Posted On: September 1, 2017
This is the nineteenth case review from my past practice. I am Dr. David Johnson a chiropractor and physical therapist in Highland Park and Lake Bluff. I am the director of North Shore Spinal and Sports Rehabilitation. I started as a chiropractor in Lake Forest Il in 1988. I integrated physical therapy into my practice in 1990.
This is a composite case one that has played out in my practice with many a distance runner in my practice over the years. The case I am going to describe is a 35-45 year old, male who comes in with a “hamstring strain” on a particular side that has been bothering them for 3-4 months.
I typically ask them how did you strain your hamstring? The response is typically, “I don’t know it just started acting up one day.” I then ask does it hurt when you run up hills. This type of patient will typically respond that it doesn’t and that running actually makes it feel better. I then ask does it hurt on long car rides? Often times the answer is yes that long car rides are the worst.
I proceed with my exam. I will have them lie on their back and raise their leg stretching the hamstring. I will elevate slowly to see if it starts to bother them. If it does I stop and have them push their heel into my hand with about 10% of their effort. I hold my hand in place. In 9 out of 10 cases this relieves their discomfort. I then pull on their foot to flex the ankle. If this increases their pain I know it’s not their hamstring.
I explain to the patient you don’t have a chronic hamstring strain but rather a subtle sciatic problem. Typically I get some push back, at this point. I then explain that a hamstring strain usually has an acute injury at the start and hurts when you run up hill. I also explain that prolonged sitting in a forward flexed posture. Loads the discs of the lumbar spine and can provoke sciatic complaints causing sciatica. I then point out that when I had them contact their hamstrings it didn’t provoke their problem but when I put more tension on the sciatic nerve it did.
Then I examine their lumbar ranges of motion and perform appropriate neurologic testing. Typically in this type of case the patient responds to extension orientated exercises like prone press ups popularized by the McKenzie Method. At North Shore Spinal and Sports Rehabilitation we then progress them into spinal stabilization and nerve mobilization.
These patients often respond quite favorably and have recovered within two-three months and continue to do well if they keep up with their home exercises.
North Shore, Dr. J and the staff were great. I started out with a pinched cervical nerve which was causing extreme pain and numbness in my arm. Surgery had been ruled out by the neurosurgeon after an MRI. My physical recommended a regimen of physical therapy which I undertook with NorthShore in November. At that time I had consistent pain in the range of 8-9 out of 10. I had trouble sleeping, driving and performing most normal daily activities due to the constant pain. I have now been through two series of physical therapy sessions with North Shore over a couple of months and the pain and numbness are completely gone. Based on my experience I would highly recommend North Shore for physical therapy treatment and the staff is extremely friendly and helpful as a bonus! Jon HeintzelmanJonathan Heintzelman
All aspects of the rehab program were done with professionalism. Intake evaluation, exercise program, massage therapy and exit evaluation were all excellent and yielded excellent results for me. All of the staff are friendly and efficient. Dr. Johnson, Jeannette, Cyprian and Mary are friendly and make an otherwise difficult experience much more tolerable. I have gone to them on two occasions over the last several years for different injuries and, in both instances, my problems were resolved. I highly recommend them.Lee Eddy
I was a patient 6 years ago, with lower back pain and herniation. My PT was excellent and I was back to exercise and resolution of pain and herniation. Recently I have had hip pain and and tingling down my leg. My evaluation with DR Johnson was very thorough and spot on. The PT with Dre was incredible. I am now pain free with a resolution of the tingling as well. I will definitely return for any future problems that may arise!Barbara Bank