Hey guys! Normally I save my mini cases and online consults for my OMPT Channel subscribers, but I wanted to give everyone a little treat for being loyal readers.
Below is the recording of our Google Hangouts session.
This Adam's post from Eat, Run, Rehabilitate.
So if you have ever read my blog before you probably know that I am a big fan of The Manual Therapist and Dr. Erson Religioso, III, DPT. It’s true and I have learned a lot from him, his blog and his videos. One of his mainstays is the ability to be dynamic, open-minded, and ever evolving and that is why he calls the way he practices The Eclectic Approach.
These are great qualities for clinicians and I have tried to adopt this style of practice myself. I learned about basic resets and repeated movement exams/treatments from Dr. E's material. I thought I had a pretty good handle on the basics. However, ask any expert in anything...The basics are basic but they are not basic. What? I mean that even if you try or practice sometime a hundred times...there is still something new to be learned or nuance to be perfected over time. So what is the point?
Well I have been struggling with some neck pain and muscle spasm for the last week as a result of my brazilian jiu jitsu training. I hadn't really done much for it because most clinicians suck at self-assessment and treatment. I at least made sure that I didn't have any fractures or other major red flags, which thankfully, I do not. So instead, I set up a consultation with Dr. E and I was able to learn a few things even though we technically didn't do anything that I didn't already know! Check it out!
So what did I learn about using repeated-motions that I didn't know before?
- I wasn't aware that I was compensating out of fear-avoidance when attempting to treat myself using repeated-motions (specifically on repeated cervical extension with retraction)
- I didn't realize how profound of an impact there would be by correcting this
- A little bit of resistance while performing the repeated-motion like an active PNF can be immensely helpful for getting to end-range
- I was not aware of how quickly I was going with my repeated-motions. Slowing down the pace of movement seemed to help lower the perceived threat and opened up my range of motion
- I didn't think this had much an impact previously, I used to let my patients go to town doing their repeated motions as quickly as possible. There were some cases where the repeated-motions didn't net the effect that I was looking for and this could be why.
Points I made during the consult
- move slowly through repeated motions when limited and/or pain
- slow = less threatening
- inability to lie on the painful side at night is a type of allodynia
- it's normally non-noxious, but cause pain
- the level of stimulus that does not meet a threshold now causes pain
- but definitely not causing damage as all you are doing is lying on a soft bed/pillow