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  • Good work Rick. Good human primate social grooming reduces stress and when it reduces so does pain related to it. Your guy sounds like he's had enough surgery to last the rest of his life.
    Diane
    www.dermoneuromodulation.com
    SensibleSolutionsPhysiotherapy
    HumanAntiGravitySuit blog
    Neurotonics PT Teamblog
    Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
    Canadian Physiotherapy Association Pain Science Division Facebook page
    @PainPhysiosCan
    WCPT PhysiotherapyPainNetwork on Facebook
    @WCPTPTPN
    Neuroscience and Pain Science for Manual PTs Facebook page

    @dfjpt
    SomaSimple on Facebook
    @somasimple

    "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

    “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

    “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

    "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

    "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

    Comment


    • Thanks Diane, I love the dycem. I've been able to incorporate DNM without too much difficulty, I hope to see you in MN if I can make the necessary arrangements in time.
      “You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.” Buckminster Fuller

      Comment


      • OK, maybe we'll see you there.
        Diane
        www.dermoneuromodulation.com
        SensibleSolutionsPhysiotherapy
        HumanAntiGravitySuit blog
        Neurotonics PT Teamblog
        Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
        Canadian Physiotherapy Association Pain Science Division Facebook page
        @PainPhysiosCan
        WCPT PhysiotherapyPainNetwork on Facebook
        @WCPTPTPN
        Neuroscience and Pain Science for Manual PTs Facebook page

        @dfjpt
        SomaSimple on Facebook
        @somasimple

        "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

        “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

        “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

        "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

        "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

        Comment


        • One of my observations

          Thompson is a chiropractic technique, as part of their analysis is an assessment for cervical syndrome; functional leg length may appear to change when the head is turned while lying prone. Usually palpation of the cervical opposite of the head facing will have a palpable tender nodule over the lamina of one of the cervical vertebra. In the past I have treated that cervical vertebral level with resultant improvement of low back symptoms and the elimination of cervical influence on apparent functional leg length discrepancy.

          Now what I've been doing is to have the patient lie supine and rotate their head and note the rotation restriction then do the DNM antero-lateral superficial cervical plexus protocol (SCM). In addition to improved cervical rotation there has also been improvement in low back symptoms (sometimes quite dramatic) and again a change in apparent functional leg length discrepancy.

          Today after this procedure I treated lower dorsal rami, which decreased but did not eliminate the LBP, so I then treated the lower rectus abdominus "trigger point" while monitoring the point of LBP until there was a more "normal' feel. Relief was pretty good after that. Injury was earlier today, probably from dead lifting.
          “You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.” Buckminster Fuller

          Comment


          • Rick,

            My head is spinning.
            Barrett L. Dorko

            Comment


            • [applauds Rick as she watches him build his woven vine bridge to swing 'cross the chasm..]
              Diane
              www.dermoneuromodulation.com
              SensibleSolutionsPhysiotherapy
              HumanAntiGravitySuit blog
              Neurotonics PT Teamblog
              Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
              Canadian Physiotherapy Association Pain Science Division Facebook page
              @PainPhysiosCan
              WCPT PhysiotherapyPainNetwork on Facebook
              @WCPTPTPN
              Neuroscience and Pain Science for Manual PTs Facebook page

              @dfjpt
              SomaSimple on Facebook
              @somasimple

              "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

              “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

              “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

              "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

              "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

              Comment


              • Originally posted by Rick Carter View Post
                Thompson is a chiropractic technique, as part of their analysis is an assessment for cervical syndrome; functional leg length may appear to change when the head is turned while lying prone. Usually palpation of the cervical opposite of the head facing will have a palpable tender nodule over the lamina of one of the cervical vertebra. In the past I have treated that cervical vertebral level with resultant improvement of low back symptoms and the elimination of cervical influence on apparent functional leg length discrepancy.

                Now what I've been doing is to have the patient lie supine and rotate their head and note the rotation restriction then do the DNM antero-lateral superficial cervical plexus protocol (SCM). In addition to improved cervical rotation there has also been improvement in low back symptoms (sometimes quite dramatic) and again a change in apparent functional leg length discrepancy.

                Today after this procedure I treated lower dorsal rami, which decreased but did not eliminate the LBP, so I then treated the lower rectus abdominus "trigger point" while monitoring the point of LBP until there was a more "normal' feel. Relief was pretty good after that. Injury was earlier today, probably from dead lifting.
                He came back in yesterday, was minimally improved with slightly less pain but was standing straight, not in antalgic flexion. Leg length was even, the lower rectus abdominus "trigger point" was not tender or relieve low back tenderness with contact. I checked the superior cluneal nerves but didn't findany tender spots. Treated the dorsal rami again but relief of tenderness was stretching the skin toward the tender point, not away, the day before it was away. I instructed him to put a small pillow under his lower abdomen, as doing that while treating him made him more comfortable. I just texted him and he stated that he is much better with just a little pain when he steps down from a curb or getting out of his truck, The shoulder replacement guy is coming in today, it will be interesting to see how much better he can get. Thanks Diane. Did I tell you how much I like dycem?
                “You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.” Buckminster Fuller

                Comment


                • You did. Dycem is great stuff. Very tractioney - then one doesn't have to be grabby or pokey.
                  Diane
                  www.dermoneuromodulation.com
                  SensibleSolutionsPhysiotherapy
                  HumanAntiGravitySuit blog
                  Neurotonics PT Teamblog
                  Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                  Canadian Physiotherapy Association Pain Science Division Facebook page
                  @PainPhysiosCan
                  WCPT PhysiotherapyPainNetwork on Facebook
                  @WCPTPTPN
                  Neuroscience and Pain Science for Manual PTs Facebook page

                  @dfjpt
                  SomaSimple on Facebook
                  @somasimple

                  "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                  “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                  “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                  "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                  "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                  Comment


                  • I don't know if this classifies as DNM or not, but stretching of skin was involved.

                    Patient is a 50-55 year old woman complaining of right shoulder pain in the are of the sensory area of the axillary nerve. Putting her arm overhead and behind her lumbar spine were the primary aggravating movements. It hurts to sleep on her shoulder at night. She has had this problem for 4-5 months.

                    Neck examination negative.
                    Shoulder movements: Markedly restricted internal rotation and abduction due to pain.
                    Neurodynamic test of axillary nerve elicits her symptoms, small movement of her neck toward the midline relieves the symptoms (structural differentiation positive).

                    Treatment: Skin stretching around the quadrilateral space combined with deep breathing. I explained the fantastic nervous system's purpose of pain, how it needs 20% of available oxygen despite only weighing 2% of our body weight etc.

                    After the treatment, the patient had nearly full range of abduction pain almost fully abolished, wondering what kind of magic I did to her.

                    I love this profession sometimes.

                    Comment


                    • Another recent case:

                      Male approx. 30 years old complains of a headache that is localized to the back of the head on both sides. Onset one week ago after being very drunk, gradually worsening the day after drinking. The pain is described as "icy" and is fairly constant. Some relief during physical activity such as chopping wood and taking a hot shower, and complete relief during sleeping hours. Can not provoke the headache with neck movements.
                      The patient has been thoroughly examined by his physician. No red flags and no significant yellow flags.

                      Exam:
                      General findings: The patient is very mobile, no obvious posture deviations. The patient had a headache during the entire exam.
                      Cervical AROM: ERP in extension, no loss of ROM. All other movements fine.
                      Long-sitting slump: Negative.
                      Palpation: The headache is worsened with palpation around the greater occipital nerves on both sides. Other areas of the neck are normal.

                      Thoughts: Sounds like his greater occipital nerves are a bit cranky. Probably from sleeping in a weird position for several hours while being drunk.

                      Treatment:
                      DNM greater occipital nerves, around 20 minutes. During the treatment the patient moved slightly on his own accord with his feet and neck, while warming up immensely in the back of the head.

                      Post-treatment:
                      No headache, cervical extension did not produce any pain. Gave the patient chin tucks to mobilize his posterior nervous system to be done several times daily.

                      Thoughts?
                      Diane?
                      Last edited by Mikal Solstad; 15-10-2014, 04:25 PM. Reason: Spelling

                      Comment


                      • Good job!!
                        That is my only thought. :angel:
                        Diane
                        www.dermoneuromodulation.com
                        SensibleSolutionsPhysiotherapy
                        HumanAntiGravitySuit blog
                        Neurotonics PT Teamblog
                        Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                        Canadian Physiotherapy Association Pain Science Division Facebook page
                        @PainPhysiosCan
                        WCPT PhysiotherapyPainNetwork on Facebook
                        @WCPTPTPN
                        Neuroscience and Pain Science for Manual PTs Facebook page

                        @dfjpt
                        SomaSimple on Facebook
                        @somasimple

                        "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                        “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                        “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                        "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                        "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                        Comment


                        • Thank you, Diane. I will post an update on friday, when he comes in for our second appointment.

                          BTW, Ginger, if you are still reading these forums, I didn't touch his facet joints.

                          Comment


                          • Update as promised:

                            He came in today with no symptoms. However, he did mention some tinnitus that has been bothering him for about a week, which came after his presenting symptoms.

                            Exam:
                            Cervical spine AROM negative.
                            The greater occipital nerve area was slightly tender on both sides. Sternocleidomastoids were hard and tender to touch (problem with superfiscial cervical plexus, perhaps?)

                            Treated his occipital nerves and superfiscial cervical plexus with DNM. His sternocleidomastoids melted during the treatment. Told him to keep doing chin tucks for about 4-5 days.

                            My knowledge regarding tinnitus is not great, is there a connection between the cervical plexus and inner ear? Can I help him with his tinnitus problems?

                            Comment


                            • Can I help him with his tinnitus problems?
                              I doubt it. :sad: Good work, though, on the other stuff.
                              That trick for superficial cervical plexus is one of my faves.
                              Diane
                              www.dermoneuromodulation.com
                              SensibleSolutionsPhysiotherapy
                              HumanAntiGravitySuit blog
                              Neurotonics PT Teamblog
                              Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                              Canadian Physiotherapy Association Pain Science Division Facebook page
                              @PainPhysiosCan
                              WCPT PhysiotherapyPainNetwork on Facebook
                              @WCPTPTPN
                              Neuroscience and Pain Science for Manual PTs Facebook page

                              @dfjpt
                              SomaSimple on Facebook
                              @somasimple

                              "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                              “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                              “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                              "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                              "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                              Comment


                              • Thank you, Diane.

                                Anecdotally, several of my colleagues have "treated" tinnitus with upper cervical spine manipulation and soft-tissue treatment to the sternocleidomastoid.

                                I'm having trouble grasping the mechanism behind this effect, if there even is an effect.

                                I will continue posting cases in the future, if no one protests.

                                Comment

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