cervical 2 - interventions and patterns Flashcards
capsular pattern - diagram
everything is limited excluding flexion
multiple segments are involved
capsular pattern is associated with what diagnosis
an arthritis pattern
Treatment of the Capsular Pattern
address the irratblity
generalized mobilization with traction
controlled ROM exercises
flexability exercises
should you do thrust mobilzation with a capsular pattern
no they do not line up well
what pattern do we see with acute synovistis/trauma
global limitation
trauma - something happened and they are now limited in all directions
synovitis - 72 hours issue, mechanical problem
- active rest
slept on it wrong pattern
The neck got held in a certain position of sometimes and the facet joints/capsules are now holding you in that position
this pt is very inflammed
Active rest with palliative measures
Arthrosis pattern
restriction in everything expected flexion
SB on both side is the most restricted
Arthrosis pattern - can this pattern be changed
no this is a permenent change
Arthrosis general presentation
Not acute, older individuals, have a history of prolonged neck issues
Rotation preserved: atlanto-axial is fine
what can cause a restriction in flexion
Acute trauma synovitis
Painful discogenic structure
Mechanical dysfunction in the CT upper thoracic spine
painful discogenic struture - flex pattern
Pain will peri (scapula) – high level of pain
Does not respond to manual therapy
Mechanical dysfunction in the CT upper thoracic spine - flexion pattern
Pain in the axial skeleton – middle of neck
Most prevalent presentation
Intervention: manual therapy
what are the interventions for flexion pattern - Mechanical dysfunction in the CT upper thoracic spin
CT distraction
seated throacic distraction
mid throacic thrust
what region is CT distraction good for
C7 - T2
Seated thoracic distraction - region
T1-T4
Mid-thoracic thrust - region
T4 -T8
follow up exercises after flexion lmitation thrusts
Anything that promotes thoracic extension
Cervical retraction and protraction
Wing armed breathing
what causes a extension/closing pattern
the facets cannot move down and back
left sided extension issue - ext, rot, SB to the left side, with segment or localized pain
what testing do we do for an extension pattern
CPU/UPAs
osteopathic side gliding
response to motion
what does response to movement look like with the extension pattern
Retract and extend - Try to see if this leads to change in pain movement diagram
Retract and rotate - same
if these do not cause a change then move onto manipulation
what are the interventions for an extension pattern:
positional release
Mid-cervical/Direct extension mobilization
CPU/UPA
what does Positional release look like
2nd MCP apply pressure at limited joint
Extension and side bend to the level
Rotate the head left and right
See what side of rotation makes things better – hold that for 30secs
Mid-cervical/Direct extension mobilization - what does this look like
chin kick, lift, shift, shove
Ext head with side bending to issue side
2nd MCP over the articular pillar
Apply an inferior medial glide
follow up for extension pattern
- Retraction cervical
- 3 finger exercise
- Hand collar self-mob
- Mob C movement (towel)
