NECK PAIN - CERVICAL SPINE PAIN - Longer Version - Mobilizations With Movement

[babybunnies]

QUESTION:How would you treat someone or would you treat someone who has a problem turning their head to the complete right or (left) due to an elevated first thoracic rib causing pain and blood circulation problems?? exercising which i already do for my neck is not enough for the bone needs to be put into place to release the pressure being put on the blood vessles and such.

[ProPTRehab]

Bottom Line, whatever works... we need to call our theoretical models theoretical so we don't misinform patients.

[ProPTRehab]

It's kind of amusing to see people dislike this video. What is there to dislike? It's not professionally filmed perhaps.

[zsmores244]

My doctor told me to go to the Chiropractor. I have an appt next wednesday and I am freaking out.....

[ProPTRehab]

@zsmores244 I'm not a chiropractor.

[tonytang2222]

bad video and audio ...

[WingThaiJ]

@tonytang2222 If he had something better to film with, I'm sure he would have used it.

[workingstiff76]

The Chiropractor in this video had the woman stretch her neck but did not attempt to adjust it by applying sudden force. I think this is the proper way to work on the neck and I applaud the chiropractor for doing it this way. Well done! Neck adjustments can be dangerous if manipulated by force.

[ProPTRehab]

@workingstiff76 Thanks, but I'm a physical therapist; however, there ARE Chiropractors who do the same or a similar thing.

[butagaris]

Awful Nokia 3300 Video Cam.

[jonlscott]

so high,...... faiiling..... asleep... but i want anouther joint

[WingThaiJ]

@jonlscott watch the shorter version...

[WingThaiJ]

@jonlscott ROFL

[dakshphysio]

the audio quality needs improvement



[WingThaiJ]

@dakshphysio This is what happens when you use a Lap Top; it's all I had sorry

[butagaris]

2:17 the lady screamed " uummhh" from pain you caused to her neck! Why did u do that u hurt that girl why? I need to expose u to police give me ur address

[ProPTRehab]

@butagaris LOL; thanks for the laugh!

[NaTesRehabMan]

I am a practicing Physical Therapist in Manila. I have a patient who has been complaining of cervical pain. His radiographic results revealed some osteophytes have formed. His pain scale in the beginning was 8/10 and after 9 PT sessions, PS was at 6/10. I think this might be helpful to him, but where are your thumb and fingers' exactly located as your client moves her neck? Are the fingers placed on the area where pain is most felt? Thank you Sir.

[ProPTRehab]

@NaTesRehabMan firstly, osteophytes have to be disrupting something to be the cause of the problem. For example, one may have osteophytes and be able to move through a pain free ROM. If this is the case, they are not the concern. Sometimes it can be a concern if, for example, right rotation with pain at the same point in the range w/same mvmnt no matter how many you do this mvmnt (bony spurs don't move) & no treatment changes this.

[ProPTRehab]

@NaTesRehabMan Thumb over thumb just over area of pain to provide a traction/distraction to the joints which results in pain-free movement in the direction that was painful. Lower c/s 45 degree angle, upper is P-A. Most of the time a lot of force is not needed. 

[LegPains]

@ProPTRehab

whats your Opinion of Structural Integration or Rolfing ?

[WingThaiJ]

@LegPains I have mixed feelings about it. For one thing, it 'will not' remove tissue obstruction from between the vertebrae. I think it's sometimes applied too hard and actually can cause tissue damage to muscles (contusion & the sort) & some people may be just fine doing independent instructed activities. As muscles and joints respond to gravity, you are likely to reassume previous postures over short time periods following treatment. For muscle imbalances I believe there is more (continued)

[WingThaiJ]

...(continued) For muscular imbalances,  there appears to be more research for the Shirley Sahrman Method (you can good her name). All of that said, it's another modality to choose from; some people will love it, some won't like anything. If someone finds benefit to it for themselves, I'm fine with it.

[LegPains]

@WingThaiJ

i have 2 bulging discs at L4 L5 and L5 S1 causing intense Leg Pain and nothing so far is helping so  i was going to try Rolfing

[WingThaiJ]

@LegPains Part I There was a recent study showing how Massage of the foot in men and the hindpaw in dogs performed by applying external pressures of 70-100 mmHg for a period of 1, 3, 5, and 10 min w/a frequency of 25 strokes per minute. This protocol was performed on individuals w/out edema, on dogs w/experimental lymphedema & men w.post-thrombotic venous edema. After 10 minutes of forceful massage, focal DAMAGE of lymphatics was present (Continue to Part 2)

[WingThaiJ]

@LegPains Part IV: Vigorous massage in lymphedema also produces loosening of subcutaneous connective tissue, formation of large tissue channels and release of lipid droplets that enter the lymphatics. By this mechanism, massage helps reduce amount of fat cells in the lymphedematous leg.

Eliska O, Eliskova M. Are peripheral lymphatics damaged by high pressure manual massage? (Continue to Part V)

[WingThaiJ]

@LegPains Part VI Lymphology [serial online]. March 1995;28(1):21-30. Available from: MEDLINE with Full Text, Ipswich, MA. Accessed March 5, 2011 - SO What do you suppose is happening with ROLFING? I think you can answer this question yourself now!

[TheYaom]

I suffer from chronic muscle spasms that make my nerve on the left side of my neck tickles and annoy me.

many time I wake up with very stiff neck and upper back hurts..... many times the neck gives me headaches that last all day.

I was told it could be my pillow and maybe i should see a chiropractor.... do u think this could help?

[ProPTRehab]

@TheYaom Muscles are rarely if every the primary cause of spinal pain, although theoretically they may become involved secondarily as one guards due to pain. It is better to have your spinal joints treated while in their natural physiologic state. Cineradiographs have shown jt separation after manipulations which places jt in a state we don't function w/in normal daily life. It can feel good, I don't object it as a last approach, but there are many ways to allow a jt to function properly w/out

[ProPTRehab]

(continued) w/out thrusting it to the point you hear a pop. Also, some try to 'loosen' a perceived point that is fixed, however, it's been shown that segments away from the area actually are the one's that "pop" because the force is transmitted to more mobile segments which are already mobile and don't need to be increased in mobility. Many chiro's are fortunately getting away from the putting a bone in place idea & are starting to focus jt function. People just need to keep up with the science

[ProPTRehab]

@TheYaom google a Brian Mulligan, PT trained therapist in your area. Headaches often come from the c/s, often the upper c/s which there are many self applied techniques that can help. There are many ways to support your head/neck when sleeping, whichever allows you to wake with the least amt of pain in a.m. is the best. Rolled towel around neck wtth bathrobe belt inside often works great as when you sleep it goes with you where you go & supports neck. I'd have to describe to you in more detail

[ProPTRehab]

Upper cervical manipulation should be avoided in patients who are taking anticoagulant drugs.

[yunn1981]

Just a thought on VBAI if thats the major concern - most well performed neck HVTs use a minimal ammount of rotation as that is considered the most significant factor in vertebral-basilar artery insult. Are you not using a large degree of rotation and in sustained manner?????

[WingThaiJ]

If you are asking me, I bring the c/s toward it's en-range in the orientation of the facet plane. I bring it toward the end-range and have the patient add overpressure and it has to be pain-free. VBI is usually a concern, as you know with extension or the addition of extension, but if there is a concern for VBI than you certainly test for this first. I don't have to hold end-range rotation any longer than what you see in the video.

[ProPTRehab]

I meant to say, VBI is a concern with extension and the addition of rotation. .

[WingThaiJ]

If the patient's history requires I test for VBA insufficiency, I will test it. However, all this procedure does is have the patient rotate to the point pain begins, placing thumb over thumb & in line with orientation of the facet joints, you can lift and add minute pressure to allow for pain-free range of movement. Also, note that there is no extension with rotation and it is unlikely to cause any problems for VBA, but again, if I find the need to test for that, I will.

[ProPTRehab]

@yunn1981 VBI is a concern with extension combined with rotation. This is a normal movement pattern of rotation and the patient adds overpressure with her own hand, while relaxed, at the end-range of the available movement.

[ProPTRehab]

Chiropractors are scoring this low because some think I'm having a dispute with them. I'm not; the procedure used can be an alternative if there is a concern manipulation may be contraindicated in certain cases; also, this technique works great for patients who need it.

[ToddSonoma]

"Manipulation not needed" could have easily said, "Awkward physical therapy mobilization not needed."

[ProPTRehab]

You comment makes no sense! Mobilizations with movements worked for this patient; and they are not awkward. It's quite comfortable for the therapist and for the patient. There was no need for end-range thrust; no need to risk even remote possibilities of manipulative problems if you don't have to. Numerous chiropractors do the exact same thing I do and the last conference produced much research validating the approach.

[shyrDOM]

no reason to be insecure. manipulation is simply not always needed. as professionals we owe it to patients to consistently educate ourselves on less aggressive techniques, just like surgeries. compare meniscal repairs/removals now to the 70's. big difference.

[ProPTRehab]

@shyrDOM: Nicely put!

[WingThaiJ]

@ToddSonoma manipulation has a good chance for cavitation; a good chance to loosen the joint taking it out of it's normal physiologic status as cineradiographs have should with such procedures. Why would you want your 1st approach to do this when such laxity is more susceptible to gravitational forces? Why wouldn't you want to reestablish normal pain-free movement, make the jt do what it's suppose to do w/out having it placed into this state via manipulation if you don't have to?

[kalabitpenge]

@ToddSonoma

Stupid Chiropractors. You think that manipulation is the answer to all problems in the world--from blindess to lameness. Grow up. We all know that you're after physical therapists as being that the PT profession is biggest threat to your survival. Bunch of morons.

[jonlscott]

@kalabitpenge yet u say there scamming millions out of people, they sound smart to me, legal robbery

so whoes winning u the doushe bitching on youtube, or this guy rolling in money

you lose

[ProPTRehab]

@jonlscott I'm not a chiropractor. Thanks!

[helifiks]

Mulligan?

[ProPTRehab]

Mulligan Mobilizations has been continued to be proven beneficial in the research. Many PhD researchers have presented at the last international meeting! It's Great when research supports what you do!

[ProPTRehab]

If manipulation works Great; this is a method that often works without having to manipulate. Just another tool!

[ProPTRehab]

Mulligan Mobilizations With Movements

[ProPTRehab]

Sorry for poor quality of audio & video; used laptop to record.