The innervation of the lower extremities is carried out by the lumbar and sacral plexus, mainly at the level of the TXII-SII segments..

With osteochondrosis of the lumbar spine, peripheral syndromes and corresponding changes of predominantly reflex origin develop not only in the joints of the pelvis, but also in the joints of the lower extremities.

These changes are described as hip periarthritis syndrome (chronic pericoxarthrosis), knee periarthritis syndrome (chronic perigonarthritis), ankle joint syndrome, neurotrophic foot syndromes, and others..

In the course of the disease, contractures, infringements and compaction of soft tissues around the joint occur, etc.. This makes it difficult and limits their function, and also statically and reflexively affects the function of the spine..

hip joint.

The study of the function of the hip joint is carried out by methods accepted in orthopedics.

Determine the length of the limb (relative, anatomical, by segments), the presence of contracture in the hip joint, range of motion (flexion, extension, adduction, abduction, rotation with a fixed pelvis). Palpation reveals seals and tender points. During repeated rhythmic active and passive movements, a certain mobilization of the joint is achieved..

Then the patient is placed on a trestle bed in the position on the stomach with the lower limbs lowered and relaxed.. The patient's arms are extended along the body, the muscles of the body are in a state of relaxation.. To perform the manipulation, the palmar surface of the left hand is placed on the outer surface of the hip joint in such a way that fingers III and IV are placed above the greater trochanter. Careful, but sharp and short, strokes are applied to these fingers with the right hand..

After this, the patient is turned on his back.; he must be relaxed. Stretching and shaking the toes several times is carried out in order to obtain a relative relaxation of the capsular-ligamentous and muscular apparatus.. After that, the first finger of the left hand: set in the inguinal region at the site of the projection of the right hip joint.

The right hand grabs the knee joint and produces maximum flexion in the hip joint until a slight crunch is felt, which is felt with the first finger.. Then the lower limb of the patient is grasped with both hands for the distal part of the lower leg above the ankle joint and a sharp pull is made along the axis of the limb.. This procedure, if indicated, is repeated several times..

Similarly, manipulation is performed on the left hip joint, which is captured by the right hand of the doctor..

At the next stage of manual therapy, the patient should stand on the floor. The doctor, being behind him, simultaneously captures both hip joints with both hands as follows: he sets the first finger in front in the inguinal region at the projection of the hip joint, and with the rest of the fingers captures the joint from behind. The patient is asked to sit down.

Simultaneously with the patient, the doctor also squats, pressing with his fingers on the area of \u200b\u200b\\u200b\\u200bthe joints and thereby increasing flexion in them to the fullest possible extent.. Then the doctor helps the patient to stand up.. The procedure according to indications is carried out several times. As a result of the manipulation, the reflex spasm is removed, the muscles relax to a greater or lesser extent and soreness decreases..

The number of sessions and courses of treatment is determined individually.

Knee-joint.

The study of the knee joint begins with examining it, identifying the volume of active and passive movements.. In order to mobilize the knee joint, sips are performed on the toes, achieving relaxation of the capsular-ligamentous and muscular apparatus.. They also carry out passive flexion and extension movements in the joint.

Manual therapy is carried out in the position of the patient and the doctor sitting on a trestle bed in a comfortable position.. The doctor is located on the side of the diseased lower limb. With the area of \u200b\u200b\u200b\u200bthe popliteal fossa, he lays it on his knee, and the patient's lower leg - on the thigh of the other leg. Then, with the fingers of both hands, the doctor covers and palpates the patient's knee joint, while simultaneously making rocking movements in it with his lower limbs..

medbe. en.