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RE: neck vs. shoulder

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RE: neck vs. shoulder - May 28, 2008 2:23:39 AM   


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Joined: March 21, 2006
From: Canada
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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. 

(in reply to ginger)
Post #: 61
RE: neck vs. shoulder - May 28, 2008 2:38:23 AM   
RPT Boss


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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.



Michael Rinaldi, PT, OCS
Avail Consulting, Inc.
Rinaldi Physical Therapy

(in reply to sslevins)
Post #: 62
RE: neck vs. shoulder - May 28, 2008 5:25:27 AM   


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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.

(in reply to RPT Boss)
Post #: 63
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