Practical 2 Flashcards
Disc Lesion w/ radiculopathy presentation
Prefer to be in extension
LBP and leg pain below knee
Numbness/tingling in specific dermatome
Sway back posture can be a presentation
Disc lesion with radiculopathy tests
Crossed SLR: stretches sciatic nerve
Bowstring: puts pressure on nerve
Disc lesion with radiculopathy mobilization
extension bias PA
Disc lesion with radiculopathy exercise
prone press up
Facet syndrome presentation
Prefer to be in flexion
Well localized LBP with hip/buttock pain above the knee
Absence of neurological deficits and nerve root tension signs/tests
AROM provokes pain (flexion/extension)
Hypomobility with spring testing
Referrals to lumbar spine region, gluteal region, trochanteric region, posterior thigh pain, lateral thigh region, groin region
kyphosis-Lordosis posture is can be presentation
Facet syndrome tests
○ Stork would be acceptable: extension, stress on capsule, increases weight bearing load on joints and causes pain
repeated or prolonged ext: stress/weight on joints
Facet syndrome mobilization
Flexion bias PA
Facet syndrome exercise
Bilateral knee to chest
Spinal Stenosis presentation
Prefer to be in flexion
More commonly in elderly >65
Onset of pain with walking and relief after resting 20 minutes or maintaining a flexed position
Normal peripheral pulses
Decreased lumbar extension and difficulty standing or lying in erect position
Neurological deficits may be cross dermatomal
Spinal Stenosis tests
Rhomberg Prolonged Extension
Flexion preference – repeated or prolonged flex/ext (10 reps/30 sec
Spinal Stenosis mobilization:
flexion bias PA
Spinal Stenosis exercise:
Bilateral knee to chest
Spondylolisthesis presentation:
○ Prefer to be in flexion
Mechanical pain worsened with activity and alleviated with rest
May be asymptomatic or made worse with extension
Prominent spinous process or indented spinous process
Grade 3 or greater have transverse skin furrow and hyperlordosis
Spondylolisthesis tests:
stork
Step defect
Spondylolisthesis mobilization:
Flexion bias PA above and below segment
Spondylolisthesis exercise
Birddog
Piriformis syndrome presentation
○ Unilateral buttock and posterior leg pain and paresthesia
Neurological MSR normal
Palpation of muscle causes referred pain down back of leg
Piriformis syndrome tests
Resisted ER
SLR
Piriformis syndrome mobilization:
contract relax ER
Piriformis syndrome exercise:
piriformis stretch
Ankylosing Spondylitis presentation
Young males
Stiff low back with pain that may radiate into the buttock, anterior or posterior thighs
Stiffness when rising with relief with movement
Loss of lumbar lordosis with increasing kyphosis in the thoracic spine and decrease in chest expansion
Ankylosing Spondylitis tests:
Chest expansion test
○ Structural vs Non-Structural kyphosis
Ankylosing Spondylitis mobilization:
Gentle PA mobilizations to get movement
Ankylosing Spondylitis exercise:
○ Prone lying and press ups- start lying, ½, and then full
Abdominal Aneurysm
Presentation
Usually asymptomatic until rupture Mild to sever middle abdominal or LBP May be associated with complaint of leg pain with exertion (claudication) Pulsatile mid or upper abdominal mass Auscultation may reveal bruit Peripheral pulses may be prominent
Abdominal Aneurysm tests
Auscultation for bruits
Observation – look for palpable mass (Do first)
SIJ Dysfunction presentation:
Primarily pain over the SI joints, butt and lateral side of the thigh
Improves with walking, standing
SIJ Dysfunction tests:
Distraction
Compression
SIJ Dysfunction mobilization:
Gaenslen’s contract/relax
SIJ Dysfunction exercise:
birddog
Instability presentation:
Painful arc in flexion Painful arc on return from flexion Instability catch Reversal lumbopelvic rhythm Gower’s sign
Instability special test
Prone instability test
Aberrant motion/gowers sign
Instability mobilization
soft tissue of paraspinals
Instability exercise:
birddog
