Unraveling the Mystery of Cervical Pain #3: TP7 Ligament Sprains

Transcription

1 Unraveling the Mystery of Cervical Pain #3: TP7 Ligament Sprains Instructor: Ben Benjamin, Ph.D. Instructor: Ben Benjamin, Ph.D. 1

2 Webinar Goal Explore the assessment and treatment of one of the most common neck injuries. Logistics Time: 1 hour Schedule: Presentation min Questions min Ongoing questions: Use chat box Pretest 1. What is the function of the intertransverse ligaments of the neck? 2. Where does the majority of neck rotation occur? 3. What is the cause of most pain at the medial border of the scapula? 4. Which ligament can cause pain in the neck, scapula, upper arm, and chest? 5. What finding(s) will help you tell the difference between a muscle injury and a ligament injury? 6. The TP7 ligament connects C7 and C8. True or False? 2

3 Anatomy Anatomy of the Neck: TP7 Intertransverse Ligament Limits side-flexion Intersection between neck and thorax Vulnerable area in the neck Locating the 7 th Transverse Process 3

4 Referred Pain Patterns in the Neck Referred Pain Patterns in the Neck Referred Pain Definition: Pain felt at a distance from its source. 4

5 Four Rules of Referred Pain Rule #1. Pain refers distally. Four Rules of Referred Pain Rule #2. Pain does not cross the midline. Four Rules of Referred Pain Rule #3. Pain is referred within the dermatomes. 5

6 Four Rules of Referred Pain Rule #4. The distance the pain refers is directly proportional to the severity of the injury. Areas that refer pain Neck Thorax Low Back Shoulders Hip Joints Areas that do not refer pain Elbows Wrists Hands Knees Lower Leg Feet 6

7 Assessment Active Rotations (Pain & Limitation) At least 50% of neck rotation occurs at C1 and C2, the atlas and axis Active Side-Flexion (Pain & Limitation) 7

8 Resisted Side-Flexions (Muscle Pain) Passive Rotations (Pain & Limitation) Passive Side-Flexion (Pain & Limitation) 8

9 Theory Assessment Test Results for TP7 Ligament Sprains Passive rotations are painful Side-flexion away from the injured side is painful Referred Pain Patterns for the TP7 Ligaments 9

10 Referred Pain Patterns for the Cervical Ligaments Causes of Pain at the Medial Border of the Scapula 1. TP7 ligament sprain 2. Rhomboid muscle strain 3. Thoracic ligament sprain 4. Subluxated rib head Primary Structures Injured in Different Parts of the Body Different parts of the body have areas that are more vulnerable. 10

11 Primary Structures Injured in Different Parts of the Body Foot and Ankle: Muscles and Ligaments Primary Structures Injured in Different Parts of the Body Thigh: Muscles Hamstring Quadriceps Primary Structures Injured in Different Parts of the Body Hip: Joint 11

12 Primary Structures Injured in Different Parts of the Body Neck: Ligaments Differentiating Scalene Muscle Injury from a Ligament Injury Resisted test vs. Passive test Direct & Indirect Causes of Pain Examples: Direct ligament sprain in the neck Indirect misalignment of neck, limited neck flexibility, chronic contraction of the neck muscles, poor movement habits, etc. It is important to address both types of causes. 12

13 Treatment Friction Therapy Myofascial Therapy Massage Therapy Stretching and Strengthening Exercises Cranio-sacral Therapy Friction Therapy: The video will be shown at the end of the Webinar Friction Therapy works on the Direct Cause of the pain. Massage Therapy 13

14 The Neck Relaxer Device Reduces occipital muscle tension Flexibility Exercises Aaron Mattes Active Isolated Stretching Method Flexibility Exercises 14

15 Neck Strength Exercises Myofascial Therapy Craniosacral Therapy Correct Movement Patterns 15

16 Referrals Alexander Technique or Feldenkrais practitioner AIS practitioner to increase flexibility and strength Works on the Indirect Causes of the Pain Questions Facebook.com/DrBenBenjamin Post-test 1. What is the function of the intertransverse ligaments of the neck? 2. Where does the majority of neck rotation occur? 3. What is the cause of most pain at the medial border of the scapula? 4. Which ligament can cause pain in the neck, scapula, upper arm, and chest? 5. What finding(s) will help you tell the difference between a muscle injury and a ligament injury? 6. The TP7 ligament connects C7 and C8. True or False? 16