Not reasonable at all !

[emad]

Hi all ;

From the paradigm of neurodyamics to neuromodulation , they gave attention to pain approach only ,however they neglect completley the Range of motion improvement .

however , we as therapists , our key role is motion improvement .

What are your views?

Regards
Emad

[nari]

emad
I am not sure what you are saying, but here is my interpretation of your question:

You think that neurodynamics/neuromodulation does not attend to ROM. True.
Sometimes, it just doesn't matter; if pain decreases, the ROM will usually increase anyway, unless we are talking really stiff joints, say, after knee replacement.
The only reason I can see to record ROM is to "demonstrate" that a change has ocurred; the problem with that is, it says nothing about function or pain.
Neurodynamics can increase ROM, Diane's skin work can increase ROM..

why do you think we neglect movement?

nari

[emad]

Nari;

Yes , i am speaking about joint stiffness , seems neurodynamics &neuromodulation are not practical in orthopedic sector .

Cuurently , i have a case of CRPS following a colle,s fracture ( actually , i do not know how orthopedists in Aust,Europe & USA address fractures , but here in the town where i am living and practise physio , orthpedists address fractures in non-invasive techniques , i mean they do not use surgery or onternal fixation , they use cast )

Back to that case of CRPS , 2 orthopedists tried to reduce the fracture 3 times , casted the woman forearm for 55 days , ending up with CRPS ;

Severe pain
limited hand joints
limited wrist
limited elbow
limited shoulder
no sleeep from pain

I followed this patient for 2 weeks using breathing and simple gentle neural glides , the pain began to decrease , here pain decrease really , but still ROM severly lost .

I found no way except using Mulligan,s concept to improve that ROM.

I do not expect the function of joints will return .

Regards
Emad

[nari]

emad

Your lady was cast for 55 days which is a long time; presumably it was a complicated fracture? comminuted?
I was not thinking of fractures with what seems to be complications when I wrote the above post; there are always exceptions, but the fact you were able to reduce her pain is good! It may be, with gradual encouragement, her joints will improve. Colles' can be a problem if a dinner fork deformity occurs but hopefully some function will return to her fingers.
CRPS can be difficult, so you and she have done well.

Nari