2018 massage and cause pain in myotherapy australia the ... · 7/06/2018 3 spine template when...

7/06/2018

1

Stiff Ribs can

cause pain in

the LEGS!

Presenter: Kym Finch

2018 Massage and

Myotherapy Australia

Conference

Gold Coast

© Kym Finch - Finch Therapy 2018

Outcomes

Challenge

Challenge your thought process

Teach

Teach new skills in interpretation of orthopaedicassessment incorporating myofascial slings and spine hypomolility

Develop

Develop new skills that allow you to improve treatment results with minimal effort on your hands

© Kym Finch - Finch Therapy 2018

7/06/2018

2

Linking stiff ribs to leg muscles

Myofascial Slings

Spine/rib Template

© Kym Finch - Finch Therapy 2018

Myofascial Slings

Continuity of muscle

attachments from one

muscle to another

© Kym Finch - Finch Therapy 2018

7/06/2018

3

Spine Template

When assessing spinal

joints for joint

play/mobility,

identification of

hypomobile joints

indicate which

myofascial sling is

involved and where to

start treatment.

© Kym Finch - Finch Therapy 2018

© Kym Finch - Finch Therapy 2018

7/06/2018

4

T© Kym Finch - Finch Therapy 2018

Pectineus

© Kym Finch - Finch Therapy 2018

7/06/2018

5

Signs and

Symptoms

Tightness in lower back

Pain/tightness in trapezius region

Mid/upper thoracic stiffness

Rounded shoulders

Forward head position

Often tight masseter/TMJ problems

“shin splints”

Plantar fasciitis

© Kym Finch - Finch Therapy 2018

How to assess for treatment

1. Thoracic

Rotation

2. Rib

hypomobility

assessment

3. Central

Thoracic spine

P/A joint play

© Kym Finch - Finch Therapy 2018

7/06/2018

6

Thoracic Rotation

© Kym Finch - Finch Therapy 2018

Why Assess for

thoracic

rotation?

It forms part of every

day movement patterns

Thoracic restriction can

overload other regions of

the body contributing to

pain and dysfunction

Particularly neck, lumbar

spine and shoulders

© Kym Finch - Finch Therapy 2018

7/06/2018

7

Causes for decreased thoracic rotation

Structural –scoliosis

Functional (reversible)

© Kym Finch - Finch Therapy 2018

Structural -

ScoliosisThe treatment aim for

structural scoliosis is to

maximise their available

rotational capability.

© Kym Finch - Finch Therapy 2018

7/06/2018

8

Functional

impairment

The treatment aim for functionally impaired

decreased thoracic rotation is to identify where the

reactive and adaptive restrictions are

© Kym Finch - Finch Therapy 2018

Thoracic Rotation

© Kym Finch - Finch Therapy 2018

This test is performed with your client sitting with their feet resting

flat on the floor.

This keeps the pelvis stable enabling the thoracic rotation to

occur through thoracic region not pivoting

through pelvis.

7/06/2018

9

Thoracic rotation

Sitting Test

Feet flat on the floor

Spacer between knees

Arms crossed with forearms against chest

Turn body to left then right

Compare rotation

© Kym Finch - Finch Therapy 2018

3 Common

“cheating”

methods

1. Thoracic rotation and

side bending at same

time

2. Retracting the scapula

3. Excessive rotation of

the neck with minimal

thoracic rotation

4. Pivoting through the

pelvis when seated

© Kym Finch - Finch Therapy 2018

7/06/2018

10

Rib Hypomobility

© Kym Finch - Finch Therapy 2018

Segmental

Spine Mobility

Joint Play

The amount of natural movement that occurs when direct pressure is applied:

p/a to the spinous process and facet joints

All joints have a neutral or mid position

7/06/2018

11

When the spine moves out of its neutral position:

uneven forces distributed through

spine results in abnormal loading on

spinal structures (ligaments, discs, facet joints etc)

Abnormal loading leads to altered mechanics which eventually can lead to pain.

© Kym Finch - Finch Therapy 2018

Tension in and around a joint whether that

be from direct muscular tension or

caused from a distal chain reaction can

cause pain in:

Joint

associated muscles

Ligaments

periosteal insertions

skin or fascia

7/06/2018

12

Hypomobility

of the Spine

is an indication of dysfunction.

Assessing joint play in

conjunction with other

orthopaedic assessments can

give us much of the

information needed to

correct musculoskeletal

dysfunctions and pain.

Treatment

Disclosure

Advise your client that

you do not manipulate

joints (“cracking” neck

or back)

The purpose of assessing

the spine is to identify

any decrease of normal

movement that might be

contributing to their

overall symptoms

7/06/2018

13

Spine Assessment

The harder you press

the less you feel

Apply light

pressure

Spine

Assessment

The aim of assessing the mobility of the spine is to guage the natural (onset) movement of the joint.

Posterior to anterior movement should be minimal.

The joint should NOT be taken to its end range.

7/06/2018

14

Thoracic “T”

Assessment

Ribs 2-5

Central Thoracic P/A

© Kym Finch - Finch Therapy 2018

T© Kym Finch - Finch Therapy 2018

7/06/2018

15

Hypomobile Joint Cycle

Myofascial sling

Underactive muscle

Hypomobile joint

© Kym Finch - Finch Therapy 2018

Ribs

Assessment

Assessing Ribs 2-5

Place the thumb along

the line of the rib at the

costo-transverse joint

Apply light pressure

P/A with inclination

towards the feet

© Kym Finch - Finch Therapy 2018

7/06/2018

16

© Kym Finch - Finch Therapy 2018

Thoracic “T”

TreatmentNeuromuscular contraction

Pectineus

© Kym Finch - Finch Therapy 2018

7/06/2018

17

T© Kym Finch - Finch Therapy 2018

Pectineus neuromuscular contraction

Legs straight with

patella pointing

towards ceiling

Cube between knees

Roll leg 1cm towards

block

Relax & repeat

© Kym Finch - Finch Therapy 2018

7/06/2018

18

After Pectineus

treatment

To alleviate muscular

pain and reinforce

the altered muscular

pattern, gluteus

maximus stretch is

suggested.

© Kym Finch - Finch Therapy 2018

Glute Stretch

Lie on back

Bend one knee

Place opposite hand on outside of

knee

Pull knee across body

DO NOT twist your back

Hold 30 seconds

© Kym Finch - Finch Therapy 2018

7/06/2018

19

Contact:

Kym Finch

www.finchtherapy.com.au

admin@positivepainsolutions.com.au

(07) 3284 1363

© Kym Finch - Finch Therapy 2018