Term
| Counter strain for Levator Scapulae (seated) |
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Definition
1. Find Levator Scapule, palpate the tender point. Tell Pt this is 10/10, maintain fingers in monitor position
2. Place knee under opposite arm of tender levator scapule
3. Tell pt to look towards wall on opposite side while relaxing
4. Using your hand bend the patients head towards the tender point without their assistance (passively)
5. When the patient states the tenderness has decreased to 3/10 maintain and hold position for 90 seconds with monitoring finger
6. Passively return the pt to original orientation and reassess. 3/10 or less = success. |
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Term
| Counter strain for Bicitpal groove. |
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Definition
1. find the biciptal groove by placing your finger above the armpit. With pts. arm in 90 degree angle have them interally and externally rotate their humerus.
2. Find the tender point. Tell pt. to rate this 10/10.
3. Take the arm of the tendpoint and have pt grab their opposite shoulder.
4. Tenderpoint should soften, pain should decrease, hold for 90 seconds once pain is 3/10 or better.
5. Passively return the patients arm to nuetral. Palpate the bicipital groove. If the area is less than 3/10 pain than success, otherwise repeat. |
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Term
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Definition
| (stuck out in the side and back) |
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Term
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Definition
| (stuck out in the front and side) |
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Term
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Definition
| (stuck out in the front and back) |
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Term
| anterior/posterior compression |
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Definition
| (stuck out in the middle and stuck in in the front and back) |
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Term
| exhaled (exhalation dysfunction) |
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Definition
(stuck down)
half breaths in to diagnose |
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Term
| inhaled (inhalation dysfunction) |
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Definition
(stuck up)
half breaths out to diagnose |
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Term
| ME for inhaled ribs 1 + 2 |
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Definition
1. contact the superior surface of the rib with your thumb.
2. have the patient look to the opposite side and down
3. Using your free hand bend the patients neck towards the stuck rib
4. Ask the pt to inhale and exhale slowly. On inhalation resist upward motion. On exhalation push down.
5. Do this 5 or so times till the motion is improved. Move the patients head back to neutral and reevaluate. |
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Term
| ME/RA for Ribs 2-6 inhalation dysfunction (inhaled rib) |
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Definition
1. Put your leg under the affected side at the level of rib you wish to treat.
2. bend the patients head towards your leg
3. Place thumb and finger on the superior surface of the rib.
4. Instruct the patient to deeply breath. During inhalation resist, during exhalation push down.
5. after 5 or so breaths should be better, return the patient to the supine position passively and reevaluate. |
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Term
| ME/RA for Ribs 7-10 inhalation dysfunction (inhaled rib) |
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Definition
1. Pt. in supine position and stand on the same side of the rib dysfunction
2. Bend them towards the side of dysfunction
3. put your thumb and index finger above the intercostal space superior. When the patient breaths in resist the upward motion. Push down when the patient exhales.
4.Repeat this 5 times and then reevaluate. |
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Term
| ME for exhaled ribs 1-2 (Scalenes) |
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Definition
1. pt. supine, you stand on opposite side of patient.
2. Have pt. place hand on forehead while looking towards the opposite side about 30 degrees.
3. place your hand on their hand. also grab superior posterior portion of rib with cupping motion and pull down and 'laterally.'
4. have pt. push their head against their hand while you resist with your hand (hold rib position while they do this). Once they relax move the rib downward and lateral (into the barrier).
5. Repeat this several times, reassess. |
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Term
| ME for exhaled ribs 3-5 (Pec Minor) |
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Definition
1. Pt. is supine while you stand on opposite side. Have pt. put arm above their head.
2. cup/grab the superior angle of the posterior rib. place hand on shoulder of affected side and have pt. push up while you resist (both motion and rib motion).
3. After 3-5 seconds, have pt relax. Move rib down and lateral. repeat about 5 times. Reassess. If rib has gone down into place, success. |
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Term
| ME for exhaled ribs 6-8 (Serratus Anterior) |
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Definition
1. Pt. is supine. You stand on same side as dysfunction. Have pt. place their arm on the opposite shoulder.
2. place your hand on superior border of affected rib posteriorly. Exert downward and lateral traction into the barrier.
3. Have the pt. push their elbow up towards the ceiling while you resist both elbow and rib motion. Do this for 3-5 seconds.
4. when the pt. relaxes exert downward and lateral traction on the rib.
5. Repeat this 5 times or so, and reassess. If the rib has moved downward success. |
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Term
| ME for exhaled ribs 9-10 (Latisimus Dorsi) |
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Definition
1. Pt in supine position while you stand at the same side as the rib dysfuncation. Have pt's arm straight out to the side and resting against your hip/thigh.
2. Find the superior angle of the posterior rib with the dysfunction.
3. Have pt. push against thigh/hip while you resist motion of arm and rib.
4. After 3-5 seconds have pt. relax. Move rib lateral and down.
5. Repeat this process about 5 times. Reassess. If rib is down=success. |
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Term
| Tx of Anterior Subluxation |
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Definition
1. Have pt. SIT at the end of the table with arm of affected side on opposite Shoulder.
2. You feel the rib you want to moniter while positioning their elbow to make sure its connecting.
3. Once you feel the connection apply lateral traction to the rib. (From medial to the rib angle)
4. Patiet may push elbow out or down while you resist arm motion AND rib motion for 3-5 seconds. Once the pt. relaxs move the rib laterally again.
5. Repeat this about 5 times then reassess. |
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Term
| Tx of Posterior Subluxation |
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Definition
1. have pt. sit at end of table with you behind them. Have pt. put their arm of affected side on opposite shoulder.
2. Grasp their elbow while placeing other hand on subluxed rib on posterior (lateral to the rib angle)
3. Move their elbow till you can feel movement of the appropriate rib. Have pt. push arm up while you resist rib motion and arm motion for 3-5 sec.
4. When the pt. relaxs move their rib laterally again.
5. repeat this about 5 times then reassess. If rib no longer sticks out on back and side = success. |
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Term
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Definition
The HUG!
1. have pt. sit on end of table while you sit on opposite side of dysfunction.
2. Have pt. put opposite arm over your shoulder. Place your fingers on affected rib.
3. Side bend pt. towards you while compressing the rib medially (towards you)
4.Have the pt inhale and then try to push their arm down on your shoulder while you resist (both arm and rib motion)
5. Repeat this 5 times and reassess. No more ribsticking out on sides = success! |
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Term
| Tx of Laterally Compressed Rib |
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Definition
Praying Mantus hold
1. have pt. sit on end of table. You stand on same side as the dysfunction.
2. Put affect arm over your shoulder. Place your hands on the anterior and posterior surfaces of affected ribs.
3. have the pt inhale and try to push down against your shoulder while you resist their their body motion and rib motion.
4. When relaxed compress the ribs anterior and laterally.
5. Repeat 3-5 times and reassess. If the ribs no longer stick out in the front and back = success. |
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