Manual mobilisation of the coccyx

I just watched a video on YouTube, in Spanish, of a therapist, doing coccyx manipulation through the clothes. 

I am interested in coccyx manipulation. Mainly as, because it is a process that is not very appealing for a therapist, and it is not great to have done as a patient: probably often gets missed. This leaves an unfortunate sub group of patients who have a mechanical dysfunction of the coccyx: but are unable to find a therapist who deals with this area. 

Don't get me wrong: it is my least favourite body part to treat. It's ethically difficult ground.

But : it seems wrong to leave people in pain for years, when we are experts in manipulation of the rest if the body, to eliminate pain,  simply because its am awkward and undesirable area of the body to treat. 

http://youtu.be/C_elJCLZt7Y

Back to the SIJ?

I watched a YouTube video today by an orthopaedic surgeon on how 25% of back and hip pain may be from the SIJ. 

He noted that clinical and radiological tests are not reliable. 

The only reliable test is an anaesthetic injection to the SIJ. If the pain is gone then it was the source. 

He suggested manipulation and noted stabilisation belts as treatments. Also RF ablation and true fixation with a screw!  

It was good to do some independent CPD. The idea that some could have a true SIJ problem and do years of treatment with the wrong diagnosis is concerning. 

It will help me to think about the patients who do not get better and what could be going on for them. 

Thinking about it : I was in a similar place : treated for years for a facet or disc problem. When it was in fact stenosis. Something not diagnosable clinically. Needing an MRI and an advanced interpreter.

 Sacroiliac Joint pain, animation - Everything You Need To Know - Dr. Nabil Ebraheim, M.D.

http://youtu.be/kvxZH7wGDfc

Manipulation and proprioception in the lumbar spine: HE Seminars Course

I went to  the HE Seminars course yesterday. A day on Evidence Based Practice for Physical Therapy. 

There were some really great talks and this included  a really good talk on lumbar spine manipulation, and proprioception, from Dr Neil Landeridge. 

This will certainly influence my practice. The idea of Manips affecting muscle spindle activity, and normalising it, then backing this up with bespoke proprioceptive functional training is exciting and feels intuitively sound. 

I really like cutting edge manual therapy and rehabilitation. 

I'm inspired to do my masters and PHd again. And MACP !

This is the mental challenge and excitement I 'jointed up as a physiotherapist' for. 

New supplies to optimise my functional rehabilitation of clients

I have been looking into supplies

To optimise my work.

Theraband is available in the colours we have plus black silver and gold strengths.

Silver and gold are only available in the latex containing variety I think.

I can't order micro hurdles in the Physio med website. I must use the catalogue.

Anatomical models and sacral nerve exits

Here are some of our sacral models.

It turns out that only one is correct.

Guess which one!!

Sacral nerves: anterior or posterior ?

I just spent some time reading up on sacral anatomy. I was wondering: since anatomical models vary which is right? Do sacral nerve roots exit through the anterior or posterior sacral foremen ?

It turns out that the anterior divisions of sacral nerves and blood vessels exit through the the anterior sacral foraminae (aka the pelvic sacral foraminae). The posterior sacral nerves and blood vessels exit the four posterior sacral foraminae.

So both models are correct, but incomplete.

Ref: www.ceessentials.net/article47

Family

I've noticed that at work I'm starting to see families. People send me their husbands wives neighbours. A lovely compliment. Thank you all!

Family

I've noticed that at work I'm starting to see families. People send me their husbands wives neighbours. A lovely compliment. Thank you all!

Advanced upper body and shoulder training

Just spent time watching the weekly warmup from www.discovermovement.com

I found it via a Physio Tweet.

Great advanced upper limb work on a speed ladder.

I will definitely use it in my practice.

I had been meaning to look up some lower body ladder and mini and micro hurdle advanced work.

I'll so this too...

Physiotherapy tools

My physiotherapy desk tools. A bit like Santa's workshop !

Boris Christmas Outfit

Boris, my faithful skeleton, loves his Christmas finery. Thank you Claire :)

DeQuervian's Tenosynovitis

I looked up and revised DeQuervain’s tenosynovitis and Finkelstein's Test after being reminded about them by Mike the Physio. Thanks Mike!

Brachial plexus path to arm

The brachial plexus and the subclavian artery pass between the anterior scalene and the middle scalene

PocketBody iPad App

I just downloaded pocket body for my iPad. Now that it is true 3D I am impressed.

PocketBody iPad App

I just downloaded pocket body for my iPad. Now that it is true 3D I am impressed.

Running Shoe Selection : the Evidence

18:46 I just spent some time reading an article on the evidence behind choosing running shoes. It is quite an eye opener: to see through the well established, but incorrect system. :

http://sportspodiatryinfo.wordpress.com/2011/02/02/choosing-running-shoes-the-evidence-behind-the-recommendations/

Radiculopathy vs peripheral neuropathy

20:30 The MACP one day nerve neurodynamic course has got me thinking.

I have been reading up on the differences between radiculopathy and peripheral neuropathy, online.

I thin I understand the difference well now now

Grading muscle strains

15:56 I have be reading up on muscle strains and their grading.

http://www.physiotherapynotes.com/2011/06/severity-of-muscle-strains-muscle.html?m=1

This has been useful

Physiotherapy Ankle Taping

15:16 I have spent an hour reading up on taping.

In taping techniques practice and principles by Rosie McDonald.

I am especially interested in ankle taping to support lateral ankle sprains and to reduce over pronation

Sinus Tarsi

15:05 I had a read up on SINUS TARSI syndrome

Liam had mentioned it and it came up again in the taping textbook that I have been reading today.

I looked it up on:

http://www.physioadvisor.com.au/8074550/sinus-tarsi-syndrome-physioadvisor.htm

I think I understand it a little better now.

15:09 I also read up on Liam's What's my Injury website.

http://www.whatsmyinjury.com/ankle-sinus-tarsi-syndrome/


I understand it a bit more now.