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Re: musculoskeletal myths#7 pubic symphesitis
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Re: musculoskeletal myths#7 pubic symphesitis - September 1, 2005 4:24:00 PM
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SJBird55
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From: Michigan
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As I had prefaced my post... I was being overly sensitive. I'm sorry I can't hear the tone anyone takes when they type or hear what words are stressed to know that I'm perceiving what I read correctly.
Anyways...
So, Geoff - You're still using basically a pain provocation kind of assessment at the patella. I'd be really curious, in particular with women, if you assessed more along the lines of the research Christopher Powers has published? And, maybe, hmmm, Powers I believe with everything I have read only tends to go as proximally as the hip? I can't remember... I think the hip though, off the top of my head. I wonder if biomechanical markers at the spine were put in place if something just might be occuring at the spine too? I don't know.. but his stuff seems to make pretty darn good sense. And, from a sports medicine perspective and from a preventative perspective, I'd think there would be a subgroup of folks that would require the kind of approach he has published. His isn't focused on the VMO at all... but seems to combine a lumbar stabilizing approach with a hip strengthening view along with what I guess I'd call body awareness or something to assist proprioceptively with the specific sport activities.
So, I guess what I'm curious about in a really round about way... you really aren't assessing function or movement patterns aside from the progressive squat which to me sounds like you are only focusing on pain, but not on the biomechanics of say what the hip is doing in regard to hip abduction/adduction or internal/external rotations. Have you by any chance happened to notice the quality of the movement pattern prior to treatment and then again post treatment?
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Re: musculoskeletal myths#7 pubic symphesitis - September 1, 2005 5:20:00 PM
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ginger
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From: Melbourne Victoria
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You are right I am not interested in what the hip is doing or not doing, I'm only interested in what activity may limit freedom at L3. The biomechanics are about an inhibitory effect referred from L3 , which disturbs the normal recruitment pattern at VMO. Fix L3 and the problem is solved. By attention to"lumbar stabilisation " Powers may make sufficient difference that inflammatory evnts are reduced at L3, which one would expect. I take the dirct route to pain relief by focusing on mobilisation first. Considerations about what may have caused the L3 hypomobility are a second order priority for me.
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The Grand Pediculator
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Re: musculoskeletal myths#7 pubic symphesitis - September 1, 2005 5:31:00 PM
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srcase
Posts: 551
Joined: November 30, 2004
From: Michigan
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Ginger,
Playing devil's advocate again....does L3 only innervate the VMO muscle??
Sarah
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Re: musculoskeletal myths#7 pubic symphesitis - September 1, 2005 8:48:00 PM
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ginger
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Joined: February 26, 2005
From: Melbourne Victoria
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Sarah Sarah Sarah, If you get to be devil's advocate , that would make me God's wouldn't it?, that's a heavy responsibility, I'm not sure I'm up to it.
But here goes, umm err, no. By this question, ( forgive my second guessing you, but isn't that Gods job ?)I wonder if you mean , is there any other effect brought about by L3 hypomobility. Well sure there is, quite often there will be medial knee pain. This is often misinterpreted as either a positive Medial meniscus sign, or a medial collateral lesion.
Once again it is immediately altered by appropriate attention to L3. Dural stretches help. No doubt Dianne will be warming up her typing fingers to offer an alternative involving neuromodulation at this point, as well she can.I'm not the subtle type however, I get such spectacular and lasting results with the continuous mobilisation method that I'm less inclined to pursue the kind of modality she describes. By this I do not intend to offer any disparagements at all, I think her ideas are brilliant, just a struggle for me at this stage to reverse gear into strange territory.
The weekend has arrived and I'm off to visit my grand daughter, talk again soon.
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Ubi est mea anaticula cumminosa?
The Grand Pediculator
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Re: musculoskeletal myths#7 pubic symphesitis - September 2, 2005 3:31:00 AM
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Shill
Posts: 1092
Joined: February 13, 2003
From: Madison WI USA
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Diane and SJ, just an FYI
I found a study on the traps and shoulder function after neck dissection, with a nice lit review included in it. From Head and Neck, june 2004. They do mention the quality of life issue versus the life issue. The percent of these folks with long lasting pain is fairly high, as you will see. I disagree as to what they call "standard PT" after this procedure, as what I consider standard PT is most of what they studied as experimental PT.
And whats a Kardassian?
A PILOT STUDY OF A RANDOMIZED CONTROLLED TRIAL TO
EVALUATE THE EFFECTS OF PROGRESSIVE RESISTANCE
EXERCISE TRAINING ON SHOULDER DYSFUNCTION CAUSED
BY SPINAL ACCESSORY NEURAPRAXIA/NEURECTOMY IN
HEAD AND NECK CANCER SURVIVORS
Margaret L. McNeely, BSc PT, MSc,1 Matthew Parliament, MD, FRCPC,2 Kerry S. Courneya, PhD,3
Hadi Seikaly, MD, FRCSC,4 Naresh Jha, MBBS, FRCPC,5 Rufus Scrimger, MD, FRCPC,2
John Hanson, MSc6
1 Physical Therapy, Rehabilitation Medicine Department, Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta T6G 1Z2 Canada. E-mail: margiem@cancerboard.ab.ca
2 Radiation Oncology, Cross Cancer Institute, Department of Oncology, Faculty of Medicine, University ofAlberta, Edmonton, Alberta, Canada
3 Faculty of Physical Education, University of Alberta, Edmonton, Alberta, Canada
4 Division of Otolaryngology, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
5 Radiation Oncology, Cross Cancer Institute, Department of Oncology, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
6 Division of Epidemiology, Alberta Cancer Board, Cross Cancer Institute, Edmonton, Alberta, Canada
Accepted 5 December 2003
Published online 10 May 2004 in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/hed.20010
Abstract: Background. Shoulder dysfunction remains a frequent complication after neck dissection procedures for head and neck cancer.
Methods. We conducted a pilot study to evaluate the effects of progressive resistance exercise training (PRET) on shoulder dysfunction caused by spinal accessory neurapraxia/neurectomy in patients with head and neck cancer. Twenty patients (mean age, 61F7.7 years) were randomly assigned to PRET or standard care intervention. Subjects assigned to the PRET group exercised
three times per week for 12 weeks. The goal of the exercise program was to enhance scapular stability and strength of the upper extremity. The resistance-training program was progressive
in terms of number of sets and repetitions performed, as well as the amount of weight lifted, depending on performance status.
Results. The completion rate for the trial was 85% (17 of 20).
The exercise group completed 93% of scheduled exercise sessions. Significant improvements were found in favor of the PRET group in active shoulder external rotation (p = .001),shoulder pain (p = .038), and overall score for shoulder pain and disability (p = .045).
Conclusions. The study results demonstrate a high rate of completion and adherence with our PRET program among patients with head and neck cancer. The preliminary findings, although limited, also suggest a potential therapeutic role for resistance exercise as an adjunct to standard physical therapy treatment.
A 2004 Wiley Periodicals, Inc. Head Neck 26: 518–530, 2004
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Steve Hill PT
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Re: musculoskeletal myths#7 pubic symphesitis - September 9, 2005 4:08:00 AM
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SJBird55
Posts: 2432
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From: Michigan
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Thanks Shill. My family members have the metastasized colon cancer to the lung and metastasized breast cancer to the shoulder, spine, hip and brain.
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Re: musculoskeletal myths#7 pubic symphesitis - September 9, 2005 5:19:00 AM
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Diane
Posts: 1506
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From: Vancouver, B.C., Canada
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Shill,
[QUOTE]And whats a Kardassian?[/QUOTE]Sorry, I didn't see this til today. A Kardassian is a star trek humanoid with flared traps that belie its reptilian ancestory. Sorry I wasn't able to find a picture. You'll see them frequently in reruns of Deep Space Nine.
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Re: musculoskeletal myths#7 pubic symphesitis - September 9, 2005 1:18:00 PM
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Synergy
Posts: 592
Joined: March 11, 2004
From: Texas
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Here's Garak, a Cardassian from Deep Space 9. :)
[IMG]http://upload.wikimedia.org/wikipedia/en/7/76/Garak.jpg[/IMG]
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Chris Adams, PT, MPT
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Re: musculoskeletal myths#7 pubic symphesitis - September 9, 2005 1:28:00 PM
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Jon Newman
Posts: 1706
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From: Amherst, WI
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Chris, how do you do that? That is how do you add a picture? I tried it once and failed. I haven't tried, tried again but I'd be willing to with guidance.
jon
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Re: musculoskeletal myths#7 pubic symphesitis - September 9, 2005 7:36:00 PM
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Synergy
Posts: 592
Joined: March 11, 2004
From: Texas
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Jon,
In order to post a picture, it needs to be located somewhere on the web. For example, right click on the picture I posted, click on properties, and then highlight the URL (i.e. http://upload.wikimedia.org/wikipedia/en/7/76/Garak.jpg). Obviously the link I just pasted appeared only as a link and not a visible image.
In order for the picture to be seen and not the link, paste the copied URL between image brackets, i.e. [img]paste URL here[/img]. Give it a shot and I'm sure it will work for you...especially since you are THE Linkmaster. :)
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Chris Adams, PT, MPT
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Re: musculoskeletal myths#7 pubic symphesitis - September 10, 2005 3:38:00 AM
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Diane
Posts: 1506
Joined: March 9, 2001
From: Vancouver, B.C., Canada
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Chris, thanks, I'm sure we all benefit from your tutoring.. the link seems to not work however. I edited out the period at the end and it still wouldn't work. :p
Anyway, yup, that's the Kardassian visage. Too bad his neck doesn't show up very well in that picture. But hey, at least you found one, and furthermore, knew how to link it, and furthermore, taught the rest of us how. :)
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Re: musculoskeletal myths#7 pubic symphesitis - September 10, 2005 9:41:00 AM
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Synergy
Posts: 592
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From: Texas
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The link doesn't work because of both the parenthesis and the period, but I needed it to appear that way for an example. I am here for the greater good of this forum so if there's anything else I can do just let me know. ;)
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Chris Adams, PT, MPT
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Re: musculoskeletal myths#7 pubic symphesitis - September 10, 2005 9:48:00 AM
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Diane
Posts: 1506
Joined: March 9, 2001
From: Vancouver, B.C., Canada
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(Doh!) :rolleyes:
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Re: musculoskeletal myths#7 pubic symphesitis - September 10, 2005 10:07:00 AM
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Jon Newman
Posts: 1706
Joined: April 24, 2004
From: Amherst, WI
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Thanks Chris. Your information has been assimilated.
[IMG]http://www.greatlink.org/data/8420/dominiongfx/tears/tear023.jpg[/IMG]
jon
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Re: musculoskeletal myths#7 pubic symphesitis - September 10, 2005 12:27:00 PM
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Diane
Posts: 1506
Joined: March 9, 2001
From: Vancouver, B.C., Canada
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Ah! Much better view of the lovely hypertonic traps.
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Re: musculoskeletal myths#7 pubic symphesitis - September 10, 2005 8:19:00 PM
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Synergy
Posts: 592
Joined: March 11, 2004
From: Texas
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[QUOTE]Thanks Chris. Your information has been assimilated.[/QUOTE]Jon, we're discussing Cardassians...not the Borg. :)
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Chris Adams, PT, MPT
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Re: musculoskeletal myths#7 pubic symphesitis - September 11, 2005 3:40:00 AM
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Jon Newman
Posts: 1706
Joined: April 24, 2004
From: Amherst, WI
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Hi Chris,
Apparently you've never seen where I work.
Here's a pic
[IMG]http://www.terrace.qld.edu.au/moo/borg/borgcubeexterior.jpg[/IMG]
My cubicle is the one with the bright light (at the center).
jon
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Re: musculoskeletal myths#7 pubic symphesitis - September 11, 2005 4:50:00 AM
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Synergy
Posts: 592
Joined: March 11, 2004
From: Texas
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ROFL Jon! My first question to you is how much do you pay in gas everyday to get to work? That's bound to be a very very expensive round trip...wouldn't you say? BTW, since you posted your place of business, here's [URL=http://home.swipnet.se/~w-50236/starwars/deathstar.jpg]mine[/URL]. Several of our floors are under construction, so pardon the apparent mess. :)
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Chris Adams, PT, MPT
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Re: musculoskeletal myths#7 pubic symphesitis - September 11, 2005 10:14:00 AM
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OaksPT
Posts: 124
Joined: November 19, 2003
From: Va
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Ah, to be a assimilated and be a PT drone, to get fed information, follow the collective, and ask no questions, and not stray from preset approved patterns of treatment. Pity the fool that deviates from the collective, you will be disconnected, left on your own to fend for yourself, and be continually referred to as sub species, with no ability to rationalize. But they are the foolish ones, we have 7 of 9.
(sorry, I was feeling philisophical this afternoon)
Scott
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Scott Oaks PT,DPT
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Re: musculoskeletal myths#7 pubic symphesitis - September 11, 2005 10:47:00 AM
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Jon Newman
Posts: 1706
Joined: April 24, 2004
From: Amherst, WI
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Chris,
So do they offer on-site parking for employees at the death star?
OaksPT,
The following 7 of 9 blurb isn't quite so philosophical and I debated about posting it in the "conversations that matter" thread but I think this might be the better place.
[URL=http://www.sherylfranklin.com/sounds/trek/women/voyager/diplomacy.wav]audio file[/URL]
jon
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[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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