Vidcast Wednesdays! Q&A: When Do You Introduce Flexion to an Extension Directional Preference? | Modern Manual Therapy Blog

Vidcast Wednesdays! Q&A: When Do You Introduce Flexion to an Extension Directional Preference?



Whether or not you have experience with MDT or not, even many CertMDTs do not get to the recovery of function phase, or what I call Stabilize (of Eval, Reset, and Stabilize).


It is a misconception that MDT tells you to avoid flexion, or flexion is bad for you. Too much of any direction would improperly load tissues, plus give signals to the nervous system that going in the opposite direction is dangerous. Today's Vidcast goes over when to reintroduce flexion after having an extension, lateral, or postero-lateral directional preference.


Bottom line:

  • wait until patient is Sx free in all ADLs 48-72 hours
  • recheck cervical or lumbar flexion
  • if full and pain free --> have patient perform repeated flexion
    • if this is full, pain free AND
    • does not cause rapid loss of extension
    • the patient is ready to slowly reintroduce flexion to their ADLs
Keeping it Eclectic...

2 comments:

  1. Why wouldn't you either start Deep cervical flexor strengthening in neutral or core stabilzation (McGill Big 3) before progressing the patients in their provocative positions/movements

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  2. Because I haven't needed to prescribe any of those movements or exercises for cervical or lumbar patients in literally years. Repeated motions and restoring symmetry with OMPT techniques works well enough for my strategies.

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