CP1 Tutorial Week 7

Summary of this term:

Techniques/Systems Core Principles/Values When do we use them?

Paul Hodges N/A Neuromotor control of movement Spinal control – lower back and
and stability changes with pain. pelvic pain
The effect of pain on motor control
and possible mechanisms.
Karel Lewit MRT: Manipulation treatment does not  Reduction of skin
(Zac) 1. Proprioceptive Neuromuscular change the shape or position of a tenderness
 Facilitation a) Hold–relax b) structure, but it could change the  Reduction of connective
Contract–relax c) Rhythmic function of the MSK system. tissue pain
stabilization  Frequently used muscles  Release myofascial pressure
2. Muscle energy procedures will have a roundness of  Shifting and stretching
3. Post-isometric relaxation shape and or convexity fascia
4. Post-facilitation stretch between origin and  Relaxation of hypertonic or
insertion overactive muscle
 Less used or atrophied
muscles will have a
hollowness or concavity of a
shape
 Observation of muscle form
by looking at the
topography of the body,
notice asymmetries and
decreased development
areas
 Observing muscles can tell
you a lot about how a
person moves and where
pain might be or develop.
Vladimir Janda Movement Patterns:  Movement patterns rather  Functional assessment of
JIMBO  Hip Extension than individual muscles and movements
 Hip Adduction looked globally rather than  Upper cross syndrome
 Hip Abduction locally for the causes of  Lower cross syndrome
 Trunk Curl-up muscle dysfunction  Inner cross syndrome
 Cervical flexion  Layer syndrome
 Push-up  Looks into Phasic and tonic
 Shoulder abduction Muscles
Pavel Koler N/A Prague school – N/A
neurodevelopmental aspects of
motor control.

Stuart MacGill  Dynamic Neuromuscular
Stabilization
 McGill ‘big 3’ - curl up;
bird/dog; side bridge
Robin McKenzie  1. flexion in standing
 2. repeated flexion in
standing
 3. extension in standing
 4. repeated extension in
standing
 5. side gliding in standing
 6. repeated side gliding in
standing
 7. flexion in lying
 8. repeated flexion in lying
 9. extension in lying
 10. repeated extension in
lying
The importance of the diaphragm in
the stability of the spine.
Injury – failure of tissue when load
exceeds tolerance/strength of tissue
Stability through stiffness – motor
control increases stability
 Mechanical pain may
develop from postural
stressed, joint derangement
or by dysfunction
 McKenzie believes that
almost all low back pain is
aggravated and
perpetuated, if not caused,
by poor sitting postures in
both sedentary and manual
workers
 Physicians should exclude
serious and unsuitable
pathologies from being
treated by mechanical
therapy. McKenzie feels the
therapist should confine
themselves to diagnosing
MSK mechanical lesions –
this is where chiros differ
from therapists
 Spinal pain of mechanical
origin can be classified into
1. Postural syndrome
2. Dysfunction syndrome
3. Derangement syndrome
 Lower back pain
Identify causes of low back pain,
disc pathology in postural
syndromes, pathology from
muscles, ligaments, disc, apophyseal
joints and fascia due to adaptive
shortening of muscles in
dysfunction syndrome and internal
derangement of the disc, alteration
in the position of the fluid in the
nucleus and the surrounding
annulus, disturbing the resting
position of the above and below
vertebrae in derangement
syndrome.
Movements are chosen to decrease
mechanical deformation by
reducing the derangement.
The movements will gradually
stretch and lengthen contracted soft
tissues, eventually reducing
mechanical deformation
  Movement of the vertebral
column, the nucleus can
alter its shape and with
sustained positions or
repeated movements will
eventually alter its position.
Gray Cook FMS The whole is greater than the sum Non acute
SFMA of its parts.
“Movement patterns are purposeful
combinations of mobile and stable
segments working in coordinated
harmony to produce efficient and
effective movement sequences”
Screening helps us identify what we
want to change, improve or
rehabilitate.
Screening may be predictive of
injury