Ten second step test

Ten second step test is for those with a serious neck problem that is causing changes in the way you walk.

It's been designed for people with neck pain and major stiffness that they think could be disturbing their gait.  Pressure on the spinal cord in the neck is very uncommon, so it's most unlikely; but it does happen.

Surprising as it may seem, a neck injury can seriously affect the way the legs work. This is known as cervical myelopathy, in which a lesion in the neck (could be any one of many conditions), presses not on the nerves that go to the arm, but on the spinal cord itself. There may be weakness and tingling in the legs, and lack of coordination whilst walking. Unexpectedly bumping into a doorway as you walk through, for example.

Can you see the difference?

Cervical myelopathy

The Ten second Step Test

Stand near to, but not holding onto, a rail or chair, if you think you might fall.

Look at your watch. Raise each leg as fast as you can, so that the thigh is parallel to the ground, and your knee is at ninety degrees. March on the spot. How many times can you do it?

Healthy strong young people can do about 16-23 steps in ten seconds.

If your lower back, hips, knees and ankles are in otherwise good order, and you can only raise your knee less than fifteen times, and you know you have a neck condition, then an assessment of your neck is in order.

Obviously even a healthy eighty-year old would have difficulty raising their knee 15 times. And an obese forty-year old probably couldn’t either.

If concerned, talk to your chiropractor.

Simple three minute test of your general level of fitness: Kasch pulse recovery test ...


Basilar Invagination

In diseases such as Rheumatoid Arthritis there may be softening of the base of the skull allowing the skull to settle deeply on the upper neck bones (or, put differently, the neck bones protrude up into the skull). Pressure on the spinal cord may occur, affecting the way you walk, hence the value of this test.

Symptoms of cervical stenosis

The symptoms of cervical stenosis are in the first instance severe stiffness of the neck. This is mostly from degenerative changes associated with old whiplash injuries that were not well managed at the time, or were so severe that they inevitably left lasting damage.

Those changes, often to the joints of Luschka, or paravertebral joints as they are sometimes called, may affect the nerves to the arms. What's odd is that some people with massive uncinate degeneration still have little symptoms, or very treatable tingling and pain in the arm.

Worse is a bony mass at the back of the body of the vertebra, that can affect the spinal cord causing cervical myelopathy.

Atlanto occipital joint anatomy

If you are concerned about this, then read more about the Atlanto Occipital joint anatomy. Atlanto (first bone in the neck) - Occipital (base of the skull). ATLANTO OCCIPITAL JOINT anatomy

Again, remember basilar is very UNcommon...


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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?

Interesting questions from visitors

CLS writes:

Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.

You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.

The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.