Post-isometric Relaxation

Use of Post-isometric Relaxation in the Chiropractic Management of a 55-year-old Man with Cervical Radiculopathy

By Frank M. Painter|June 5, 2012|Chiropractic Care, Post-isometric Relaxation, Radiculopathy|

Use of Post-isometric Relaxation in the Chiropractic Management of a 55-year-old Man with Cervical Radiculopathy

SOURCE: J Canadian Chiropractic Assoc. 2012 (Mar); 56 (1): 9-17

Peter Emary, BSc, DC

Private practice: Parkway Back Clinic, 201C Preston Parkway, Cambridge, Ontario, N3H 5E8. Phone: 519-653-2101. E-mail: drpeter@parkwaybackclinic.ca

Introduction

Cervical radiculopathy (CR) is an impingement or inflammatory irritation of the cervical spine nerve root(s), resulting in pain (or numbness) radiating along nerves of the upper extremity; [1,2] the C6 and C7 levels are most often affected. [1,3] Limited research is available on the incidence and prevalence of CR; however, the incidence rate (in Rochester, Minnesota) has been reported at 83.2 cases per 100,000 people per year (107.3/100,000 for males vs. 63.5/100,000 for females), with peak incidence in those aged 50–54 years. [1] A history of physical exertion or major trauma precedes the onset of symptoms in less than 15% of cases. The most common causes are cervical spondylosis and intervertebral disc herniation, [1,3] accounting for approximately 70% and 20% of cases, respectively. [1] In the former, posterior vertebral body osteophytes and/or facet joint/ligamentum flavum hypertrophy encroach upon the intervertebral foramen; posterolateral herniation of disc material results in foraminal encroachment in the latter. In either case, cervical nerve root pain and dysfunction can occur. [4]

There are other similar articles at the:

Radiculopathy and Chiropractic Page

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Passive Range of Motion Testing and Post-isometric Relaxation of the Shoulder

By Frank M. Painter|February 14, 2012|Post-isometric Relaxation, Shoulder|

Passive Range of Motion Testing and Post-isometric Relaxation of the Shoulder

The Chiro.Org Blog

SOURCE: Chiro.Org’s Shoulder Page

Passive range of motion (ROM) testing of the shoulder is accomplished with the patient supine, and the shoulder joint slightly off the table. The humerus should be abducted to 90° away from the body, so that full internal and external rotation of the humerus can be explored. From the neutral position (with the forearm pointing at the ceiling) normal ROM findings would involve a full 90° of external and internal rotation.

Passive Range of Motion Testing

Internal Rotation. Internal rotation of the shoulder is controlled by four muscles: the
subscapularis (C5–C6),
pectoralis major (C5–T1),
latissimus dorsi (C6–C8), and
teres major (C5–C6).
The anterior deltoid assists.

The starting position would be with the patient’s forearm pointing straight up at the ceiling. From this position the arm can and should be able to rotate a full 90° in either direction.

The individual on the right has lost almost half of his ability to internally rotate at the humerus, due to shortening of the external rotators.

The common link between all these muscles is the C5 segment. Subluxation of C5 is common in those who present with shoulder complaints.

External Rotation. External rotation of the shoulder is conducted by
the infraspinatus (C5–C6)
and the teres minor (C5),
with assistance by the posterior part of the deltoid.

The individual on the right has lost about one-third of his ability to externally rotate at the humerus, due to shortening of the internal rotators.

Mild over pressure on the forearm during this test will usually elicit pain and withdrawal sign by the patient.

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Stabilizing The Pelvis, Using the Modified Kemps and Straight Leg Raise Tests And Post-isometric Relaxation (PIR)

By Frank M. Painter|January 7, 2012|Modified Kemp's test, Orthopedic Tests, Pelvic Stability, Post-isometric Relaxation, Straight Leg Raise|

Stabilizing The Pelvis, Using the Modified Kemps and Straight Leg Raise Tests And Post-isometric Relaxation (PIR)

The Chiro.Org Blog

SOURCE: Chiro.Org’s Low Back Pain Page

Dr. Leonard Faye reminds us in Chapter 6 of Schafer’s text “Motion Palpation” that:

“In all low-back pain cases, it is essential to test for
hamstring, quadriceps, and psoas length.”

The picture on the left displays the positioning for the Modified Thomas Test. This test is is a very effective way to assess the length of 2 different muscles.

When the patient holds their knee to their chest, the following 2 things should become immediately apparent:

If the psoas is of normal length, then the dependent thigh should be free to hang down 45° below the plane of the table. In this picture, the patient’s right psoas is significantly shortened.
If the quadriceps are of normal length, the angle of the knee (between thigh and leg) should approximate 90°

If the psoas is shortened, it pulls the thigh into (some degree of) flexion, so the thigh cannot fully extend. This shortens your gait. Recalling that the origin of the psoas includes the lower thoracic vertebra, the lumbar segments I-IV, and the neighboring intervertebral discs, you can see why shortness would destabilize the lumbar and pelvic joints. Also… if the psoas is in contraction, the gluts may become inhibited by reciprocal inhibition.

If the quadriceps are shortened, it draws the leg into extension. Because portions of the quads originate on the pelvis, a shortened quads also distorts normal pelvic motion. (more…)