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RE: neck vs. shoulder
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RE: neck vs. shoulder - May 27, 2008 9:23:39 PM
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rwillcott
Posts: 352
Joined: March 20, 2006
From: Canada
Status: offline
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Ginger,
I believe I was taught this exact technique on a cervical course. If I recall it was first presented by Maitland. I do use it occasionally with success. Do you grip at all through the anterior neck? Or do you simply place your overlapped thumbs over the transverse process?
PS: Your time in hippie camps sounds like a fun.
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RE: neck vs. shoulder - May 27, 2008 9:38:23 PM
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RPT Boss
Posts: 7
Joined: May 19, 2008
Status: offline
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Hi.
Your logic sounds very good. If you get JOSPT, check out a 2007 article by Greg Haddick (a Kaiser residency grad in Cali) in which he uses PA mobs and neural glides to resolve a case of shoulder pain.
It's a case-report, so take it for what it's worth, but it appears relevant to your situation.
Be firm in your stance with the orthopod. Most know that the c-spine can generate shoulder sx, but they don't know what to do about it. Simply doing a Spurling test doesn't rule it out (which is what most will do) because it has a low sensitivity.
The c-spine can actually produce real pathological problems at the shoulder. The studies I've read suggest anywhere from 20-27% of shoulder compliants to GPs are found to have no significant pathology at the shoulder, but instead have disorders of the neck. Thus the term, "non-specific arm pain" is working its way into the EBM vernacular.
I teach a CEU course on this. It's a "How To" heuristic course (i.e. based on evidence) without getting too obtuse and giving you a migraine or leaving you feel dumb.
If you're interested in knowing more, PM me.
Otherwise, keep up the good work. Hold your ground; your logic and instincts seem solid.
Regards,
_____________________________
Michael Rinaldi, PT, OCS
Avail Consulting, Inc.
Rinaldi Physical Therapy
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RE: neck vs. shoulder - May 28, 2008 12:25:27 AM
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ginger
Posts: 647
Joined: February 26, 2005
From: Melbourne Victoria
Status: offline
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Rwillcott, Yes it is important to acknowledge the massive contribution by Maitland in joint dynamics and treatments. His methods were the basis on which I proceeded to add further value to Mobs. Cm does not rely on Active movement tests , as in maitland , is not defined into grades, and goes on for much longer than maitlands method. The effects are better, particularly where referred events are involved. I don't hold the neck as you described, and use only one thumb on cervical joints. Two is ok , but usually not required ,in that strength , as would be applied with two thumbs overlapping, is rarely needed on the neck. Differernt for lumbar and sometimes thoracic applications, there I may use two at times.
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