Stiff Ribs can cause pain in the LEGS!

Transcription

1 Stiff Ribs can cause pain in the LEGS! Presenter: Kym Finch 2018 Massage and Myotherapy Australia Conference Gold Coast Outcomes Challenge Teach Develop Challenge your thought process Teach new skills in interpretation of orthopaedic assessment incorporating myofascial slings and spine hypomolility Develop new skills that allow you to improve treatment results with minimal effort on your hands 1

2 Linking stiff ribs to leg muscles Myofascial Slings Spine/rib Template Myofascial Slings Continuity of muscle attachments from one muscle to another 2

3 Spine Template When assessing spinal joints for joint play/mobility, identification of hypomobile joints indicate which myofascial sling is involved and where to start treatment. 3

4 T Pectineus 4

5 Tightness in lower back Pain/tightness in trapezius region Signs and Symptoms Mid/upper thoracic stiffness Rounded shoulders Forward head position Often tight masseter/tmj problems shin splints Plantar fasciitis How to assess for treatment 1. Thoracic Rotation 2. Rib hypomobility assessment 3. Central Thoracic spine P/A joint play 5

6 Thoracic Rotation It forms part of every day movement patterns Why Assess for thoracic rotation? Thoracic restriction can overload other regions of the body contributing to pain and dysfunction Particularly neck, lumbar spine and shoulders 6

7 Causes for decreased thoracic rotation Structural scoliosis Functional (reversible) Structural - Scoliosis The treatment aim for structural scoliosis is to maximise their available rotational capability. 7

8 Functional impairment The treatment aim for functionally impaired decreased thoracic rotation is to identify where the reactive and adaptive restrictions are Thoracic Rotation This test is performed with your client sitting with their feet resting flat on the floor. This keeps the pelvis stable enabling the thoracic rotation to occur through thoracic region not pivoting through pelvis. 8

9 Thoracic rotation Sitting Test Feet flat on the floor Spacer between knees Arms crossed with forearms against chest Turn body to left then right Compare rotation 3 Common cheating methods 1. Thoracic rotation and side bending at same time 2. Retracting the scapula 3. Excessive rotation of the neck with minimal thoracic rotation 4. Pivoting through the pelvis when seated 9

10 Rib Hypomobility Joint Play Segmental Spine Mobility The amount of natural movement that occurs when direct pressure is applied: p/a to the spinous process and facet joints All joints have a neutral or mid position 10

11 When the spine moves out of its neutral position: uneven forces distributed through spine results in abnormal loading on spinal structures (ligaments, discs, facet joints etc) Abnormal loading leads to altered mechanics which eventually can lead to pain. Tension in and around a joint whether that be from direct muscular tension or caused from a distal chain reaction can cause pain in: Joint associated muscles Ligaments periosteal insertions skin or fascia 11

12 is an indication of dysfunction. Hypomobility of the Spine Assessing joint play in conjunction with other orthopaedic assessments can give us much of the information needed to correct musculoskeletal dysfunctions and pain. Treatment Disclosure Advise your client that you do not manipulate joints ( cracking neck or back) The purpose of assessing the spine is to identify any decrease of normal movement that might be contributing to their overall symptoms 12

13 Spine Assessment The harder you press the less you feel Apply light pressure The aim of assessing the mobility of the spine is to guage the natural (onset) movement of the joint. Spine Assessment Posterior to anterior movement should be minimal. The joint should NOT be taken to its end range. 13

14 Thoracic T Assessment Ribs 2-5 Central Thoracic P/A T 14

15 Hypomobile Joint Cycle Hypomobile joint Myofascial sling Underactive muscle Ribs Assessment Assessing Ribs 2-5 Place the thumb along the line of the rib at the costo-transverse joint Apply light pressure P/A with inclination towards the feet 15

16 Thoracic T Treatment Neuromuscular contraction Pectineus 16

17 T Pectineus neuromuscular contraction Legs straight with patella pointing towards ceiling Cube between knees Roll leg 1cm towards block Relax & repeat 17

18 After Pectineus treatment To alleviate muscular pain and reinforce the altered muscular pattern, gluteus maximus stretch is suggested. Glute Stretch Lie on back Bend one knee Place opposite hand on outside of knee Pull knee across body DO NOT twist your back Hold 30 seconds 18

19 Contact: Kym Finch (07)