When studying Megan's history and symptoms, critical moments and events stand out in her timeline of pain and dysfunction. Nine years ago, after her second child was born, Megan noticed for the first time that her left foot was slightly wider and longer than her right foot. The timing of this condition is relevant because during her pregnancy, a hormone called relaxin is released into her system to relax the pelvic ligament during childbirth. However, relaxin can also relax the ligaments in other parts of the body, and due to the relaxation of the ligaments, the longer and wider left foot will indicate the major collapse of the arch. This was a turning point in Megan’s history and has since adversely affected her health. The loose ligament may never fully recover its fully stable strength, and it may be because of the painful pain she felt on her left medial side after a few years. A fallen bow will cause excessive internal rotation, which in turn will cause the tibialis anterior muscle and possibly the posterior tibial muscle to be under undue stress as they attempt to stabilize and counteract excessive internal rotation. A stressed or overwhelmed muscle will form a trigger point [TP] inside it. For the tibialis anterior muscle, this may refer to the anterior medial pain as it passes through the retina. TP in the posterior tibial muscle transfers pain to the plantar/foot arch. Excessive internal rotation will result in shortening of the tibialis longus, which will further inhibit the sacral muscle, which will further exacerbate the problems in the continuous vicious circle.

The whiplash experienced last year also increased Megan's problems, and since then she has occasionally had headaches and stiff neck. Whipping injuries will almost certainly affect her suboccipital muscles, sternocleidomastoid [SCM], scalene and other stabilizers in the neck and spine. This whipping can result in incorrect neck movement, which in turn leads to TP in the SCM and may result in long bones on one side [left side] due to differences in leg length. The TP here puts these muscles in a shortened state, causing the head to rotate to the right hand side. If longus colli is involved, it will cause power chain problems and affect the humerus on the side of the lower limbs, further exacerbating the sagging bow. Because the humerus longus is in this unhealthy state, it may have an effect on the pelvic ligament and its ability to hold the tibia in place. Megan said that one day last year, she felt a pain in the right ankle and helped an obese patient from the supine position. She experienced locking/stucking and spread QL, multiple births and painful soft tissue pain to her hips. The fact that she was locked in the right torso flexed showed that QL was on the right side after insulting, and we later found that her right side of the base of the humerus was one inch higher, and the right tibia was rotated backwards, resulting in an imbalance of posture, Megan's 2/3 weight is on her right side. This additional load and posture imbalance results in painful firing in the rotor region and lateral thigh pain caused by weakening of the gluteus medius and tendon bundle problems due to excessive working tension fascia stretching.

With all these pains reaching an unbearable level, Megan turned to prescription drugs, codeine-based painkillers, antidepressants, Zalof, anti-inflammatory pills, all of which were exacerbated by the accumulation of toxins in her system. Her question. She is also affected by painkillers, possibly by doing something she will not do to harm the tissue if she has a natural analgesic system to stop her. The elastic support band and tape will make the situation worse by promoting the atrophy of the supporting muscle tissue.

Megan's right shoulder is lower than the left side, probably because the latissimus dorsi muscle strains the tibia and inhibits the hypertrophy of the upper trapezius and pectoralis minor muscles, causing the scapula to pull forward and downward.

When we consider Megan's problems, symptoms and medical history, we can understand that she is suffering from severe pain and dysfunction above and below the functional power chain. From the plantar fascia pain, spastic tibia longissimus, inhibition of the tibia, medial rotation of the tibia, medial knee pain, lateral thigh pain, rotor pain, lumbosacral pelvic pain and dysfunction, posterior right iliac crest, left lower anterior The spine, 2/3 weight imbalance to the right, QL and back pain, shortened state, latissimus dorsi, neck extensor and flexor all have problems, we have to ask which functional power chain problem we are dealing with. In my opinion, considering all the fields involved, it will be a spiral slant chain.

Megan must be told that her treatment will be broad and long-term, as some problems have been around for some time and will involve neural retraining to address dysfunction and imbalance.

• Medical check.
• Medical record.
• Posture assessment.
• ROM test / nerve test.
• All shortened and restricted muscles must be relaxed/extended by TP treatment, METs, position release/strain-reverse training.
• Inhibition of muscle must be emitted and enhanced by tapotement, METs and intensive exercise.
• STR, cross fiber friction, etc. are required for any bond area.
• One consideration is to refer PCI to the initial left foot and plan to strengthen the field for a long time.
• There is no mention of Megan's nutrition, but I will refer her to experts in the field to ensure that she is not undernourished and will hinder the healing process.

Neuromuscular Physical Therapy – Case Study of Megan was originally published on Spring