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PT 206 > UE, spine > Flashcards

UE, spine Flashcards

1
Q

What causes Subacromial rotator cuff impingment?

A

Repetitive overhead lifting

Typically seen in laborers, and athletes

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2
Q

What structures are affected in subacromial RC impingement?

A

Tendons of RC are compressed under the coracoacromial arch

Results in mechanical wear, stress, and friction

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3
Q

What is the Neer painful arc test?

A

during ABD of the arm pt. feels No pain 0-60, pain 60-120, no pain 120-180
Occurs secondary to compression of RC against coracoacromial arch

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4
Q

What is the Hawkins- Kennedy test?

A

Sh. flex to 90 degrees, elbow bent + IR

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5
Q

During the Hawkins Kennedy test where will most pts. feel pain?

A

sh. flex to 90

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6
Q

Due to anatomic crowding what structure is most commonly affected in subarcromial RC impingement?

A

Supraspinatus

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7
Q

What are the non-surgical rehab goals for pts. w/ subacromial RC impingments?

A 
Scapular stability and restoration of NML G-H and S-T rhythms 
Decrease irritability (burisitis and tendonitis)
Return to painfree, functional overhead activities
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8
Q

What is primary shoulder impingement?

A

Mechanical compression of the RC tendons (primarily the supraspinatus) as they pass underneath the coracoacromial ligament and b/t the acromion and coracoid process

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9
Q

What is secondary impingment?

A

GH instability

The instability causes the humeral head to elevate reducing the subacromial space

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10
Q

What is the result of secondary impingement?

A

Impairment of muscle coordination and weakness of scapular stabilizers

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11
Q

What age range is affected by stage I subacromial RC impingement?

A

younger than 25 y/o

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12
Q

What are the clinical presentations of stage I subacromial RC impingement?

A

Edema and hemorrhage

Pain is worse w/ sh. abd greater than 90

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13
Q

What age range is affected by stage II subacromial RC impingement?

A

25-40

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14
Q

What are the clinical presentations of stage II subacromial RC impingement?

A

Fibrosis and tendonitis stage
Irreversible b/c of long term repetitive stress
Supraspinatus, biceps tendon, and subacromial bursa become fibrotic
Pain at night and w/ ADLs

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15
Q

What age range is affected by stage III subacromial RC impingement?

A

40 y/o and above

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16
Q

What are the clinical presentations of stage III subacromial RC impingement?

A

tendon degeneration, RC tears, and RC ruptures

Associated w/ long hx of repeated sh. pain and dysfunction, muscle weakness and atrophy

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17
Q

Goal of prefunctional phase w/ subacromial RC impingement

A

Relief of sx,
Ex to maintain or increase motion
Modify ADL –reduce amt of overhead reaching
Meds (NSAIDS) and modalities
Cross body stretching, IR muscle stretching **with caution
Later in Phase I: strengthening rotator cuff and scapular stabilizers

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18
Q

Goal of return to function phase w/ subacromial RC impingement

A

Phase II: more advanced scapular stabilizers
I, Y, T (sagittal, scaption, and transverse - with rotation – plane) aka tri-planar motion
Scapular stabilization exercises – rowing, scaption, press ups, push ups with scapular protraction

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19
Q

Goal of return to activity phase w/ subacromial RC impingement

A

Painfree ROM, and return to painfree function – esp overhead activities; strengthening activities in overhead positions. Oscillatory training (eg., BODYBLADE) in I, Y, T

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20
Q

What types of surgical repairs can be done for subacromial RC impingment?

A

Sub acromial decompression
Distal Clavicle Excision
Rotator cuff repairs (small, medium and large repairs)

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21
Q

What rehab activities are recommended for phase 1 post surgery?

A

Codman’s**; active ROM in an increasing arc of motion below 900
Scap stab with retraction then progress to protraction
UBE – no resistance; light, bilateral CKC
Small repairs: early (3wks post surgery), painfree AA ROM, submax isometrics
Medium and larger repairs must wait full 4 – 6 weeks before starting

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22
Q

What rehab activities are recommended for phase 2 post surgery?

A

Phase II: 5-12 wks: AROM above 90o; thera band short arcs; increase reps for scap stab add eccentric and PRE’s. Oscillatory training if painfree

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23
Q

What rehab activities are recommended for phase 3 post surgery?

A

Phase III: 12 + weeks (note may be longer with bigger tears)

PREs; advance CKC to single arm exercise;

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24
Q

What are the main RC strengthening exercises

A 
Forward elevation
Scaption
Prone horizontal abduction with external rotation
Press ups
Seated rows
Prone scaption at 120o 
Push up “plus”
Planks, bilateral and lateral planks (unilateral)
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25
Q

Who is more likely to suffer a GH dislocation?

A

ME

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26
Q

Which type of dislocation occurs more anterior or posterior?

A

Anterior

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27
Q

In what position is the arm during a posterior dislocation?

A

Abd, elevated (flexed), IR

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28
Q

In what position is the arm during a anterior dislocation?

A

Abd, elevated (flexed), ER

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29
Q

What is a Bankhart lesion?

A

an avulsion of the capsule and glenoid labrum off of the anterior rim of the glenoid resulting from traumatic anterior dislocation of the shoulder

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30
Q

What is a Hill-Sachs lesion?

A

a compression or impaction fracture of the posterolateral aspect of the humeral head as a result of anterior sh. instability

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31
Q

What % of the time to RC tears occur w/ acute ant. dislocations in patients?

A

Over 40 = 30% of the time

Over 60 = 80% of the time

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32
Q

Prefunctional phase for GH dislocation

the non-operative management

A

Protect joint (4 to 6 wks) can do ROM to non-affected jts.
If severe, may immobilize
Gradual mobility of shoulder – Codman’s, wand, pulleys; avoid excessive ABD and ER; gain active control of ROM, AA stretching for elevation
Strengthening
Sub-max isometrics with shoulder in neutral humeral position
Progress to almost max isometrics then IR / ER with tubing at minimal degree of ABD

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33
Q

Where does the long head of the biceps originate

A

supraglenoid tubercle

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34
Q

Return to function phase for GH dislocation the non-operative management

A

A ROM in straight planes progresses to concentric and eccentric strengthening of rotator cuff muscles * cautions: adding ER with ABD
Cuff weights, thera tubing
Restoration of S-T and G-H rhythms - scapular stabilization exercises
Mirror for visual feedback
Cable systems plyo toss

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35
Q

Return to activity phase for GH dislocation the non-operative management

A

Isotonic strengthening using
OKC
CKC
May need to adjust positions to prevent excessive ER with ABD or IR with FL

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36
Q

Prefunctional phase for GH dislocation the operative management

A 
Slow protective ER
wks 1 -3- 0 -30
wks 4-6- 30-45
wks 7-9- 45 – 75 
wks 10-12- 75 – 90
Scap pro/retract
Gain active control of ROM, AA ROM
slow progressions of flexion and abduction – may not get to 135o until post op week 6
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37
Q

Return to function phase for GH dislocation the operative management

A

progress to full ROM – look at ST and GH joints!; Strengthening with theraband, free weights; move to eccentrics, UBE; at CKC

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38
Q

Return to activity phase for GH dislocation the operative management

A

Advanced CKC, plyo-toss; sport specific training

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39
Q

What is the expected total rehab time following a GH dislocation surgery?

A

Total time 3 – 5 months

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40
Q

Adhesive capsulitis occurs more commonly in which population?

A

Females, 40-60 y/o

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41
Q

What is the goal of the acute phase of Tx for adhesive capsulitis? What modalities?

A

Management of pain and inflammation

Use: ice, heat, US, phonophoresis, and infrared

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42
Q

What therax should be done in the acute phase of adhesive capulitis

A

Motion in PFR- PROM, AROM, AAROM ex in PRF- wand, pulley can be used
relaxation of muscle guarding at the GH joint, cervical area, and ST muscles

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43
Q

During the acute phase why are ROM activities important?

A

stimulate the removal of metabolic waste, increase local blood flow, and assist in the reduction of edema

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44
Q

What may the PT prescribe if the patient has severely restricted GH motion?

A

joint mobilizations

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45
Q

Scapular stabilization exercises can be employed to…

A

regain normal sh. motion, function, and scapulohumeral rhythm
*must regain normal motion before specific strengthen

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46
Q

What is the goal of PT in the subacute phase of adhesive capulitis tx?

A

begin painfree movement

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47
Q

What is the goal of PT in the chronic phase of adhesive capulitis tx?

A

restoration of GH and ST rhythm and full functional movement

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48
Q

What movement is most restricted in adhesive capsulitis pts.?

A

ER

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49
Q

How do AC sprains or dislocations typically occur?

A

A fall on the acromion (direcet force)

or when force is transmitted from a fall on an outstretched arm (indirect force)

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50
Q

What are the characteristics of a grade I AC joint sprain

A

Partial tearing of AC ligaments, joint tenderness
No instability or laxity and minimal loss of function
Usually fine after a couple weeks

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51
Q

What are the characteristics of a grade II AC joint sprain

A

Complete rupture of AC ligaments w/ partial tearing of coracoacromial ligaments
Mod. pain and dysfunction
Reduction in sh. abd and add
Will see a palpable gap b/t acromion and clavicle

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52
Q

What are the characteristics of a grade III AC joint sprain

A

Dislocation b/t acromion and clavicle
Rupture of AC and coracoacromial ligaments
Distal clavicle becomes displaced superiorly
Pts. experience severe pain and limitation of sh. motion

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53
Q

What are the grade 2 and 3 prefunctional activities

A

AA – A ROM in painfree ROM; Scap Stab ex; Sub max isometrics

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54
Q

What are the grade 2 and 3 return to function activities?

A

isometrics; OKC and CKCl scap stab; PREs with free weights or thera band

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55
Q

What are the grade 2 and 3 return to activity exercises

A

Plyo toss ; advanced rhythmic stabilization; strengthening of rotator cuff muscles.

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56
Q

How does scapular fractures occur?

A

direct, severe trauma

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57
Q

What modalities can be done to assist the healing process

A

Ice and sh. immobilization for 2-3 weeks

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58
Q

How do clavicular fractures normally occur?

A

direct or indirect trauma

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59
Q

What group typically suffers the most occurences of the this injury?

A

men younger than 25

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60
Q

What is the goal of tx

A

reduction of fracture fragments, maintaining the reduction, and minimizing immobolization of the GH joint

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61
Q

How long is the period of immobolization for a clavicular fracture?

A

4-6 weeks

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62
Q

What is the 4 part classification of proximal humerus fractures?

A

Humeral head, lesser tuberosity, greater tuberosity, and humeral shaft

63
Q

Proximal humerus fracture types?

A 
Stable Fx 
Sling, immobilize; begin gradual ROM; isometrics and easy CKC
Unstable Fx, multiple pieces
ORIF
Longer immobilization
Risk of AVN
64
Q

GH joint replacement prefucntional phase

A

Day 1 -2 and up to 1st week : AAROM – respect limits; isometrics ; AROM non-affected joints
Week 1 -3 : Codman’s, scapular motions progress to scap stability; AROM

65
Q

GH joint replacement return to function phase

A

Week 4-6: light resistance and scap stab; theraband for HEP

66
Q

Joint mobs used post GH joint replacement

A 
S-T joint mobs
Gliding scapula on chest wall
G-H joint mobs
Distraction (or long axis traction)
gliding
67
Q

Joint mobs- Top slide

A

loose pack and closed pack positions demonstrating joint congruence

68
Q

Joint mobs- bottom slide

A

The convex –concave rule. When the joint is concave (the fixed segment, pictured as A) the arthrokinematic (joint) motion is opposite from the osteokinematic (bone) motion . The solid thick arrow is the direction of mobilization force. Example : Gleno-humeral joint
When the joint is convex (the fixed segment, pictured as B), the arthrokinematic motion is in the same direction as the osteokinematic motion. The solid thick arrow is the direction of the mobilization force. Example: Knee joint.

69
Q

PT name for tennis elbow?

A

Lateral epicondylitis

70
Q

How does lateral epicondylitis occur

A

Repetitive overuse leads to tendonitis of ECRb, and other common extensors

71
Q

What activities can bring on lateral epicondylitis?

A

Use of hand tools like hammer, pliers, screwdriver or activities involving wrist rotation, pulling, extending and hand grasping

72
Q

What motions will bring on the pain w/ palpation?

A

active and or resisted wrist ext, and full passive wrist flexion

73
Q

What is the PT name for golfer’s elbow?

A

Medial epicondylitis

74
Q

How does medial epicondylitis occur?

A

Repetitive overuse to pronator teres, flexor carpi radialis, flexor digitorum sublimis and flexor carpi ularis at the medial epicondyle

75
Q

What motions will bring on pain w/ palpation?

A

active and or resisted wrist fl ,and full passive wrist ext

76
Q

Which epicondylitis occurs more?

A

Lateral

77
Q

What are the goals managing epicondylitis during the acute phase of injury?

A

resolving pain and swelling and protection of area from unwanted stresses to allow healing

78
Q

What modalities should be used during the acute phase of epicondylitis?

A

Ice massage, phono/iontophoresis, NSAIDs, and “relative rest”

79
Q

What is relative rest?

A

Balance b/t rest and activity during muscle healing

80
Q

Should you immobilize the pts. elbow? Why or why not?

A

Should not immobilize
Brace and allow early, protected and controlled motion
This allows collagen to lay down, mature and minimize scarring down

81
Q

What advice should we give pts. to deal w/ epicondylitis?

A

pain-free ADLs, sports, etc.; active gentle static stretching to wrist extensors; sub-max isometrics for wrist ex, wrist fl, pronation and supination, rad and ulnar deviation

82
Q

If epicondylitis pain does not resolve, what may be a tx option?

A

may have local injection of corticosteroid; RARELY a surgical procedure

83
Q

Subacute phase management of epicondylitis

A

Gradual addition of resistance exercise (begin with sub-maximal isometrics) and stretching within pain-free ranges
Modalities such as heat and US

84
Q

Chronic phase management of epicondylitis

A

Gradual addition of resistance exercise (begin with sub-maximal isometrics) and stretching within pain-free ranges plus resistance exercise- use eccentrics over concentrics
Modalities such as heat and US
Use of a COUNTERFORCE brace my help spread overload force on the common wrist extensor origin

85
Q

Medial valgus stress overload (AKA pitcher’s elbow) commonly occurs w/ which sports?

A

Any sport w/ repetitive overhead motion- baseball pitching, javelin throwing, raquetball, and tennis

86
Q

The shape of this structure in the swings the ulna in a valgus/ lateral direction during elbow extension?

A

Trochlea

87
Q

What compromises the lateral collateral ligament complex?

A

Lateral RADIAL collateral ligament, lateral ULNAR collateral ligament, and annular ligament

88
Q

What are the acute goals in the management of MVSO?

A

Acute phase: Goals reduce pain and swelling
NSAIDs, ice, phono/ iontophoresis
Rest (not active rest)
Protection from valgus stresses

89
Q

What are the subacute goals in the management of MVSO?

A

Gentle low-load static stretching within pain-free ranges. No valgus stress ( up to 12 weeks). Wrist motions (fl, ext, rad d, ulnar d) and pronation – supinaton are emphasized. Elbow fl and ext in increasing arcs of motion as long as painfree
OK to begin wrist and hand muscle strengthening

90
Q

What are the chronic goals in the management of MVSO?

A

Gradually add resistance exercise to elbow fl / ext
Gradual return to throwing
*eccentrics over concentrics

91
Q

What tendon is grafted during a Ulnar collateral ligament reconstruction?

A

Palmaris longus

92
Q

How long may it take to for a pt. to return to throwing following a UCL reconstruction?

A

3 months. to 1 yr.

93
Q

When is surgical repair needed for MVSO?

A

When conservative treatment fails (pain persists, cannot return to function)
May need osteotomy to remove osteophytes and fibrotic, degenerated tissues

94
Q

Post MVSO surgical rehab plan

A

Immobility to protect against valgus stress, followed by early protected motion, followed by ROM, followed by strengthening

95
Q

More detailed MVSO rehab plan

A

Immediate: start wrist, hand and shoulder ex to maintain ROM – Protect against valgus stress
By wk 3: ROM to -20o ext to 110o flexion. Modalities. PREs in concentric and eccentric wrist motions; sub max isometrics for elbow fl. & ext. OK to strengthen shoulder – CAUTION: Resisted ER causes valgus stress @ elbow!
Weeks 4-6: full elbow ROM. PREs to elbow fl& ext. Gentle pro/sup ex
2-4 MONTHS: strengthening, plyometric ex.

96
Q

What does the LCL prevent?

A

rotational instability btw distal humerus and proximal radius and ulna

97
Q

At what age are LCL dislocations most prevalent?

A

under 10

98
Q

What is the non operative goal of LCL management?

A

restore ROM within limits of stability while slowly progressing stresses on the healing structures. Patient usually in hinged brace

99
Q

When can you progress to functional and sport specific activities w/ a non-operative LCL injury?

A

15 days to 8 weeks

100
Q

When can you begin PREs w/ a non-operative LCL injury?

A

10-14 days

101
Q

When should you initiate isometric activities w/ a non-operative LCL injury?

A

1-10, multiangle isos

102
Q

LCL inury post op managment

A

Patient is in 90o posterior elbow splint with full pronation. NO elbow ROM for initial 4 -6 wks. Wrist and shoulder ROM only if painfree at surgical site.
Brace usually removed after week 6. Begin light strengthening for wrist, forearm and elbow muscles. Progressive strengthening to rotator cuff and scap stabilizers
Weeks 8-10 : get to full ROM at elbow. Progress to advanced strengthening. By wk 10, eccentrics and plyometrics. Sport specific exercise with increasing reps, weight and timed bouts
After wk 16: progress t interval sports program.
Goal for rehab is Full ROM and strength within 15% of the opposite side

103
Q

A volkmann’s ischemic contracture can cause a blockage in what structures?

A

Arterial and venous obstructions- usually the brachial artery

104
Q

In a distal 1/3 humerus fracture how long should the pt. be immobilized? What should you begin after immobilization?

A

4-6 weeks
Progressive active motion
Local heat/massage to increase circulation, decrease protective muscle spasms

105
Q

What are the types of fracture complications?

A

nonunion, malunion, and joint contracture

106
Q

If a pt. says they have numbness, tingling, and feel cold, where is the potential problem?

A

vein, artery, or nerves

107
Q

What are the S&S of Volkmann’s ischemic contracture

A

Severe pain in forearm muscles
Painful and limited finger muscles
Purple discoloration of hand with prominent veins
Initial paraesthesia followed by anesthesia
Loss of radial pulse; loss of capillary return
Pallor, anesthesia, and paralysis

108
Q

A spiral fracture in a child can be a sign of?

A

abuse

109
Q

Type 1 T or Y fractures?

A

nondisplaced fx, that extends b/t the 2 condyles

110
Q

Type 2 T or Y fractures?

A

a displaced fx w/o rotation of the fx fragments

111
Q

Type 3 T or Y fractures?

A

a displaced fx w/ a rotational deformity

112
Q

Type 4 T or Y fractures?

A

a severely comminuted fx w/ significant separation b/t the two condyles

113
Q

What is the cause of carpal tunnel syndrome?

A

Overuse, repetitive motions of wrist

Compression neuropathy of median nerve

114
Q

S & S of Carpal tunnel syndrome?

A

numbness; tingling; pain; muscle weakness in grip and pinch(may be seen as clumsiness or dropping objects); swelling in hand and forearm; atrophy of thenar muscles; symptoms worse at night

115
Q

CTS goals of PT

A

treatment: eliminating motions that cause pain, NSAIDs, splinting in functional position of the hand (aka “clamdiggers” or 0-200 extension, with finger flexion)

116
Q

What ligament is cut during a CTS surgery?

A

transverse carpal ligament

117
Q

Non operative management of CTS

A

Splinting for 4-5 weeks
Return to functional activities with protection (stay away from motions that cause pain)
ROM, Gripping, stretching
1MHz pulsed US, nerve gliding ex, carpal bone mobilization and yoga stretching have some evidence of reducing symptoms

118
Q

operative management of CTS

A

Immobilize 10-14 days, but begin finger ROM immediately
AROM once stitches are out
AROM to resisted exercise and scar management
Gradual, controlled weight bearing on the palm
Full weight bearing may be painful for up to 6 months

119
Q

What is another name for DeQeurvain’s tensoynovitis?

A

Blackberry thumb

120
Q

Tx of DeQuervain’s tensoynovitis

A

same as CTS

121
Q

What area is affected in a pt. w/ DeQuervains?

A

Pain and swelling at radial styloid, and decreased motion of the thumb

122
Q

What is the mechanism of injury in wrist sprains?

A

fall onto a hyperextended hand; sprain to wrist flexor ligaments

123
Q

What is the mechanism of injury in Skiers thumb?

A

thumb is caught in strap of the ski pole when the skier falls and pole is stuck in the snow, hyperextension and valgus stress; sprain to ulnar collateral lig at the MCP joint of the thumb

124
Q

What grades of ligamentous injury will show reformation and stability following immobilization?

A

Grade 1 and 2

125
Q

Grade 3 ligamentous injury will need?

A

surgical repair and prolong immobilization

126
Q

Goals of rehab of ligamentous injuries

A

Immobilization and avoid all movements that stress the ligaments that were sprained.
Initially: Rx for pain and inflammation, decrease edema; followed by gentle active ROM in all painfree ranges, tendon gliding, submax isometrics.
Gradually adding progressive resistance exercise – case for eccentric strengthening and CKC ex.
Increase speed, sustained gripping and alternating concentric eccentric exercises.
Complete rest 8-12 wks

127
Q

What are the characteristics of CRPS

A

pain, hyperesthesia, edema, discoloration, loss of motion and function (Pain, trophic changes, autonomic disturbances, and functional impairments) 2 Types: s/p trauma with and without nerve injury

128
Q

Why does CRPS occur?

A

Unclear why it happens; speculation about severe, prolonged vasoconstriction following initial injury causing pain and abnormal vasomotor reflexes. Speculation about personality disorders and low pain threshold.

129
Q

Goals to prevent CRPS?

A

PREVENTION: control pain and swelling; manage hyperesthesia; protected motion advances to active motion as pain, swelling and hyperesthesia subside. Associated with adhesive capsulitis; immob to wrist and hand. Do ROM at MCP and IP joints
Aerobic activities to increase cardiac output

130
Q

What comprises a motion segment?

A

The vertebrae above, below, and the disc b/t

131
Q

What are the 5 L’s of lifting mechanics?

A

Load, lever, lordosis, legs, lungs

132
Q

Radicular pain sensations

A

achy, burning, numbness, tingling, that reaches back of calves and toes

133
Q

Acute phase management of muscle strains?

A

NSAIDS, clinical modalities; reduce stress on affected areas: HOW? Find positions of comfort for relative rest
With reduced symptoms: add gentle isometrics and later gentle stretching
William’s flexion exercises

134
Q

Goals of Tx for muscles strains?

A

Reduce or eliminate inflammation
Restore muscle strength
Restore flexibility
Enhance aerobic fitness (decrease body weight)
Restore function and patient education
Back school; work hardening ; work injury managment

135
Q

What is the goal of traction?

A

to centralize symptoms, not peripheralize

136
Q

What are the key exercises used for ligament sprains?

A

Abdominal strengthening
Neutral spine
Spinal stabilization in sitting, supine, and prone
Spinal stabilization in more challenging positions and activities
William’s program
McKenzie program

137
Q

4 Phases of ligament Tx

A

Phase I: healing and pain control
Phase II: early active and passive motion
Phase III: prevention of re-injury
Phase IV: return to work

138
Q

Where does intervertebral discs get their nutrition from?

A

vertebral bodies above and below

139
Q

What causes the changes to occur to disks?

A

Aging, dehydration, degradation of annulus rings

140
Q

Interventions post spinal surgery?

A 
Post surgery first 1 week
DVT prophylaxis 
Bed mobility
Log rolling
Position for toileting
No val salva 
Amb – FWB is allowed, however pt may be more comfortable WBAT with device
Next few weeks
Gentle exercise
Progress to more aggressive exercise, prevention, education 
Return to work
141
Q

What interventions are used to treat spinal stenosis?

A

Williams program and traction

142
Q

How are lumbar spine fx treated?

A

bedrest followed by gradual OOB; lumbar stabilization isometrics. Avoid lumbar flexion and rotation

143
Q

Tx for Spondylolysis &

Spondylolysthesis

A

avoid extremes of fl or ext and vertical loading (weight lifter’s positon); abd strength; neutral spine stabilization; stretch tight muscle in LEs

144
Q

Scotty dog sign, neck broken

A

Spondylolysthesis

145
Q

Tx of whiplash

A

initially rest! How? Soft cervical collar; later: AROM and submaximal isometrics; stabilize shoulders (scap stabilization ex!) and postural feedback during exercise

146
Q

What structures are injured during cervical hyperextension?

A

tearing of SCM and longissimus coli; pharyngeal edema, tearing of ant longitudinal lig; separation of c-spine vert end plate of disc

147
Q

What structures are injured during cervical hyperflexion?

A

tears of posterior cervical muscles; tears of nuchal lig and posterior longitudinal lig; intervertebral disc injury

148
Q

Tx for FW head posture

A

Double chin stretching (axial extension or cervical retraction)

149
Q

Tx for cervical disc injuries?

A

Treat with flexion or extension

Follow up with c-spine stabilization exercises

150
Q

Cervical spondylosis

A

usually C5-C6 and C6-C7
Treat initially: pain relief
Later: 4-way isometrics and extension or flexion exercises

151
Q

Thoracic Inlet (outlet) syndrome?

A

Compression of neurovascular structures exiting the superior triangle – usually subclavian art and vein and brachioplexus
“cervical rib”, shortened or hypertrophic scalenes; rib or clavicular problems; often see increased upper thoracic kyphosis

152
Q

What to stretch for Thoracic outlet syndrome?

A

Scalenes
SCM
Pectorals
Levator scap

153
Q

What to strengthen for Thoracic outlet syndrome?

A

Thoracic extension motions incl: seated scapular retraction, prone scapular and thoracic extension; seated rowing with thera tubing
Axial extension
Cervical postural feedback
Workplace modifications

PT 206 (3 decks)

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