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Manual therapy and self-care treatment of wrist sprain, strain & tendinitis

A wrist sprain is challenging to treat with manual therapy because it is essentially an overstretching of ligaments, which causes joint instability.

manual therapymassageself-caresprainstrainstretchingtendinitisWrist

What are the causes of sacroiliac joint dysfunction?

The sacroiliac joint is unique in that it is a transitional joint between the sacrum of the spine and the ilium of the pelvic bone of the lower extremity.

fasciahypermobilityhypomobilityinstabilityligamentSacroiliac Jointsacroiliac joint dysfunctionSI jointSIJstability
a pathologic disc: here we see a herniated disc

What is a pathologic intervertebral disc?

This article addresses the causes of the three different types of pathologic disc conditions: degenerated disc, bulging disc, and herniated disc.

bulging discDischerniated discIntervertebral discPinched nerveprolapsed discruptured discsequestered discslipped disc

What is the medical approach to wrist sprains, strains, and tendinitis?

The medical approach to wrist sprain/strain is usually to recommend rest, a brace, and non-steroidal or steroidal anti-inflammatory medication.

anti-inflammatorycase studymanual therapymassagemedicationnon-steroidalRxsteroidstretchingwrist sprainwrist strainwrist tendinitis

What are the signs and symptoms of sacroiliac joint dysfunction?

Because of the tendency of one sacroiliac joint (SIJ) to compensate for the other when motion is dysfunctional, typically both SIJs become dysfunctional.

assessmenthypermobilityhypomobilehypomobilityinstabilitymobilityPainrange of motionSacroiliac Jointsacroiliac joint dysfunctionSIJstability

What are the self-care and medical approaches to spinal joint dysfunction?

As a rule, moist heat followed by stretching is beneficial for spinal hypomobilities, and strengthening is beneficial for regions of spinal hypermobility.

case studyjoint mobilizationManipulationmanual therapymisalignmentself-carespinal joint dysfunctionstretchingsubluxation

What are the signs and symptoms of sciatica?

The exact location of the symptoms of sciatica would be determined by which neurons are compressed; in other words, which nerve root level is affected (from L4 to S3), and whether they are sensory or motor neurons.

disc pathologyfoot dropleg painnumbnessparesthesiapiriformissciatic nervesciatica

What is whiplash and what are the causes of whiplash?

Whiplashes are usually associated with automobile accidents, but can occur during other activities such as playing sports or from a slip and fall.

car accidentCervical spinehyperextensionhyperflexioninjurymuscle spindle reflexnecksprainstrainstretch reflexwhiplash

What are the self-care and medical approaches to rotator cuff pathology?

Self-care for the client/patient with rotator cuff pathology depends on the specific muscle that is affected and the specific pathology that is present.

case studyGlenohumeral jointinfraspinatusjoint mobilizationmanual therapymassagerotator cuffself-careshoulderstretchingSubscapularisSupraspinatusTeres Minor
The Achilles tendon is the attachment of the major plantarflexors of the ankle joint

Associated disorders of the Achilles tendon.

Achilles tendinitis involves swelling of the tendon; Achilles tendinosus involves tendon degeneration. Achilles bursitis involves swelling of the bursa.

Achilles tendinitisbursitiscalcaneal tendinitisparatendinitispump bumprupturetendinosus

How do we treat Whiplash with manual therapy?

A whiplash/neck sprain is problematic to treat because it involves overstretching of ligaments, which causes joint instability.

cervical sprainjoint mobilizationmanual therapymassagestretchingwhiplash

How do we assess (diagnose) whiplash?

Assessing a whiplash injury from another condition of the neck is straightforward because a whiplash by definition follows a macrotrauma of the neck,

assessmentcervical straindiagnosishistoryphysical examrange of motionsprainwhiplash
The Achilles tendon is the distal tendon of the gastrocnemius and soleus muscles

What are Achilles tendon disorders and what are their causes?

Achilles tendinitis most often occurs due to overuse of the gastrocnemius and soleus contracting to plantarflex the ankle joint.

AchillesAchilles tendonbursitiscalcaneal tendonparatendinitisrupturetendinitistendinosus

What is Slumped Spinal Posture and What Are its Causes?

The longer we allow ourselves to sit in a slumped posture, the more imbalanced is our spine and the more gravity pulls our trunk toward flexion.

lumbar hypolordosisposterior pelvic tiltpostural distortion patternslumped postureslumped spinal posturethoracic hyperkyphosis
manual therapy for an Achilles tendon disorder includes massage to the plantarflexors

How do we treat Achilles tendon disorders with manual therapy?

Manual therapy for a chronic Achilles tendon disorder is aimed at decreasing plantarflexor tightness and breaking up excessive fascial adhesion scar tissue.

Achilles tendinitisarthrofascial stretchingbursitiscalcaneal tendinitisjoint mobilizationmanual therapymassageparatendinitisRICEsoft tissue manipulationstretchingtendinosus
excessive flexion of the spine, such as shoveling snow see here, can result in a pathologic disc

What are the causes of a pathologic intervertebral disc?

One cause of a pathologic disc (e.g., bulge, herniation) is excessive flexion postures, which drive the nucleus posteriorly against the taut annular fibers.

bulging discDischerniated discIntervertebral discprolapsed discruptured discslipped disc

Signs, Symptoms, and Assessment (Diagnosis) Slumped Spinal Posture

Slumped spinal posture is characterized by slumped postural dysfunction from the pelvis to the head. Assessment is made upon static postural examination.

assessmentdiagnosisphysical exampostural distortion patternsignsslumped postureslumped spinal posturesymptomsthoracic hyperkyphosis
resistance tubing exercise to strengthen the quadriceps can help a client with patellofemoral syndrome

What are the self-care and medical approaches to patellofemoral syndrome?

Perhaps the one most important aspect of self-care for patellofemoral syndrome (PFS) is to strengthen the quadriceps femoris musculature.

chondromalacia patellacrepitusknee painpatellofemoral syndromeQuadricepsQuadsself-carestrengthenstretching
There are many causes of overpronation which causes a dropped arch (flat foot)

What is overpronation and what are its causes?

A supple flat foot is caused by either lax ligaments and/or weak musculature that cannot support the arch when weight-bearing.

Collapsed archflat footOverpronationpronationrigid flat footsubtalar jointsupple flat foottransverse tarsal joint
manual therapy for overpronation often includes joint mobilization of the tarsals from plantar to dorsal

How do we treat overpronation with manual therapy?

The role of manual therapy for a rigid flat foot (overpronation) is to loosen fascial adhesions that are locking the bones in a position of pronation.

arthrofascial stretchingCollapsed archflat footjoint mobilizationmassageOverpronationpronationrigid flat footsoft tissue manipulationsupple flat foot

What are the self-care and medical approaches to whiplash?

Once the acute stage of a whiplash has resolved, moist heat followed by stretching of the neck can be recommended to the client.

case studycervical spraincervical strainself-carestretchingwhiplash
tight adductor symptoms

Tight adductor? Symptoms and signs to consider for groin pulls

The most common tight adductor symptom – also known as a groin pull – is pain in the medial thigh at the site of the strain.

adductor straingroin pullpubic painthigh pain
Pinch Test for assessment (diagnosis) of an Achilles tendinitis

Signs, symptoms, and assessment (diagnosis) of Achilles tendon disorders

The most common symptom of Achilles’ tendinitis is pain at the Achilles tendon. Pain is usually not present at rest, but will be evident upon palpation.

Achilles tendinitisbursitiscalcaneal tendinitisinflammationPainpalpationparatendinitisrupturetendinosus

How we assess (diagnose) sacroiliac joint dysfunction?

Assessment of sacroiliac joint dysfunction is done by motion palpation, in which the joint is challenged to move while the motion of the joint is assessed.

assessmentdiagnosisGrade IVGrade Vmotion palpationPSISsacroiliac joint dysfunctionSI jointSIJstatic palpationstork test

How do we treat sacroiliac joint dysfunction with manual therapy?

The treatment for a hypomobile sacroiliac joint (SIJ) joint is Grade IV joint mobilization (also known as arthrofascial stretching).

arthrofascial stretchingGrade IVGrade IV joint mobilizationGrade Vhypermobilityhypomobilityjoint mobilizationPosterior superior iliac spinePSISSacroiliac JointSacrumSI jointSIJ
lower crossed syndrome is seen in Figure A

Signs, symptoms, and assessment (diagnosis) of Lower Crossed Syndrome

Assessment of lower crossed syndrome is made by the characteristic postural dysfunction of increased anterior pelvic tilt with hyperlordotic lumbar spine.

anterior tilt of the pelvis. pelvic tiltfacet syndromehyperlordosisJandaLordosislower crossed syndromelumbar spinepostural assessmentpostural distortion patternpostureUpper crossed syndrome
meralgia paresthetica is caused by compression of the lateral femoral cutaneous nerve

What is meralgia paresthetica and what are its causes?

Meralgia paresthetica is a condition in which the lateral femoral cutaneous nerve is compressed, causing pain or altered sensation into the lateral thigh.

inguinal ligamentlateral femoral cutaneous nervemeralgia parestheticaNerve compressionparesthesiathigh pain
Active straight leg raise assessment for a pathologic disc

How do we assess a pathologic disc?

For a pathologic disc of the lumbar spine, the principle assessment test is straight leg raise (SLR). This can be performed actively or passively.

assessmentdiagnosisDiscforaminal compression testphysical examslump teststraight leg raiseverbal history

Self-care and medical approaches to sacroiliac joint dysfunction

Moist heat and stretching is recommended for a hypomobile sacroiliac joint (SIJ) and/or tight musculature that accompanies a hypomobile or hypermobile SIJ.

case studyjoint mobilizationSacroiliac Jointsacroiliac joint dysfunctionself-careSI jointSIJstretching
an inversion ankle sprain

Signs, symptoms, and assessment (diagnosis) of ankle sprain

When an inversion sprain is acute, the typical signs and symptoms are pain and swelling (inflammation) in the lateral ankle near the lateral malleolus.

ankle sprainecchymosisinflammationinversion sprainPainpalpationrange of motionswellingvisual inspection
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