Not sure if this is a clinical pearl but it has managed to help improve Sh flexion for two of my pts. Both of them had limited post op Sh flexion . They were mainly able to lift up till about 160 degrees. Their limitation was probably caused by over- activation of their traps. It was visible that they Sh shrug or side bend their neck on the affected side when they performed Sh flexion. Below is a picture showing the difference in ROM (Sorry for my bad photography skills) Wit

I have been seeing a variety of LBP patients for some time now. Most of them would demonstrate a DN/DP when assessed for MSE or MSF. When they show a lack of Lx mobility during the assessment, I would ask them to perform the Mckenzie exs or Repeated Extension in Lying (REIL) for about 10 repetitions. More often than not, their ability to extend or flex their spine would improve by an average of 30%! Here's a video of the exercise: The fact that they could regain mobility with

These are a few things I would do when my patients visit me with LBP. Pain History Where the pain was, what type of pain it was, any pins and needles (P+N), any numbness (N), intermittent/constant and the VAS. Aggravating factors: Sitting, standing, driving, sports etc Relieving factors: Meds, massage, rest etc 24 hours pattern: Better, same or worse Interpretation: Area = Reinforces my hypothesis of what needs to be treated Dull ache = Muscular related Sharp or shooting = Ne

So, this is a HEP for those who wants to maintain their progress following their Cervico-thoracic or Thoracic manipulation. Here's an example! This exercise is ideal for those who have a stiff middle back or those who have limited movements around their Shs. Position your hips and knees in a half kneeling position and maintain it at around 90 degrees. Whilst you rotate, keep the movements around your hip at minimal. #Thoracic #Mobility #Exercise

Sciatic Nerve Mobilisation One of my favourite intervention for clients with “buttock pain” (Piriformis Syndrome), radiating pain down the leg (Sciatica) and/or “tight” hamstrings. I have used this numerous times and most of my clients feel the difference the next day. The theory is simple: Promoting nerve mobility. However, this improvement must be maintained with some sort of constant input. For example, slump exercise and or self-nerve mobilisation in supine or standing ev