This is certainly true and PT is the best way to rehab it. I would ask your questions to the therapist as they will be the ones who have the best practical advice. If you are having significant weakness, you can always seek a second opinion while going through therapy. Neuro would be a reasonable choice as it is related to the spine and possible issues with nerve innervation. There are some great orthopedists that specialize in spine that would also be appropriate. Ask the therapist. They will usually be very forthcoming about who to see and who not to see.

By "doctor" do you mean an MD that wants to do an exploratory surgery-- like throwing a dart in the dark?

Further, I would say that a DO can be a better physician than an MD, but your misunderstanding of what constitutes a "doctor" is a common misconception amongst the general public (so don't feel bad).

---

Proud Representative of Slowtwitch Anti-Atheists Society.

Now, now. Don't let the distinctions get in the way. There are ortho's that are actually D.O. phyiscians. I have a friend who is a fantastic sports med guy that is also an ER physician and sports med doc. The title does not ever tell about the quality of the provider or the care they are capable of providing. Sure, there are some bad D.O. phyisicans out there, but there are some equally wretched MDs as well.

If you are not getting the answers you need from the current doc, get a second opinion. It isn't about hurting someone's professional feelings; it should be about getting good information and helpful treatment.

If you still have visible atrophy this far out then that may be a primary focus. Either try very isolated and aggressive glute strengthening to fatigue multiple times a week and if thats not working then possible nerve conduction or innervation tests. Talk to a sports physiatrist if thats the case. I'd be curious as to the efficiency of the exercises chosen for those glutes and technique. Also PTs can tend to be on the conservative side and you may need the complete opposite, but it sounds like some innervation issues could exist.

SIJ trauma can cause inflammation to surrounding peripheral nerves. Have them check pelvic alignment before, during and after exercises.

Good luck

I would be worried that you might have an S1 radiculopathy. you could've suffered an L5-S1 disc protrusion encroaching on the S1 nerve. This would exacerbate symptoms with walking uphill because of forward flexion onto the disc. an MRI or EMG along with thorough neuro exam may help confirm.

Then again, I'm just a schmuck DO MSK/Spine physiatrist.

 Hey Prior .... I hope you get a real notable SI problem so that I can shut my Chiro office doors when you come knocking.

Very helpful info, thank you.

I do not now and have never had back pain. Not even pain in the SI area.

I can still bounce my right butt cheek independently of the left and I can bounce them simultaneously. Seriously. I'm not talking about dancing (although some strippers do this), but I'm talking about stimulating the gluteal muscle(s) by simply thinking about it… the significance about this to me is that it is unlikely that the muscles are paralyzed- although the gluteus medius might be innervated by a different nerve (branch) compared to the gluteus maximus or other accessory muscles...

I've been thinking about seeing a neurologist, but I want to stay with the same practitioner b/c I think he can help me recover faster, but b/c he is not a runner or triathlete it may take him longer b/c he relies heavily on my subjective input.

---

Proud Representative of Slowtwitch Anti-Atheists Society.

You are medical doctor specialising in Physiatry?

Why? Everyone does the exact same "Adjustment" the exact same way no matter what I ever went to a Chiro for.

I thought about an educated response to your post but decided against it since all I would get back is some more profession bashing. Its a bit mind boggling that a question is asked in a serious manner and several bloggers decide to shit on someone else's profession. This site is full of professionals and I would like to guess that there are many Osteopaths/Chiropractors that not only compete in Triathlon but also follow this forum. Why don't you divulge what you do to support your family and then some of the other contributors can bash and shit on what you do.

x2

Yet another example not all sense is common.

I just noticed chiropractors serve as the medical directors for the US olympic committee. Clearly that must be a dark form of witchcraft or other quackery, otherwise why would they even be serving our greatest athletes?

There are equally great and awful DO's, MD's, DPT's, ATC's, DC's. We all have something to offer. Find a person who is well credentialed and well referred you like and trust. If you don't respond to their treatments, you're a consumer and have every right to leave and find someone else!

---

"No matter how hard you train, Somebody will train harder. No matter how hard you run, Somebody will run harder. No matter how hard you want it, Somebody will want it more, I am Somebody"~ST Post

Listen, I really am not bashing. I have been to Chiro's on four different occasions in over a 15 year period for different reasons. All 4 visits went like this. Filled out a form with pertinent questions. Asked to watch a video on the reasons to keep coming for improved health. Meet the Doctor who is very professional and shows genuine concern. Then does the "adjustment". All visits the exact same, with every Doctor. Then two offered for a fee, ectro something on the exact site of pain and a massage chair.
I am sorry if you think that is bashing. 4 Doctors, 4 the same experiances. These guys were recommended. Also others tell me the "adjustment" is always the same. If you think that is bashing, well I am sorry, but those are the facts. You were the one with the snarky remark to the other poster.

Kenney,

Most of my appointments are 20-30 minutes long.

I'm sorry that's been your experience, but I've heard just as many horror stories from patient's that did not respond to other forms of care. My office is nothing like that.

See my previous post.

No videos, no "educating". My rules are generally simple: You're clearly getting better in 3-6 treatments, typically immediately, and continue to see obvious improvements until you are close to asymptomatic. I then rapidly space out your visits until you are pain free or your home exercises correct the problem.

If I can't help in that given time frame, you fire me.

When you're pain free and fully functional, I fire you.

---

"No matter how hard you train, Somebody will train harder. No matter how hard you run, Somebody will run harder. No matter how hard you want it, Somebody will want it more, I am Somebody"~ST Post

As in my recent post. All "MY" (n=1) visits have been the exact same and were a complete waste of $$$. One of the Doctors plan, just happened to be equal to the number of visits my insurance paid for. There is a reason many do not care for Chiro's. Maybe the answer is the policing within the profession itself.

Found the info pasted below. This pretty well describes the difficulty that I have while walking uphill, and it could explain why my hamstring often feels strained.


Gluteus maximus lurchInjury to this nerve leads to a gluteus maximus lurch. When gluteus maximus is weak/injured, trunk extends (lean back) on heel-strike on weakened side. This compensates for weakness of hip extension.
Damage to the inferior gluteal nerve causes loss of extension at hip, and causes the buttock to waste.
The normal gluteus maximus gait is when the gluteus maxims begins to contract at moment of heel-strike, slowing forward motion of trunk by arresting flexion of hip and initiating extension. When gluteus maximus is weak, trunk lurches backward (gluteus maximus lurch) at heel-strike on weakened side to interrupt forward motion of the trunk.[11]
There is great difficulty in preventing the flexion of the trunk heel strike so the person may use trunk extension before heel strike to maintain balance causing a backwards lurch.[6] The trunk lurches back on the stance phase side hyperextending. The backwards trunk lurch persists throughout the stance to maintain the gravitational force line behind the hip axis locking the hip into extension. There is an apparent forward protrusion of the affected hip due to exaggerated hip motion and the person may also hold the shoulders backward to keep the center of gravity behind the joint. The hamstring muscles often compensate for the gluteus maximus weakness resulting in a near normal gait pattern but most often theses muscles are affected together

---

Proud Representative of Slowtwitch Anti-Atheists Society.

Sounds like your health wasn't the ultimate priority.

If you choose to try another one of my colleagues, I recommend searching for one here. Although nothing is every concrete, there is a very high chance you'll have a great experience.

---

"No matter how hard you train, Somebody will train harder. No matter how hard you run, Somebody will run harder. No matter how hard you want it, Somebody will want it more, I am Somebody"~ST Post

Well then let me publicly apologize for any offense. Though my experiences were bad then, I certainly will not go so far as saying they are quaks out to fleece. I honestly just do not get it after going. I am in my mid fifitie's and do ultra's now.
Honest question, is not the adjustment of straightening the spine what is done, and do not all the Doctors do it the same way? I honestly have never heard of any other manipulations done. They used a hand tool on a specific spot but besides that, always the same. Maybe this post is showing my complete ignorance, but the other people I ask that swear by you guys say its the same adjustment they get.......
This is getting of the orignal post...................again my apologies to you

I'll PM you privately, sorry to the OP

---

"No matter how hard you train, Somebody will train harder. No matter how hard you run, Somebody will run harder. No matter how hard you want it, Somebody will want it more, I am Somebody"~ST Post

Um DO's go to medical school and are physicians. The main difference between DO school and MD school is the additional osteopathic training which a lot of DO's rarely to never use once they are practicing (unless they only do osteopathic medicine which is rare in and of itself). Chiro on the other hand . . . . . .

Thats not entirely correct.

DO's by definition go to Osteopathic school, just like I went to Chiropractic school.

You are correct that the primary DO/MD distinction is the requirement of osteopathic training (less than 200 hours compared with my 1500). I agree its not employed by most DO's in practice.

Total hours of education are equivalent, all studies support it. The primary difference is my significantly shorted residency requirement: 1 year vs. 3 for a MD/DO.

Why? My interventions are manual, non-surgical, non-invasive, and are considered amongst the safest you can try. In fact I'm generally as dangerous as star-gazing or getting your hair done at the salon. If I was performing high risk, surgical techniques, you bet your bottom dollar I would want more hands on training!

I would be absolutely worthless in an ER, orthopedic surgical setting, or even at a nurse's station. That's not what I'm trained to do, but I know when that referral needs to be made, and I've got a great network of amazing DO/MD friends to refer to!

When it comes to mechanical pain and nerve related injuries? I'm the American Medical Association's recommended solution.

---

"No matter how hard you train, Somebody will train harder. No matter how hard you run, Somebody will run harder. No matter how hard you want it, Somebody will want it more, I am Somebody"~ST Post

Send me a PM with your information and I'll try to find a DPT/DC/DO that is trained to help you.

---

"No matter how hard you train, Somebody will train harder. No matter how hard you run, Somebody will run harder. No matter how hard you want it, Somebody will want it more, I am Somebody"~ST Post

Back to the original ?, I have had some success with acupuncture activating some muscles that were causing me problems. You need to find a good one that works with musculoskeletal complaints primarily. There are some out there just not a lot.

The rest of you get your own room and duke it out there.

long time schmuck DC orthopedist agrees

explore denervation issues at this point
EMG/electrophysiology eval needed

.

---

RayGovett
Hughson CA
Be Prepared-- Strike Swiftly -- Who Dares Wins- Without warning-"it will be hard. I can do it"