What’s all this neuro stuff about?
I’m really interested in all the neuro stuff you guys do. What’s that all about?
I’m glad you asked!
Let’s say hypothetically, you came to me because you hurt your knee a couple months ago while playing with your kiddo. It’s been affecting your ability to play golf, tennis, workout, kneel down on the ground, cross your leg, and even just walking it starting to become slightly difficult.
When you arrive at the office, you’re going to go through our standard battery of tests, both neurological and orthopedic. The orthopedic testing is going to evaluate your area of complaint (the knee) as well as the rest of your structural system to make sure nothing is out of alignment and the biomechanics are working properly. This would be equivalent to checking the alignment and steering wheel and tires of your car.
You will also receive a neurological evaluation. We will look at the function of your eyes, your inner ear, your balance and coordination, your nerves, and your cognition- in essence we evaluate your brain. This is like a mechanic inspecting your car’s motor, drivetrain and electrical system to make sure nothing faulty is contributing to the electronic alignment control system.
Our philosophy is that the body and the brain will not optimally function without the other. When something goes wrong with one of them, something goes wrong with the other (this is also backed by all scientific literature).
Back to the story.
You present for evaluation. I find that you have breakdown in your balance system with our CTSIB and Single Leg Stance testing (example here). Our FDA cleared balance platform medical device measures proprioception, vision, and vestibular and compares to age-matched statistics. These findings help us determine which neurological systems might be contributing to your knee injury, or if the knee injury is simply due to an orthopedic injury.
On your exam we find your scores as follows: (example general test to the left)
Proprioception is at 50%
Vision is at 25%
Vestibular (inner ear) is at 25%
Next we perform a VNG (a device used to test eye movement and function). This helps us further evaluate your vision and inner ear function. Upon basic evaluation of a simple Nystagmus test we find that your eyes tend to drift right, and refixate left, which would be the definition of a Left Beat Nystagmus. We see these very often and they are not associated with pathology, they’re related to an imbalance in your vestibular system which controls your balance and coordination, as well as muscle tone and shunt stability of your trunk, hips, spine, and limbs. (read up on nystagmus here)
We would then conclude testing with a physical examination, evaluating your knee, and reassessing your entire neurological system at the beside to further see anything our diagnostics cannot see.
Once we determine the cause of your knee injury, the seriousness of the injury, and the state of your neurological system that helps to stabilize your knee, we begin therapy.
We usually start with working on your chief complaint (in this case it would be the knee). We work on all the orthopedic structures that connect to the knee (feet, hip, spine, quads, hamstrings, calves, adductors, glutes, etc), then we continue to stabilize the nystagmus and other neurological findings we had in your initial evaluation.
Most of our patients claim that we were able to help them more or faster than any other doctor they’ve been to, and I would suggest that if this is the case, it’s because of the training we have and the ability to conduct and apply an extensive evaluation and comprehensive therapies that help to stabilize your entire system, not just your knee (in this case).
In addition to the neurological and orthopedic systems we also review labs, run labs, alter nutrition, provide supplements to help improve physiology and to optimize your metabolic system, (running a food sensitivity test and removing inflammatory foods, while providing supplements to heal the gut lining and reduce inflammation is an example of this approach)
Call us at 480-756-2600 or message us via our Contact Us page