Neurodynamic techniques used in physical therapy include nerve gliding, nerve tensioning, and nerve flossing. Nerve gliding involves gentle movements that aim to mobilize and stretch the nerves, promoting their flexibility and reducing any restrictions or adhesions. Nerve tensioning techniques involve applying controlled tension to the nerves to improve their mobility and reduce any compression or irritation. Nerve flossing techniques combine movement and tension to gently glide the nerves through their surrounding tissues, promoting optimal nerve function and reducing pain or discomfort.
Neurodynamic techniques help in the management of nerve-related pain by addressing the underlying causes of the pain and promoting nerve mobility and function. These techniques can help release any tension or compression on the nerves, reducing pain and improving overall nerve health. By improving nerve mobility, neurodynamic techniques can also help reduce inflammation and promote healing in the affected areas. Additionally, these techniques can help desensitize the nerves, reducing their sensitivity to pain signals and improving pain tolerance.
Collagen Supplementation for Joint Pain and Arthritis: Does it Really Work?By Dr. Sean M.Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DNRecently I was presenting at the annual conference of Athletic Trainers' Association of Florida (ATAF) and I was overwhelmed by one consistent question: why didn't you talk about collagen supplementation? My talk was specifically on orthopedics for older adults and naturally I focused on osteoarthritis (OA) and how important exercise and diet are for that condition. I did touch on some supplementation, but I left off collagen because my last examination of this supplement, using one of my favorite websites Examine.com, yielded mediocre results. However the participants at the sports medicine conference piqued my interest and convinced me that perhaps I had missed something -- almost every single one of these participants had some form of joint pain or stiffness and felt significantly better after taking collagen daily. So, back to the literature, and asking some of my clients, I went!What is Collagen?Collagen is a protein found in the body that provides structure and support to various tissues, including joints, bones, tendons, and ligaments. It may play a role in maintaining joint health and may have potential benefits for individuals with joint pain. A few small-scale studies have shown positive results in reducing joint pain and improving joint function when individuals with osteoarthritis took collagen supplements. These studies often used specific collagen formulations, such as collagen peptides or hydrolyzed collagen, which are broken down into smaller peptides for better absorption by the body. However, it's important to note that the findings of these studies are not yet conclusive, and more robust research is necessary.The ResearchIt's worth mentioning that joint pain can have various causes, and collagen supplementation may not be effective for everyone. Factors like age, underlying health conditions, overall diet, and lifestyle habits can also influence joint health. For instance, a meta-analysis on collagen supplementation for OA showed improvements in the WOMAC, a functional score for knee arthritis, but it didn't yield significant results for knee pain. Meanwhile, another review article looking at collagen supplementation for joint pain, muscle protein synthesis, and body composition found that collagen did significantly reduce joint pain (it had effect on the other metrics). Here's a nice table listed in the article:The joint pain included in the review included knee pain and Achilles tendinopathy, all predominately in an athletic population. Another glaring observation is several of these studies included physical therapy and exercise prescriptions with the supplementation (Yay! Nutrition and Physical Therapy), which can also alter the results and effects of collagen as well. It's important to see the doses varied in the studies from 5, 10, to 40 grams per day; moreover, the collagen can come in varying form from peptides, hydrolyzed proteins, to denatured collagen. Having such variability in the type of collagen also likely explains the variability in responses and data.DosingSo, roughly how much and what type of collagen should a client take? Well, many studies have used dosages ranging from 8 to 12 grams of collagen peptides or hydrolyzed collagen per day for joint-related benefits. Research suggests that type II collagen supplementation may help reduce joint pain and improve joint function in individuals with arthritis, particularly osteoarthritis. It is believed to work by helping to restore and support cartilage health, potentially reducing inflammation and promoting joint mobility. It's important to note that collagen supplements are available in various forms, such as powders, capsules, and liquids, and their concentration of collagen can vary. Therefore, it's crucial to follow the manufacturer's instructions and consult with a healthcare professional to determine the appropriate dosage for your specific needs.It's also worth mentioning that collagen supplements are often combined with other ingredients, such as vitamins, minerals, or herbal extracts, which may influence their effectiveness. If you decide to try collagen supplementation for joint pain, it's a good idea to choose a reputable brand and look for products that have been tested for quality and safety. I suggest using Labdoor.com to help you or your client find a high-quality collagen supplement, if and when appropriate.SummaryIn the end, perhaps the participants at the ATAF conference were right -- there is something to say about collagen and joint pain. Not every study is exact and more research needs to be done on what dose, what age, what condition, and what exercises should be done with the collagen -- but that's why we practice physical therapy! Love to hear your thoughts and maybe some of your clients' responses to collagen. If you like what you see here then know there is more in our 3 board-approved continuing education courses on Nutrition specific for Physical Therapists. Enroll today in our new bundled course offering and save 20%, a value of $60! Earn CEUs in most states for PTs! Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below! Learn more online - new online discussion group included! Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. NEW - Online Discussion Group Live cases webinars lecture Live Q&A over 600 videos - hundreds of techniques and more! Check out MMT Insiders Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
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Posted by on 2023-07-24
In this episode, Erson goes over a tough case of constant and flared up cervical pain with radiating complaints. What do you think of his solution? Have you ever had a similar case that responded to sustained holds better than repeated loading or traditional techniques? Untold Physio Stories is sponsored byThe Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices. Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
Posted by on 2023-07-17
Erson tells a story of getting back to rock climbing after a 20 year break. After a finger injury that wasn't healing, he got some totally unexpected great advice from another climber. What do you think of the solution and has anything similar ever happened to you? Untold Physio Stories is sponsored byThe Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices. Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
Posted by on 2023-07-06
Tension-type headache (TTH) is a prevalent and burdensome condition that affects many individuals. Recent research suggests that the cervical spine, specifically the trigemino-cervical nucleus caudalis, may play a role in the development of TTH. This nucleus facilitates the exchange of pain signals between the upper cervical spine and the trigeminal nerve, which is involved in headache generation. Links between the upper cervical spine and TTHStudies have shown that individuals with TTH often exhibit musculoskeletal impairments. Common findings include forward head posture and restricted cervical range of motion. These physical dysfunctions may contribute to the headache symptoms experienced by TTH patients. Neck pain and sensitivity in the cervical spine are frequently reported alongside TTH and may worsen the clinical presentation of the headache. These symptoms could be epiphenomena resulting from the sensitization of the trigemino-cervical nucleus caudalis.While forward head posture is a common observation in TTH, its direct relevance to the headache remains a topic of debate. Similarly, the relationship between restricted cervical range of motion and TTH is not well understood. It is uncertain whether these musculoskeletal impairments are causative factors or consequences of the headache.Clinicians often use the cervical flexion-rotation test to assess upper cervical spine mobility, which has proven useful in diagnosing cervicogenic headache. However, its application and significance in TTH are not extensively studied. Further research is needed to elucidate the role of this test in TTH diagnosis and management.Another intriguing observation is the reproduction of headache pain through manual stimulation of the upper cervical spine in both cervicogenic headache and TTH. This suggests that referred pain from the cervical spine may be involved in the pathophysiology of primary headaches. Understanding this mechanism could lead to novel therapeutic approaches for TTH.Additionally, trigger points in the neck-shoulder muscles may contribute to TTH symptoms by generating muscle referred pain. These trigger points can refer pain to other areas, including the head, and may exacerbate the headache experienced by individuals with TTH. Managing TTH in practiceA multidisciplinary approach involving physical therapy interventions targeting musculoskeletal impairments, exercise, and psychological aspects is essential for the management of TTH. The effectiveness of cervical treatment approaches varies, and personalized strategies should be tailored to individual patients. Understanding the role of the cervical spine in TTH and differentiating between cervical components and sources can aid in the recognition and treatment of diverse headache presentations. Our cervical spine models help professionals manage the connections between TTH and the role of the cervical spine. Check out my exclusive blue nucleus anti-nocebo version!via Dr. Jerome Fryer - Dynamic Disc Designs Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below! Learn more online - new online discussion group included! Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. NEW - Online Discussion Group Live cases webinars lecture Live Q&A over 600 videos - hundreds of techniques and more! Check out MMT Insiders Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
Posted by on 2023-07-05
Neurodynamic techniques are indicated for patients with musculoskeletal disorders who experience nerve-related symptoms such as pain, tingling, numbness, or weakness. These techniques can be used to address nerve entrapment or compression caused by tight muscles, scar tissue, or structural abnormalities. They are particularly beneficial for conditions such as carpal tunnel syndrome, sciatica, thoracic outlet syndrome, and radiculopathy. Neurodynamic techniques can help improve nerve mobility, reduce pain, and restore normal function in these patients.
Neurodynamic techniques differ from traditional stretching exercises in several ways. While traditional stretching focuses on lengthening and relaxing muscles, neurodynamic techniques specifically target the nerves and their surrounding tissues. These techniques involve a combination of movement and tension to mobilize the nerves, whereas traditional stretching primarily involves passive stretching of muscles. Neurodynamic techniques also take into account the individual's pain threshold and aim to stay within a pain-free range of motion, whereas traditional stretching may involve stretching to the point of discomfort.
Yes, neurodynamic techniques can be used to improve nerve mobility and function in patients with neurological conditions. These techniques can help address nerve dysfunction, such as nerve entrapment or compression, which is common in neurological conditions. By promoting nerve gliding and reducing any restrictions or adhesions, neurodynamic techniques can improve nerve conduction and restore normal nerve function. This can lead to improved motor control, sensory perception, and overall functional abilities in patients with neurological conditions.
There are certain contraindications and precautions to consider when using neurodynamic techniques. These techniques should be used with caution in patients with acute nerve injuries, as they may exacerbate the injury or cause further damage. Patients with severe pain or inflammation may also require modifications or a more gradual approach to neurodynamic techniques. Additionally, patients with certain medical conditions, such as vascular disorders or blood clotting disorders, may need to avoid or modify these techniques to prevent complications. It is important for physical therapists to assess each patient's individual condition and tailor the neurodynamic techniques accordingly.
Potential side effects or complications associated with neurodynamic techniques are generally minimal when performed correctly and within the patient's pain tolerance. However, some patients may experience temporary discomfort or increased symptoms during or after the treatment session. This is often a normal response as the nerves are being mobilized and may indicate that the technique is targeting the affected area. In rare cases, patients may experience nerve irritation or exacerbation of symptoms if the techniques are performed too aggressively or beyond the patient's pain threshold. It is important for physical therapists to closely monitor the patient's response and adjust the techniques as needed to minimize any potential side effects or complications.
Therapists employ a comprehensive approach to assess and treat thoracic outlet syndrome (TOS). To assess the condition, therapists may conduct a thorough physical examination, evaluating the patient's posture, range of motion, and muscle strength. They may also utilize diagnostic tests such as electromyography (EMG) and nerve conduction studies (NCS) to assess nerve function. Treatment for TOS typically involves a combination of manual therapy techniques, such as soft tissue mobilization and joint mobilization, to address musculoskeletal imbalances and reduce compression on the affected nerves and blood vessels. Therapists may also prescribe specific exercises to improve posture, strengthen weak muscles, and enhance overall flexibility. Additionally, they may provide education on ergonomics and lifestyle modifications to prevent further aggravation of symptoms. In some cases, therapists may collaborate with other healthcare professionals, such as physicians or surgeons, to ensure a comprehensive and multidisciplinary approach to managing TOS.
When implementing ergonomic interventions in manual handling tasks, there are several considerations that need to be taken into account. Firstly, it is important to assess the specific task and identify any potential risk factors or hazards that may contribute to musculoskeletal disorders. This includes evaluating the weight and size of the objects being handled, the frequency and duration of the task, and the posture and movements required. Secondly, the physical environment should be evaluated to ensure that it is conducive to safe and efficient manual handling. This may involve modifying the layout of the workspace, providing appropriate equipment and tools, and ensuring adequate lighting and ventilation. Additionally, training and education should be provided to workers to increase their awareness and understanding of proper lifting techniques, body mechanics, and the importance of taking regular breaks and using assistive devices when necessary. Regular monitoring and evaluation of the ergonomic interventions should also be conducted to assess their effectiveness and make any necessary adjustments. Overall, implementing ergonomic interventions in manual handling tasks requires a comprehensive and systematic approach that takes into consideration the specific needs and requirements of the task and the workers involved.
Therapists employ various strategies to address muscle imbalances in athletes and mitigate the risk of injuries. Firstly, they conduct a comprehensive assessment to identify any asymmetries or weaknesses in the athlete's musculature. This assessment may involve evaluating muscle strength, flexibility, and range of motion. Based on the findings, therapists develop personalized exercise programs that target specific muscle groups to restore balance and improve overall function. These programs often incorporate exercises that focus on strengthening weak muscles, stretching tight muscles, and improving neuromuscular control. Additionally, therapists may utilize techniques such as manual therapy, myofascial release, and corrective exercises to address any soft tissue restrictions or imbalances. By addressing muscle imbalances through targeted interventions, therapists play a crucial role in preventing injuries and optimizing athletic performance.
Cupping therapy has been found to have a positive impact on local blood circulation and tissue oxygenation. The application of cups to the skin creates a vacuum, which helps to increase blood flow to the area. This increased blood flow brings more oxygen and nutrients to the tissues, promoting their overall health and function. Additionally, cupping therapy has been shown to stimulate the release of nitric oxide, a molecule that helps to dilate blood vessels and improve blood circulation. This enhanced circulation not only improves tissue oxygenation but also aids in the removal of waste products and toxins from the area. Overall, cupping therapy can be an effective modality for improving local blood circulation and tissue oxygenation, leading to enhanced healing and recovery.
The Alexander Technique is a method that aims to improve posture and movement patterns by addressing the underlying habits and tensions that contribute to poor alignment and inefficient movement. Through a process of self-awareness and conscious control, individuals learn to release unnecessary muscular tension and re-educate their bodies to move with greater ease and efficiency. By focusing on the relationship between the head, neck, and spine, the Alexander Technique helps individuals develop a more balanced and aligned posture, allowing for improved movement patterns and overall body coordination. This technique emphasizes the use of the body as a whole, rather than isolated parts, and encourages individuals to move with a sense of lightness and freedom. By retraining the body and mind to work together in a more integrated manner, the Alexander Technique can lead to long-term improvements in posture and movement patterns.