Case Update: The Dreaded Lateral Shift | Modern Manual Therapy Blog

Case Update: The Dreaded Lateral Shift

Previous update here and original case here

The patient followed up two weeks after his last visit. This was his 7th visit. He stated he was still a bit nervous but was back to all ADLs. He was still slightly shifted, which was most likely his normal structure. ROM was full and pain free in repeated sidegliding, flexion, and extension in standing. Hip ROM was WNL for IR and flexion, which were previously limited. Lumbar myofascia and QL was also WNL to palpation.

I reassured him that the painful memories of this still sub-acute time frame experience will fade, like all pain does. He was also told to keep up with his HEP, albeit less often with the extension in standing, unless he notices a loss. If so, he should just up his repetitions. He understood if his HEP is not taking care of any new acute symptoms to immediately come in for care, as the acute stage is when we can treat it the fastest according to research. This is an important point I make sure to tell all my patients! Another point that I tell all patients on discharge day, "If the Sx return in the absence of trauma, even though I will be happy to treat you again, it is your fault for slacking on your home program."

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