One of the 5 E's of The Eclectic Approach is "Easy." With most special tests having very little sensitivity and specificity, plus just generally being provocative in regard to Sx, why would you use them?
1) Cervical retraction and sidebending in supine
- originally posted here with video
- forget the press and guess or poke and hope
- check and correlate with a loss of ability to accept load on the ipsilateral side of complaint
- learn how to integrate this into your clinical practice in the Clinical Practice Patterns of the UQ on Modern Manual Therapy Premium
2) terminal knee extension
- original post here
- a loss of terminal knee extension has been correlated with a lack of function and re-injury after ACL repair
- passively check the knee in supine for terminal knee extension and if lost, that becomes your mobilization to fix it
- after restoring this, re-check single limb stance, hop, etc
3) passive shoulder extension
- again, a simple screen that actually checks a common loss of shoulder Mobility and thoracic rotation to the ipsilateral side
- the directional preference is then one of these three resets which can easily be taught to the patient
- I enjoy educating patients that their "tight" hamstrings are often just motor control issues or a perception of stretch, but not a "length" issue
- many times active is limited and passive is significantly greater, automatically fitting the patient into a Rapid Responder category
- the previous post on Wednesday shows how to make Rapid Responders out of the seemingly "tightest" hamstrings with 2 easy steps
5) Half kneel ankle dorsiflexion
- original post here
- this is a simple and reliable test to give the patient baselines for home and performance
- if this is limited and asymmetrical, they need to reset it
- here are simple ankle resets to teach them
Giving patients easy baselines they can see and feel empowers them and lets them know they need to work on their homework more often. Empowering them with self assessment and treatment and some Pain Science Education is what will improve your outcomes into that magic 6 visit range that gives your business a boost!
Keeping it Eclectic....