L4/5 Disc Protrusion Case Study

Introduction   This case report will outline the relevant subjective history and discuss the relevance of the objective examination. Then the analysis behind the rationale for the clinical diagnosis is reviewed. This is followed by an outline of the treatment plan and the discussion and evaluation that led to its formation. Why the objective markers were chosen is discussed, followed by how the treatment progressed and an explanation of why modifications were made. Lastly a reflection on the effectiveness of the treatment is given including the impact of the orthopaedic medicine course...

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What Structure Is Causing The Pain?

There are four main sources of pain and each produces a specific pattern of pain. Central Somatic Structures E.g. Dura mater, posterior longitudinal ligament, annulus fibrosus of the intervertebral disc Mulisegmental pain This can be central, central unilateral, bilateral, proximal or distal Referred tenderness 2. Central Neurological Structures E.g. Spinal cord No pain Multisegmental reference of parasthesia (bilateral hands and/or feet) Upper motor neuron lesion: spastic muscle weakness, increased reflexes, spastic gait, extensor plantar response (Babinski reflex) 3. Unilateral Somatic Structures E.g....

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Case Study: The Sacrotuberous and Sacrospinous Ligaments As Sources Of Sciatic Pain

“It is well recognized that radiculopathy, usually due to pressure on the dural sleeve of one of the lumbar nerve roots, can be responsible for this pain (Sciatica). On the other hand, ‘sciatica’ is more often due to referred pain from the sacrotuberous ligament” Dorman (1999)   Sacro-illiac ligament referral patterns (Hackett 1958) I re-read this statement after flicking through my notes on “Movement stability and low back pain” by Vleeming et al (Dorman 1999) trying to find solutions to a client’s long standing radicular pain that was not resolving. His primary symptom was radicular pain...

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Supraspinatus Tendinopathy Case Study

Introduction   This case report will outline the relevant subjective history and discuss the relevance of the objective examination. Then the analysis behind the rationale for the clinical diagnosis is reviewed. This is followed by an outline of the treatment plan and the discussion and evaluation that led to its formation. Why the objective markers were chosen is discussed, followed by how the treatment progressed and an explanation of why modifications were made. Lastly a reflection on the effectiveness of the treatment is given including the impact of the orthopaedic medicine course...

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Synopsis of; Chamberlaine, G., 1982. Cyriax’s friction massage: A review. Journal of orthopaedic and sports physical therapy, 82, 16-22.

Clinically outstanding results are often seen with the use of frictions. Frequently within just over ten minutes movements become pain free and range of motion improves. They are a key treatment in orthopaedic medicine. Where the core treatment is often cortisone injection or frictions to the injured site.  When administering deep transverse frictions (DTFs) clients often ask, “what does this actually do?”. This is an excellent question. Chamberlaine ‘s article written back in 1982 provides some answers. She states the rationale for DTFs in chronic injury is primarily to move the tissue and...

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