Manual therapy Blog: orthopedic manual therapy, physiology and anatomy

back extension exercise for a lumbar pathologic disc (e.g., herniated disc)

What are the self-care and medical approaches to treating a pathologic disc?

Self care for a herniated disc: avoid postures/activities that increase stress upon the disc and stretching/strengthening the musculature around the disc.

piriformis syndrome occurs when the sciatic nerve is compressed between the piriformis and the superior gemellus (seen here)

What is piriformis syndrome and what are its causes?

Piriformis syndrome occurs when a tight piriformis muscle compresses against the sciatic nerve, causing symptoms of sciatica into the lower extremity.

posterior glide / translation motion of the spine

Motions of the Cervical Spine

Table 1 shows average healthy ranges of axial motion of the cervical spine (head and neck), from the atlanto-occipital joint through the C7-T1 joint.

The greater occipital nerve can be compressed by a tight upper trapezius or semispinalis capitis

Manual Therapy Precautions When Working the Neck

It is essential to exercise caution when working the anterior neck. However, this should not prevent therapeutic manual therapy work to the anterior neck.

Superficial anterior view of the muscles of the neck

Musculature of the Cervical Spine

To perform orthopedic manual therapy to the neck that is accurate and specific, we need to know the attachments and actions of the muscles of the neck.

Frontal plane cross section of the cervical spine demonstrating the ligaments

Ligaments of the Cervical Spine

The “action” of a ligament is similar to that of an antagonist muscle. If either is tight/taut, it restricts motion in the opposite direction.

Cervical Spinal Joints

The disc joint is a cartilaginous joint that is composed of outer fibers called the annulus fibrosus that encircle the inner nucleus pulposus.

FREE DCOMT video – Communicating with the Client When We are Stretching Them

For manual therapy care to be successful, client communication is extremely important. This video explores who to effectively communicate with the client.