Podcast
Questions and Answers
What is the main reason why slump is more aggressive than SLR?
What is the main reason why slump is more aggressive than SLR?
- Compression with sitting affecting disc and neural structures (correct)
- Lack of sensitivity in the maneuver
- Reducing nerve movement through soft tissue
- Inability to reproduce symptoms
Which technique involves getting the nerve to move through a 'container' to address adverse soft tissue causing issues?
Which technique involves getting the nerve to move through a 'container' to address adverse soft tissue causing issues?
- Repeated extension
- Supine leg holding
- Cervical flexion
- Flossing (correct)
What is the goal of therapy intervention when dealing with pain?
What is the goal of therapy intervention when dealing with pain?
- Reducing ROM
- Centralization of pain (correct)
- Increasing neural tension
- Peripheralization of pain
What is neural tension defined as in the context provided?
What is neural tension defined as in the context provided?
Why should one be careful with nerve pain according to the text?
Why should one be careful with nerve pain according to the text?
What position is recommended to start radicular pain treatment?
What position is recommended to start radicular pain treatment?
What is the main purpose of performing manual traction?
What is the main purpose of performing manual traction?
What could be a consequence of having one segment out of alignment in hypermobility?
What could be a consequence of having one segment out of alignment in hypermobility?
Which technique focuses on compression of innominate bones for form closure?
Which technique focuses on compression of innominate bones for form closure?
Why is symmetry in the pelvis critical when considering loading bilaterally or on a single leg?
Why is symmetry in the pelvis critical when considering loading bilaterally or on a single leg?
What is the purpose of performing active SLR as part of the treatment for hypermobility?
What is the purpose of performing active SLR as part of the treatment for hypermobility?
How can patients correct for good pelvic symmetry according to the text?
How can patients correct for good pelvic symmetry according to the text?
What is the recommended sequence of steps when correcting an anterior rotated pelvis?
What is the recommended sequence of steps when correcting an anterior rotated pelvis?
Why is it important to activate local muscles rather than letting global muscles take over?
Why is it important to activate local muscles rather than letting global muscles take over?
What is the key emphasis when focusing on anterior neutral spine or 'Pelvis Neutral'?
What is the key emphasis when focusing on anterior neutral spine or 'Pelvis Neutral'?
What is the purpose of lumbar stabilization training?
What is the purpose of lumbar stabilization training?
Why should individuals be taught to sit properly and maintain a normal lordotic curve?
Why should individuals be taught to sit properly and maintain a normal lordotic curve?
What role does activation of the transverse abdominis play in lumbar stabilization?
What role does activation of the transverse abdominis play in lumbar stabilization?
What should be considered when assessing a patient's movements that trigger pain in the lumbar spine and pelvis?
What should be considered when assessing a patient's movements that trigger pain in the lumbar spine and pelvis?
When working with a patient in physical therapy, what should you focus on incorporating into the plan of care?
When working with a patient in physical therapy, what should you focus on incorporating into the plan of care?
What is a crucial aspect to address before a patient can accomplish their most important task or activity?
What is a crucial aspect to address before a patient can accomplish their most important task or activity?
When assessing a patient's movements, what should be determined to understand if they are resistant to move or if they move too much?
When assessing a patient's movements, what should be determined to understand if they are resistant to move or if they move too much?
In the context of manual therapy, what factor should be considered when deciding if a patient can rely on self-management?
In the context of manual therapy, what factor should be considered when deciding if a patient can rely on self-management?
What is the purpose of using instrumentation like the Chattanooga Stabilizer in stability training?
What is the purpose of using instrumentation like the Chattanooga Stabilizer in stability training?
What does the SI Belt assist with when it is worn low around the hips?
What does the SI Belt assist with when it is worn low around the hips?
In what manner can the lumbar corset or support be beneficial for individuals?
In what manner can the lumbar corset or support be beneficial for individuals?
What type of exercises can be performed using the Chattanooga Stabilizer while maintaining a certain pressure?
What type of exercises can be performed using the Chattanooga Stabilizer while maintaining a certain pressure?
What is a feature of the SI Belt when worn around S2 to provide stability to SI joints?
What is a feature of the SI Belt when worn around S2 to provide stability to SI joints?
How does utilizing multiple postures challenge stability during exercise?
How does utilizing multiple postures challenge stability during exercise?
Why is exercise referred to as the most potent and underutilized free antidepressant?
Why is exercise referred to as the most potent and underutilized free antidepressant?
What is the importance of biomechanical correctness in exercise?
What is the importance of biomechanical correctness in exercise?
Why is activating local muscles emphasized over global muscles during exercise?
Why is activating local muscles emphasized over global muscles during exercise?
What determines the amount, plane, and speed of motion during exercise therapy activities?
What determines the amount, plane, and speed of motion during exercise therapy activities?
Why should exercises be conducted with good form and posture?
Why should exercises be conducted with good form and posture?
In what way does exercise therapy focus on empowerment for patients?
In what way does exercise therapy focus on empowerment for patients?
What is the most common mechanism of injury for osteitis pubis?
What is the most common mechanism of injury for osteitis pubis?
Which group of athletes is most prone to developing osteitis pubis?
Which group of athletes is most prone to developing osteitis pubis?
What is a common symptom of meralgia paresthetica?
What is a common symptom of meralgia paresthetica?
Which factor is NOT considered a predisposing factor for meralgia paresthetica?
Which factor is NOT considered a predisposing factor for meralgia paresthetica?
What treatment approach is recommended for meralgia paresthetica?
What treatment approach is recommended for meralgia paresthetica?
What should be initiated when acute symptoms of osteitis pubis subside?
What should be initiated when acute symptoms of osteitis pubis subside?
What is a possible anatomical variant that may predispose to injury in E FAI?
What is a possible anatomical variant that may predispose to injury in E FAI?
Which of the following is a resultant symptomatic pathology associated with E FAI?
Which of the following is a resultant symptomatic pathology associated with E FAI?
What sign involves putting the thumb in front of the groin area to assess hip pain?
What sign involves putting the thumb in front of the groin area to assess hip pain?
What does FADIR sign indicate in E FAI?
What does FADIR sign indicate in E FAI?
Which condition covers all hip pathologies that are not arthritic, according to the text?
Which condition covers all hip pathologies that are not arthritic, according to the text?
What is recommended as the highest level of therapeutic exercise prescription in E FAI?
What is recommended as the highest level of therapeutic exercise prescription in E FAI?
In exercise dosing, what is the recommended course of action if a person experienced a flare-up and the symptoms lasted for 24 hours?
In exercise dosing, what is the recommended course of action if a person experienced a flare-up and the symptoms lasted for 24 hours?
Which scale is used to measure perceived exertion levels from 1 to 10, with 10 being extremely tough, in gauging exercise intensity?
Which scale is used to measure perceived exertion levels from 1 to 10, with 10 being extremely tough, in gauging exercise intensity?
What type of exercises are typically prescribed for endurance training?
What type of exercises are typically prescribed for endurance training?
For power training, what is the recommended number of sets and intensity level?
For power training, what is the recommended number of sets and intensity level?
What aspect is emphasized in the exercise progression to correct deviations and reduce pain?
What aspect is emphasized in the exercise progression to correct deviations and reduce pain?
What does the acronym RPE stand for in exercise prescription?
What does the acronym RPE stand for in exercise prescription?
Which condition is characterized by pain often aggravated by sitting, squatting, or walking, and is more common in females?
Which condition is characterized by pain often aggravated by sitting, squatting, or walking, and is more common in females?
What is the best piriformis stretch according to the text?
What is the best piriformis stretch according to the text?
Which injury results from a direct blow to the iliac crest and may exhibit exquisite tenderness in soft tissues around that area?
Which injury results from a direct blow to the iliac crest and may exhibit exquisite tenderness in soft tissues around that area?
What differentiates a Morel-lavallee lesion from a quad contusion?
What differentiates a Morel-lavallee lesion from a quad contusion?
'Greater Trochanteric Pain Snapping Hips' is also known as:
'Greater Trochanteric Pain Snapping Hips' is also known as:
What is a key characteristic of core muscle injury or athletic pubalgia without a true herniation?
What is a key characteristic of core muscle injury or athletic pubalgia without a true herniation?
What should be considered when managing proximal hamstring injuries?
What should be considered when managing proximal hamstring injuries?
'Morel-lavallee lesion' is commonly managed with which intervention?
'Morel-lavallee lesion' is commonly managed with which intervention?
What is a common symptom of a core muscle injury or sports hernia that helps differentiate it from other conditions?
What is a common symptom of a core muscle injury or sports hernia that helps differentiate it from other conditions?
What activity can exacerbate symptoms of proximal attachment injuries?
What activity can exacerbate symptoms of proximal attachment injuries?
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Study Notes
Treatment Principles for the Lumbar Spine and Pelvis
- Key goals to accomplish during PT: incorporate functional meaningful activities, consider category/classification of hypomobility, hypermobility, instability, and inflammatory issues
- Suspected pain generators: hands-on or hands-off treatment, reliance on manual therapy, and self-management
- Big picture considerations: resistance to movement, excessive movement, local pain, and radiating pain
Radicular Pain
- Radicular pain can also be referred to as peripheralization
- Goal of therapy intervention: centralization of pain
- Neural tension: inability of the nerve to slide and glide through tissue
- Flossing: technique to reduce adverse neural tension
- Be cautious with nerve pain due to latency
Hypermobility
- If one segment is out of alignment, it can cause biomechanics shift for the rest of the spine
- Excessive movement: constantly changing/shifting
- Causes of hypermobility: trauma, pregnancy, and SI instability
- Pain can be located in buttocks, hip, and groin
- Transitional movements and walking are uncomfortable
Treatment for Hypermobility
- Form and force closure: perform active SLR, compression of innominate bones, and sacrum wedged between two hemi-pelvis
- Muscle energy technique (MET): assess symmetry, need to assess if ASIS are level in supine
- Correction: patient can correct to have good pelvic symmetry
- Self-correction: whatever thumb is closer to the ground when checking ASIS
Lumbar Stabilization
- Stabilization training: combination of motor control, neural input, and passive restraints
- Sub-maximal training that should become subconscious
- Training should adapt to static and dynamic movements
- Teach in multiple positions, with normal breathing
Pelvic Thigh Pathology
- Osteitis pubis: classification based on tx mechanism of injury, overuse, stress injury
- Signs and symptoms: palpation tenderness over pubic symphysis, symptoms often exacerbated by passive ABD, resisted ADD, or abdominal contractions
- Management: rest, NSAIDs, normalize SIJ, and osteitis pubis cont management
Meralgia Paresthetica
- Definition: dysfxn of sensory lat femoral cutaneous n of the thigh
- Predisposing factors: obesity, pregnancy, and tight pants
- Signs and symptoms: pain and parethesias over upper anterolateral thigh
- Management: avoidance of irritating activities, selective rest, NSAIDs, SIJ screen/tx, wt loss, and ADL modifications
Piriformis Syndrome
- Definition: deep aching in the sciatic notch of the buttock
- Signs and symptoms: referred posterior thigh pain, often aggravated by sitting, squatting, or walking
- Management: ultrasound, HP manual therapy, and soft tissue mobilization, gentle piriformis stretching, and address faulty pelvis, hip, or foot mechanics
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