What is a ‘typical’ posterolateral disc protrusion and how is it so successfully managed by the passive extension protocol innovated by Robin McKenzie? An evidence based review Erl Pettman  FCAMT. OMT. DSc (h.c) Adjunct professor of the Doctor of Science (DScPT) program, Andrews University, Mich. With consideration to lumbar discogenic pain, where does pain come […]

Erl Pettman FCAMPTIFOMPT Quebec City, 2012 A brief historical perspective: The proposition that specific spinal segmental thrust technique (SSSTT) is necessary to remedy spinal segmental dysfunction is not new and goes back at least to the writings of Hippocrates (1). Based on architecture and vertebral position a specific thrust on a ‘mal-aligned’ or prominent (gibbus)

November 2010 Andrews University

The CERVICAL SPINE
During rotation of the head in a weight-dependent position the entire body tends to rotate in the same direction. This produces a force that threatens to penetrate whatever ground surface supports the body. This is resisted by ‘ground reaction’. This vertical thrust through the body is responsible for the formation of the typical scoliotic curve seen in the spine during rotation.

All vertebrae must obviously rotate in the same direction but the vertical loading creates a distinct change in the side-bending that occurs within the spine and this occurs at the thoraco-lumbar junction.

NAIOMT May 2010 Symposium

History:
The term ‘Facilitated Segment’ was first introduced by Irvin Korr in 1947 (Korr IM 1947) and supported by his co-worker Denslow J (Denslow JS et al 1947).

The original model proposed was extremely simple. Repetitive, abnormal input of afferents from spinal structures and/or visceral structures would converge on the same segment of the spine. This repeated bombardment would decrease ‘synaptic resistance’ thus making transmission of impulses to the efferent system (skeletal muscle and viscera) easier, i.e, ‘facilitated’.

The Hip Bone’s Connected to the Foot Bone…

The hip to foot relationship in energy transfer and conservation

Introduction

Gracovetsky pointed out in his classic article ‘The Optimum Spine’, how, if ‘Survival of the Fittest’ is truly a workable hypothesis then the term ‘fittest’ must relate to an organism’s ability to minimize its energy consumption as it attempts to survive in, or even dominate its environment. If this is applicable to humans then the species owes its achievements primarily to the unique form of erect bipedal gait, known as striding.

A literature search on the sternoclavicular joint rapidly makes the reader aware that there are a very limited number of publications on this joint and these predominantly cover medical and surgical concerns. Anatomical and biomechanical references are designed, most often, to support medical or surgical interventions.

From a Physical Therapy perspective this joint would appear to be the ‘poor cousin’ of the shoulder girdle in both interest and investigation.

Erl Pettman PT. FCAMPT. British Columbia, Canada – Teachers Meeting IFOMT Rotterdam 2008

The chronic pain patient has undoubtedly challenged and perplexed manual therapy practitioners for centuries. Occasionally, clinicians have risen to that challenge and changed our perception, even our definition of the term ‘chronic’. Notably, James Mennell (differential diagnosis) and James Cyriax (selective tissue tension testing) helped immeasurably in assessment and diagnosis. The idea that a patient’s symptoms could originate from anatomically ‘distal’ sites, and that the ‘original culprit’ could be isolated by careful physical assessment is now mundane, or at least it should be.