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Case study of lower extremity instability resolving with Atlas Orthogonal care.

Lower back result with atlas work.


   Patrick Gallagher, D.C., B.C.A.O.

Chiropractic First PC

1304 East Ash Street

Goldsboro, North Carolina 27530

(919) 735-4300

Disclaimers:  This is only a single case and I only stating the clinical findings and outcome of this case. I am not purporting anything beyond that.

Patients consent to this case study was obtained and is on file.

Key Words: Atlas Orthogonal,


Patient had sought out full spine chiropractic care, over the counter medicine and prescription with no relief. Under Atlas Orthogonal (AO) care there was noticeable improvement upon the first atlas correction.

The patient was a sixty three year old female with a chief complaint of left knee instability in addition to sharp low back pain that she wakes us with. She had fallen down on the follow dates due to her left knee giving out; 1/9/14, 1/12/14, 1/14/14, 1/18/14 and 1/22/24.  She had no previous history of left knee instability. .During the consultation she shared that she had left leg foot drop dating back seven years.  Yet this would go away after five to six chiro. visits. The patient had tried 2 weeks of full spine adjustments that equaled four office visits with no lessening of the pain nor improvement in the knee’s instability. After the first fall on 1/9/14 the patient began taking three Advil every four-six hours. After her fourth fall the patient added to the Advil 100 mg of Neurotin and 500 mg of Relafen on 1/18/14.

Patient states she has kidney stones flair up the month of December and the first week of Jan.. She also complains of headaches.  Otherwise the patient reports in good health and is concerned about her knee giving out on her.

The remarkable part was the examination, more so what didn’t show up. The Range of Motion (ROM) of the dorsolumbar spine was all within normal limits. No pain or discomfort was noted in that section of the exam. All orthopedic testing of the lumbar spine was negative.  Even static and motion palpation of the lumbar spine failed to elicit any discomfort. The only positive finding on the lumbar spine was a weakness upon dorsiflexion of the left big toe challenging the Extensor Hallucis Longus muscle.  Yet the Heel Walk test was negative.  One would expect that to be positive if the L-5 nerve root was involved. *

  A width measurement two finger above her left knee showed that side 1 cm narrower.

Cervical Spine examination revealed a decrease in left rotation and stiffness and pain in the sub-occipital area with left lateral flexion.  Right shoulder depression elicited left sided neck pain.  Scanning of the upper cervical spine was done on a scale of 0-3 with 0 being no pain nor palpable finding and 3 being the highest score. Left C-2 was a grade 1 and right C-2 was a grade 2.  Supine leg check revealed the left leg was a quarter inch shorter, while the prone leg check showed a balance leg length.  All other testing was negative.

The patient was diagnosed with cervical subluxation of C-1, ICD 839.01.

Management and Outcome:

The first visit on 1/24/14 the patient had her atlas/C-1 adjusted with the Atlas Percussion Instrument, followed by ten minutes of rest. As of today 3/3/14 the patient has not had to have her atlas adjusted again. The following nine visits she was treated with the Activator Adjusting Instrument using the Advanced Activator analysis while her upper cervical spine palpated clear. The patient maintained an incident and medicine diary. After her first visit her use of medicine declined in time between dosing. On 1/30/14 she was taking two Advil and one Neurotin, on 2/3/14 she was only taking Advil. After 2/4/14 she was no longer taking any meds. The back pain was gone on that date and yet the numbness in her knee lasted until 2/17/14. She has three more visits remaining in her care plan. She is now focusing on re-strengthen her left leg with one leg squats and calve raisers.


Finding the true cause to a patient’s chief complaint is paramount in their care. As in this case the chief complaint was her left knee was so unstable that it was “giving out” on her.  This is typical a low back problem.  The low back examination proved negative in all aspect shy one. In cases like this if reveals how impactful an atlas displacement can be.  That when a case presents itself that the symptoms don’t line up with the findings look to the “master control switch” of the nervous system. Freeing up the nervous system to function as it was intended to.

*Physical Examination of the Spine and Extremities by Stanley Hoppenfeld p. 227

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