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A coaching colleague of mine has posed the following questions and is eager to obtain some more professional comments. Dr Mel C Siff [log in to unmask] ------------------------------------- <One of my teenaged athletes who has been having chronic lower back pain was recently evaluated by a physical therapist. He did the knee jerk and ankle jerk reflex tests, and told her that, based on these tests, the nerves surrounding L5 disc were not affected. In one of Cailliet's books, he says, "The knee jerk and ankle jerk reflexes are routinely tested to determine the integrity of nerve roots L3-L4 and S1. There is no reflex to test L5, as the muscles innervated by this root have no specific tendon." This lass was having balance problems (always tripping over her feet) and her left middle three would often go numb. (In the past the doctor called it "restless leg syndrome" and not to worry about it.) Cailliet says "The ability to pick one's toes up and clear the floor while walking so one does not scuff one's foot in walking is a function of L5." My question is, has there been a change in the extend of the effectiveness of the reflex tests since Cailliet's books have been published? Or should my athlete seek out another therapist? Also, she had problem rising from a squat (and this is figure skater), but in an X-ray taken a year ago there was no problem with L3-L4. Calliet states, "The L3-L4 nerves go to the thigh muscles. These thigh muscles extend (straighten) the knee and permit a person to do a bend at the knees, do a deep knee bend, rise from a sitting position, climb or descend stairs, and do squats. These muscles permit the patient to walk, run, jump, and so forth by virtue of the fact that they control the muscles that perform these activities." Also, "By virtue of their specific distribution, if these nerves (L2, L3, and L4) are irritated, they will cause weakness of the thigh muscles. This weakness will make it difficult to do a deep knee bend, go up and down stairs, or get in and out of a chair. So, my second question is, is it possible that the X-ray is not a good way to determine irritation in the discs? Or could the doctor simply had misread the X-ray? Any insight would be appreciated. > ---------------------------------------- Dr Mel C Siff Denver, USA [log in to unmask]