouldn't be able to pick it up otherwise.' So, I ask him why he doesn't use his knees and hips more.
That's when he tells me that he was born with club feet: a congenital condition where the feet are twisted inwards, out of their normal position.
He'd had successful surgery to correct it when he was a baby, but it had left him with very limited ankle mobility, something that he rarely thought about because for him, this was normal.
This meant that whenever he picked something up off the floor, got out of a chair or lifted something heavy, he was forced to move through his spine. Throughout his entire life.
Moving like this isn't an issue for most people if it's occasional. But, when you can't move any other way and it becomes your default movement pattern for decades, it can lead to problems.
The intervertebral discs in your spine are like tough, fibrous rings with a gel centre. If you repeatedly bend your spine in the same direction (especially under load), those outer fibres can start to delaminate - fraying, layer by layer.
Do this for years, and it can eventually result in a disc bulge or herniation. Daniel's operation when he was a baby had set the stage for this happening decades later.
Given the length of time he'd been moving in this way, I didn't know how much we'd be able to improve his ankle mobility. But, fortunately, we managed to make significant improvements in just a few weeks.
This allowed him to squat lower while keeping his spine in a more neutral position. He could sit, stand, bend, pick things up without aggravating his injured disc every single time. More importantly, he now had awareness of what the problem was and how to prevent further damage.
When he stopped provoking his disc 50 times a day, it finally had a chance to calm down and start healing.
None of the medical professionals Daniel had seen in the previous ten years had taken the time to observe how he moved. Neither had they asked him in detail about his personal history.
The key to Daniel's recovery was there waiting to be found. He just needed the right kind of assessment.
