Hi Tanya Van MD...

I think you are actually right and that the muscle reaction is more forceful than you would expect.

I believe that they are working so hard because something else is driving the problem.

You say that hypomobility of the Wikipedia reference-linkSIJ exists...how do you assess this?

You also say that manipulation is difficult and not firm - what do you mean by this?

In my opinion, focusing on the lower leg symptoms are not going to solve your problems but i think you already know this...have you assessed every joint from the foot up? I think this is where you should be now - test each joint in the foot to the ankle then the knee, hip, SIJ, each L/S joint, each costovertebral and costotransverse and T/S joint. You are looking to see if they are doing their job properly. It will take time but i think you need to be thorough and work through her problem systematically and logically.

Let us know how it goes