|
|
Re: Restricted Shoulder Abduction
|
Logged in as: Guest
|
|
Users viewing this topic:
none
|
|
Login  | |
|
Re: Restricted Shoulder Abduction - September 15, 2005 4:32:00 AM
|
|
|
OaksPT
Posts: 124
Joined: November 19, 2003
From: Va
Status: offline
|
Ginger,
Now I know you're nuts: tuna range in weight from 150 lbs each (albacore) to 1500 lbs (bluefin) so holding two by the tail just is not going to happen.
Try guppies or goldfish.
Scott
_____________________________
Scott Oaks PT,DPT
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 15, 2005 4:40:00 AM
|
|
|
Alex Brenner PT MPT OCS
Posts: 1057
Joined: February 29, 2004
From: Kentucky
Status: offline
|
Holy crap, Jason, that may be the funniest post I have ever read on this website. hahahah
_____________________________
Alex Brenner, PT, MPT, OCS
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 15, 2005 4:44:00 AM
|
|
|
Bournephysio
Posts: 585
Joined: April 25, 2002
From: Calgary
Status: offline
|
Scott,
No one said physio was for the weak.
guppies goldfish. What a joke. You might as well use sea cucumber.
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 15, 2005 6:09:00 AM
|
|
|
JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
Status: offline
|
See, Doug, that's where your experience comes in. I can't believe I didn't think of sea cucumber before!
They are salt water, but so much easier to keep in a tank...
What was I thinking with perch???!!!
You should do a CEU course....
:)
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 15, 2005 7:25:00 AM
|
|
|
chiroortho
Posts: 655
Joined: February 18, 2004
Status: offline
|
Shame on me but I just think it's odd that ginger is a guy. It's just me, I'm sure.
_____________________________
Greg Priest, DC, DABCO
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 15, 2005 8:02:00 AM
|
|
|
SJBird55
Posts: 2432
Joined: May 10, 2004
From: Michigan
Status: offline
|
Same here, Greg. Every time I see "ginger" I get an image of the Gilligan Island Ginger...
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 15, 2005 8:35:00 AM
|
|
|
apolipo
Posts: 115
Joined: December 22, 2004
From: Grand Rapids, MI
Status: offline
|
I can't remeber laughter ever hurting anyone (except for the occasional strained ab or rib), so I am glad we can have a sense of humor about this.
Julie and Jason,
I'm not sure whether the IGHL/post. structures can be stretched or not, but I do attempt to do this. Maybe my technique is crap, but I don't really think so. I can agree that isolated exercise, concentric or eccentric, may help make a better neuromuscular connection. I would think high rep/low weight with good technique would be the most beneficial. Despite my reservations, I am now having a pt. do sdly isolated ER. I will have her do high reps w/ little to no weight. What can it hurt? (that last question was rhetorical)
Ginger/Geoff,
I have read some of your previous "myth" posts and it would be an understatement to say that you manage to catch peoples attention. I don't necessarily want to agree or disagree with you on the subject of referred pain and facet mobilization. One thing I have to come to realize is that in the grand scheme of things, we don't really know squat. I always have a certain level of instinctive distrust for someone who has all the answers.
With that said, what exactly is your underlying theory for why long duration/sustained facet mobilizations could decrease pain and increase muscle recruitment enough to immediately improve restricted shoulder motion?
mike t
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 15, 2005 2:23:00 PM
|
|
|
ginger
Posts: 658
Joined: February 26, 2005
From: Melbourne Victoria
Status: offline
|
Dear Mike T, my theories on the physiology of spinal and referred pain have been posted here previously, look in the open forum under "the physiology of spinal pain, a theoretical model"
Looks like the playground has been noisy overnight, what with all the amusement and all, glad to hear you've been busy grasping the model I propose, along of course with the essence of piscatorial treatments.
I gather OAKSPT is not a fisherman/woman, tuna come in all sizes , as do all pellagic fish, beautiful fast creatures. I was a tuna poler in my twenties in the great southern ocean off Ceduna in South Australia, did three seasons as a deckie on tuna boats for the fun and adventure, You should try it Jason, might do better than as a PT , seeing as how you find some concepts too difficult ( only joking buddy, you'll get it some day)
Have a nice weekend and don't forget the open graves if you are in the church yard, wouldn't have you falling in.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 15, 2005 2:41:00 PM
|
|
|
ginger
Posts: 658
Joined: February 26, 2005
From: Melbourne Victoria
Status: offline
|
Of interest may be a patient I saw yesterday, 28 yo computer operator, female , tall thin and fit.Complained of two weeks of L shoulder pain.presented with limits to pain free range, and some inhibition to normal scapulo humeral rythym. pain felt at 65 to 135 dgrees of abduction.
complaining of pain at night, unable to sleep on L side, b/c of pain with compression of glenoid.
palpably tender C2 to C7 on L, much more than R.
Mobilised all the L cervical facet joints till significant release from hypertonus felt. along with reduction in palpable tenderness to facet joints. Took thirty minutes to achieve this with continuous mobs.
Immediate pain freedom reported to shoulder. Immediate restoration of normal pain free range, immediate restoration of normal scapulohumeral rythym post treatment.
This is a typical scenario repeated over and over 5 days a week etc etc
I expect to see her one more time , to go over the same and R side joints , and to deal with upper thoracic joints as well. I expect a full recovery after another treatment, as I usually see with presentations like hers.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 15, 2005 4:48:00 PM
|
|
|
OaksPT
Posts: 124
Joined: November 19, 2003
From: Va
Status: offline
|
Ginger,
Your right I'm not a fisherman by trade, I'm a physical therapist, what type of occupation do you have?
I guess the size of the tuna you catch depends on where you fish, but since you're address is earth, your playground isn't confined as mine.
Scott
_____________________________
Scott Oaks PT,DPT
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 15, 2005 5:54:00 PM
|
|
|
ginger
Posts: 658
Joined: February 26, 2005
From: Melbourne Victoria
Status: offline
|
Scott, Tuna wander like albatross all over the major oceans of the world, staying in packs of similar size . They are one of the fastest and most exciting of fish to catch. As polers we would stand along the gunwhale on the outside of the vessel, suspended on open metal racks with feet at about sea level. The really exciting part of the catch was the first fish. as they stay together you couldn't tell from sonar or visual cues how big they were, so we would all be on full alert till we caught one. Standing with a twelve foot bamboo or fibreglass pole with a steel trace line long enough to attach a barbless hook with a live pilchard attached we would hold ourselves ready to heave when the line was taken.
If it was between 5 and 20 kgs the poor little thing would be yanked out of the water with such force by the lucky first poler( bonus payment) that it would often sail right over the boat and land in the water 20 metres away. Things would get a lot more hectic if they were between 20 and 40 kilos ( able to be lifted by a single pole), and absolute pandemonium if the were bigger than 60 kgs, which would require polers to attach one line to two poles. Beyond that size the polers stood a good chance of being dragged over the side with a fast strike. Fabulous fun.
Gave up fishing in my early twenties and went back to the film industry for a few years before deciding that physiotherapy was for me. Started uni in melbourne at 28 and commenced practice in 85. Yourself?
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 16, 2005 6:25:00 AM
|
|
|
JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
Status: offline
|
Ginger-
Sounds like a great case report. Why don't you write it up?
(just joking buddy, on the evidence in practice thing -- you'll get it someday)
Enjoy your weekend...
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 16, 2005 2:52:00 PM
|
|
|
connie.pt
Posts: 76
Joined: March 28, 2005
From: Michigan
Status: offline
|
I agree with the "holy crap" comment on your fresh fish post... laughed so hard the tears were flowing!
Mike, how about strengthening the rotator cuff in the position where you want it to work, ie external rotation in an abducted position. Could be that the deltoid is overpowering the rotator cuff & not allowing the caudal glide to occur.
A comment on supraspinatus strengthening: I use RROM in the zero to 30 degree range of abduction to strengthen it. This is the range where the supra is the most active during AROM.
Connie
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 16, 2005 5:35:00 PM
|
|
|
coloradojulie
Posts: 413
Joined: November 10, 2002
From: colorado usa
Status: offline
|
What does tuna have to do with shoulder abduction? This clever banter is giving me a headache, and clearly, Ginger has the gift!
_____________________________
PRC
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 17, 2005 7:37:00 AM
|
|
|
Bournephysio
Posts: 585
Joined: April 25, 2002
From: Calgary
Status: offline
|
Ginger, you do realize that your treatment using cervical mobs might have nothing to do with cervical pathology?
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 17, 2005 4:36:00 PM
|
|
|
anoopbal
Posts: 124
Joined: May 3, 2005
Status: offline
|
I am reading Sahrmann's text about movement syndomes and how she treats it with taping, changing the way the patient sleeps, and move around. She talk about how reducing inflammationa and joint manipulations practices are just fixing the consequence than cause.
What do you guys think about her concepts?
Thanks
Anoop
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 17, 2005 7:24:00 PM
|
|
|
ginger
Posts: 658
Joined: February 26, 2005
From: Melbourne Victoria
Status: offline
|
Dear Bournephysio, yes of course , and that I get such immediate and regular good responses when treating in this way is more likely due to having my tongue skewed to the left and holding my bum cheeks together while mobilising. Could be the humidity in the room, the bench facing east west, or even the fish!, But just maybe, hold on to your hat , just possibly, it really is because I turn off protective activity around the joint and this leads to a deinflamed joint and nerve that provides the best possible result. AhAh grasshopper ( say with squinty eyes ), just maybe this boy got something here. Nah couldn't have, he's got too much bluster, too much unscientific lack of verisimilitude. Much to ponder,must consult grail.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 17, 2005 7:30:00 PM
|
|
|
ginger
Posts: 658
Joined: February 26, 2005
From: Melbourne Victoria
Status: offline
|
Oh before I get back to wipe on wipe off, I do not accept that cervical protective activity leading to inflammatory events is pathological . This is normal protective activity, regular states of hypertonus of intimate paravertebral musculature , a feature of a response to percieved threat.Able to be reversed by movement to facet joints. No fish required.
Ahhhh, sensei hungry with talk of fish.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 17, 2005 8:25:00 PM
|
|
|
Bournephysio
Posts: 585
Joined: April 25, 2002
From: Calgary
Status: offline
|
ginger, looks like you have a lot of reading to do on the effects of manual therapy and neurophysiology. Just because you lack the vision to see an alternative explanation doesn't mean that it doesn't exist.
|
|
|
|
|
Re: Restricted Shoulder Abduction - September 17, 2005 10:32:00 PM
|
|
|
yves
Posts: 32
Joined: October 1, 1999
From: Nanaimo, Vancouver Island BC Canada
Status: offline
|
Hi Ginger: You wrote
"just possibly, it really is because I turn off protective activity around the joint and this leads to a deinflamed joint and nerve that provides the best possible result."
I use to think this way a few years ago, and here is some fine tuning of what I beleive is happening.
With mechanical deformation and impaired or abnormal neural mobility, pain occurs which sets up a reflexive protective response. I use to think that I was the one who turned off protective activity, because with my hands I too mobilized the neck to alter the mobility of the nervous system. However I also found that stimulating the abdominal viscera acheived very compatible results and at times even faster.
But I beleive that however you are able to turn off the protective neuro muscular reflex, you will restore the mobility of the joint or is the nervous system responsible for the joint?
Because your results are rather immediate, I don't beleive that the so called inflamed joint is actually chemically inflamed as inflamation does not change within seconds. Rather perhaps the brain and its processing of pain and perception of neuromuscular guarding is actually the organ that can turn on or off within seconds.
Ginger writes:
"This is normal protective activity, regular states of hypertonus of intimate paravertebral musculature , a feature of a response to percieved threat.Able to be reversed by movement to facet joints"
I agree with the above, and one can reverse this response many ways, including the mobilization of the cervial facet joints, yet when they are just to sore to mobilize,then decrease the sympathetic response, add some abominal breathing, and most of the touch pain will resolve.
If you want to reduce your treatment time and number of visits, do Barrett Dorko's simple contact to restore the mobility of the nervous system followed by Frankendrais work.
Having just spent a weekend with Barrett, his work is extremly efficient and no one gets hurt.
Spend a weekend with Barrett, and he will give you all the science to explain what Ginger has been doing and more as well as help the therapist move on from only the joint, muscle, nerve to now the patient/ big picture, who has the most efficient solution, when given the opportunity to express themselves and move themselves out of pain or mechanical deformation and resolve their own abnormal neural dynamics.
But are we willing take that leap in faith? that the patient can walk out of he forest themselves.
Bournephysio writes:
"Just because you are not intelligent enough to see an alternative explanation doesn't mean that it doesn't exist".
This kind of writing in not helpful for any one. My patients continue to amaze me in their fortitude to struggle daily in their recovery be it a stroke or an amputation etc...they appreciate our caring and rarely criticize us for operating at the novice level with decreased self confidence or so call expert level who knows it all... I have often led myself to beleive in my infalibility, only to be humbled consistently when a patient shows me the solution and produces a result that I would of never imagined possible.
We can not measure the power of the patient's will to move on or change.
I know that you can do better than be critical of somebody's intelligence.
My greatest acheivements have been when my patients beleived in me or when my supevisor beleived in me especially when I didn't in myself.
regards,
yves
|
|
|
|
 New Messages |
 No New Messages |
 Hot Topic w/ New Messages |
 Hot Topic w/o New Messages |
 Locked w/ New Messages |
 Locked w/o New Messages |
|
 Post New Thread
Reply to Message
Post New Poll
Submit Vote
Delete My Own Post
Delete My Own Thread
Rate Posts |
|
0.094
|
Printable Version
