Forum Replies Created
-
Posts
-
I use the full length 1/2 foam roll. Yes, the 1/2 foam roll promotes thoracic extension (or at least promotes neutral or a decrease in the moderate kyphotic posture so many of us are in all day) and promotes clearing of the scapula (not pinned directly vs the bench) while still promoting good spine alignment with better scapular tilt and the mm length tension relationship. I also have pts focus on deep neck flexor activation as most all of these pts will have postural control issues and moderate fwd head posture with non-existent cervical stabilizer activation. Many pts will require a small towel roll behind their head (btw their head and the 1/2 roll) to achieve a neutral cervical lordosis based on the amt of forward head posture they present with. The foam roll gives them the manual cue of a neutral spine while also providing a little support vs gravity depending on the angle of the bench but even with full erect sitting. So many pts require that cuing and support to be successful at all in good postural control. That neutral posture will also help to better clear the GH joint to reduce impingement and promote better cuff activation by reducing the relative IR position poor posture causes.
I have 2 full length mirrors on wheels in my clinic and utilize them with almost every pt for postural education and cuing as well as for feedback for everything…pelvic and spine positioning, cuing for knee positioning during WB and gait activity…etc. The more feedback a pt has verbally, and with visual and tactile cuing, the more they improve their motor patterns and understand the benefit of what we offer them.Oksana-with pts who are unable to produce elevation (scaption or flexion) vs gravity, I also use the SL option but have never used a TBall for extra support during manual cuing but I do like that option too. Laura–I ALWAYS use a mirror for all of my shoulder pts as so many automatically go into an excessive UT dominant pattern and shrug on the affected side due to lack of scap stabilizer activation. Another step I use for those who can’t control this pattern in standing is to have them on an incline bench with a half roll behind them…in front of a mirror and have them then perform the ROM in scaption and then progressive elevate the bench to a more upright position as they gain motor control. it’s amazing that I’ve actually seen a pt go from a 45 degree angle to full upright in one session with the NM re-ed. most don’t retain it btw sessions at first though. Any thoughts on why I use that 1/2 foam roll and not just flat vs. the bench? what is the best way to cue the pt to replicate this type of progression at home?
Hey Nick
not a bad form…definitely focuses on function and specificity of patient centered goals and provides some great objectivity to track for both PT and patient. BUT, I feel patients are so overwhelmed with the amount of paperwork we already require of them upon intake that this may be overkill. if we’re collecting a good subjective and focusing on patient goals and objectivity of those goals upon history taking, we will already have this in our documentation and have reviewed it with patients and can track his/her progress with our focus on short and long term goals. Others may find this form very helpful but in my practice I think it might be overkill for most patients. would you use it?Hey Nick
Did I miss it or do you know if there were specific aggs producing her distal (forearm/hand) symptoms?
Are her symptoms different on her work vs non-work days and could/did you affect any of her symptoms in real time with sitting postural education?
Did you also educate her on specific work station changes? (chair, desk, monitor, phone…etc?). We have SO many pts who present with postural problems driving so many of their symptoms are hugely contributory with underlying chronic problems that might not be the prime problem but a big enough issue that if you don’t address that, the pt will spend 40+ hours/week in a poor position which inhibits improvements in clinic or w/HEP.