“Given that the physical therapy profession has clearly been wrong so many times before, why do the current pain science advocates appear to suggest that this time we have it right?” Should therapists be so “…blinkered by a single approach or school of thought that they deny, or cannot see, the value of another?”
The therapist performed a static assessment of the client’s posture and noted the typical upper crossed syndrome with a hyperkyphotic thoracic spine, a hypolordotic lower cervical spine, a hyperlordotic upper cervical spine, protracted head, protracted scapulae, and medially (internally) rotated arms.
When stretching the pectoralis musculature in a doorway, it is helpful to place the hand/forearm against the doorframe at various heights so that different aspects of the pectoralis musculature are preferentially stretched.
Moist heat and stretching is recommended for a hypomobile sacroiliac joint (SIJ) and/or tight musculature that accompanies a hypomobile or hypermobile SIJ.
An excellent self-care exercise is to recommend that the client/patient lie supine on an exercise ball to help move the thoracolumbar spine into extension.
As a rule, moist heat followed by stretching is beneficial for spinal hypomobilities, and strengthening is beneficial for regions of spinal hypermobility.
Once the acute stage of a whiplash has resolved, moist heat followed by stretching of the neck can be recommended to the client.
The medical approach to wrist sprain/strain is usually to recommend rest, a brace, and non-steroidal or steroidal anti-inflammatory medication.
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.
For the long term treatment of plantar fasciitis, the underlying cause of the overpronation (collapsed arch structure), if present, must be addressed.
Self-care for piriformis syndrome involves heat followed by stretching. The client can perform either the Figure-4 or the horizontal adduction stretch.
Self-care application of heat and stretching is an extremely important part of the treatment regimen for clients with spasmed neck muscles.
Self-care for the client/patient with low back muscle spasm should include moist heat followed by stretching. Double knee to chest stretch is beneficial.
Self care for a low back strain / sprain involves avoiding offending postures and activities such as bending and lifting, and using heat and stretching.
An easy & effective self-care stretch for frozen shoulder is the “finger walk” on a wall. To warm the tissues, heat should be applied before stretching.
Perhaps the most important self-care advice for De Quervain’s syndrome is to avoid as much as possible offending postures and activities of the thumb.
Self-care for golfer’s elbow should include heat followed by frequent stretching of the hand and fingers into extension. Ice is used if swelling is present.
Self-care for tennis elbow should include frequent stretching of the hand and fingers into flexion. If inflammation is present, icing should be done.
Case Study: Kerrati came in for wellness massage, but during the postural examination, the therapist noticed that her right arch drops markedly.