I really enjoy treating kids, especially elementary aged and teenagers because they tend to respond so well to osteopathic manipulation. Recently I wrote about a 5-year-old with left leg pain that was keeping her awake at night and really limiting her with playing and being active. She had somatic dysfunction present that was changing how her pelvic girdle was functioning and was creating her pain. A couple visits and she is back to normal. I had another experience with a young lady recently, aged 9 that was very similar. She is a dancer, active, very talkative and an all-around enjoyable great kid! Her mom got ahold of me based on a recommendation from another teens mom that I helped back into sports. This young lady’s mother called me back in September and seemed very exasperated due to the fact she had a child with leg and hip pain that was really affecting her being a kid. It all started back in mid-May when her left leg began to give way with walking for some unknown reason. It kept getting worse and by the end of May she was unable to sit in the criss cross position on the floor due to pain and lack of motion in her left hip. At the beginning of June, she went to Nationwide Children’s and saw an orthopedic physician. X-rays were performed that came back normal and she got the diagnosis of bursitis and was prescribed anti-inflammatories. I see this all too often. One of the problems is a horrible exam is performed or not really performed at all. If a good clinical exam was performed, it would be known the pain was not coming from hip bursitis…very frustrating! Of course, the anti-inflammatories did not work, and her symptoms became worse and at this point she was having a hard time walking, was crying in pain and could not rotate her hip into external rotation, which is the position where the toes turn out. She had an MRI done in mid-June that also came back as normal so the ortho doctor performed a hip joint injection for pain control and diagnostic purposes. She did not get any relief from the injection and at the end of June she started traditional physical therapy. It was thought maybe she had a labral tear, but this was ruled out at this point in time. Her pain kept getting worse and the ortho department at Children’s Hospital sent her to the Sports Medicine Department in July. She was prescribed gabapentin, which is a powerful nerve pain reducer and anticonvulsant medication, along with another round of anti-inflammatory medicine. Her pain did not change, and she was using crutches at this time and due to the lack of progress Children’s Sports Medicine department sent her to Cleveland Clinic’s rheumatology department to make sure she did not have an autoimmune disorder. After that trip, the young girl and her family were left deflated and feeling hopeless because Cleveland Clinic was unable to help. Time continued to pass, and nothing really changed, and it was mid-August when another hip injection was tried without help. Around this same time, the exhausted little girl was sent to Children’s Cincinnati for a second opinion and to further rule out a labral tear. She underwent another injection under sedation with a specialized MRI that can better visualize the hip labrum. That test also came back normal. Throughout all this time, her whole summer was lost, she missed out on dance, which she loves, and the beginning of school was being affected. The whole family was feeling hopeless I was told. It was the end of September when I received a phone call from the young girl’s mother. It was explained to me what was going on and what the symptoms were and a general history of all the treatments that were tried. From the phone conversation I remember saying I am pretty sure I can help in a couple of visits. It sounded like the typical history of a lumbosacral dysfunction that was shutting down the glutes and causing pain to go into the hip and into the leg. These dysfunctions are not easily diagnosed unless a good clinical exam is performed, and one knows what to look for. These are the kinds of patients I fix all the time and the history tends to be similar so that is why I was confident I could help this young lady. The first treatment was in the beginning of October and I knew what was going on from the evaluation I performed. She had left hip and leg pain, had a moderate limp with gait, had very little hip external rotation present, very weak glute max and medius muscles, and core weakness. Her left hamstring was increased in tone/tightness due to her glutes being shut down and inhibited, which happens quite often. The hamstrings will tighten to help create stability of the pelvic girdle when the glutes are not doing their job. I treat using Muscle Energy Technique, which is an Osteopathic Manipulation, along with myofascial release, stretching, and exercises that complement the manual medicine. After the first visit she did not feel significantly better, but when I assessed her on her second visit, I knew I would win the battle. Her spine moved better, her glutes were firing easier, and her hamstrings were not as toned/tight. She still had some of the same dysfunction present due to the fact her spine had not been properly mechanically working for months. By the third visit she was significantly better. She looked pretty much back to normal. I did see her for a fourth visit just to make sure we had it beat. She was able to return to dance and get back to be the normal, rambunctious little girl she had been before May when this all started. This is why I am so passionate about manual medicine and the manual medicine program at Michigan States Osteopathic Medical School. These professors and teachers have changed my way of thinking bout the body, how to assess and treat pain. The more I learn, the more I realize I am only scratching the surface of healing from manual medicine. The bad part is people don’t know manual medicine exists and they are so used to just taking medicine, doing traditional therapy, or listening to the physician that says nothing is wrong. Well there are other treatments that are very successful and powerful out there, but the hard part is getting people with pain to learn about them. I’m trying one patient and word of mouth at a time!