At Gift Gathering now and reviewing all that has happened over the past 3 days. The information from week 25 was the focus for GG2.
The focus was on movement of the pelvis, trunk, scapula and humerus. The Gray Institute calls the combined movements of these regions as Peltrunkularus.
On the first day we assessed the following movement, XXX, Right foot same side rotation lunge with bilateral hand right rotation @ shoulder reach and head rotated to the same side. We assessed the restriction in the motion of the hands and then “chunked” what was happening between “blocks” within the body e.g. head on Thorax, scapula, Thoracic spine, Thoracic and Lumbar Spine, Lumbar spine and Pelvis and Pelvis on Hips.
We were looking for areas in the body, which were influencing the bilateral hand reach to the right. When we used FMR techniques we could identify the influence of each area on the bilateral hand reach. We actually found the scapula and thoracic spine were the pain restrictions to the bilateral hand reach. The foot was also blocked at the subtalar joint.
On the same day we practiced FMR techniques to load the scapula in all three planes. These techniques felt great and were very effective in increasing GHJ motion. It was important to tweak the techniques to avoid impingement in the shoulder. The focus was always painfree motion. These techniques were later tweaked to include the GHJ. The ratio of scapula to GHJ loading should be 75%: 25% respectively.
Often the postures we assume will influence the position and movement of the scapula. The FMR techniques, which can counteract these gravity created scapula postures, were horizontal abduction, flexion and abduction. To assist the muscle loading to improve elevation motions we can use FMR techniques for extension to assist flexion and adduction to assist abduction.
When assessing CRB we must look at both sides of the body, as one will influence the other. Commonly the hips need to be assessed bilaterally e.g in right sided same lunge, the right hip is loaded in the glutes and the opposite is loaded in the adductors.
We went on to assess the motion in the Thoracic spine from a global perspective. There were 6 motions to assess. We looked at FMR techniques to facilitate or slow motion down at any area within the Chain. These handling techniques were useful for increasing or decreasing motion where I thought it was needed. Remember to get good thoracic motion to keep the arcs of motion large with the hands. Some people like a target to aim for and this could be done with a mark on the wall
Tips in assessing are to first go Global, then local, and back to Global. Try to keep the motion as authentic as possible.
With FMR techniques I want to keep the facilitation to the bare minimum and aim to be authentic. I want to take my hands off as fast as I can.
If there are problems it always helps to get back to the pelvis, as all other drivers are trying to influence it. In other words, all the drivers will focus on loading the pelvis, as the first bone to explode is the pelvis-hip. The pelvis must be loaded first. If we aim treatment and assessment at the pelvis first we can see what the rest of the body is doing to it and we can start treating it. Gary calls this “Going home”. An example of load and explode in the pelvis is TZ1. When the glutes explode they help to swing the contralateral leg forward.
Rolation is combining the rotation of the pelvis with translation along its axis e.g anterior pelvis tilt will be combined with translation on the left and right lateral axis, Transverse plane rotation will be combined with translation up or down the superior to inferior axis.
These combined motions can be assessed and facilitated with FMR. Remember the order they may occur in loading e.g. rotation before translation or translation before rotation. Remember the order they occur in the explode e.g. translation inferiorly with rotation to the right of the pelvis when it is loaded. In the explode rotation to the left can start before the translation superiorly begins.
Walkuffle is the combination of walk in all three planes with a shuffle i.e. side to side walking with feet coming together with each step. This can be used as an assessment tool and treatment.
We discussed pain with sitting and it is not a matter of the right chair and ergonomics. It is about the body being compressed and the need for the body to be decompressed with movement. Maybe actions at the desk need to greater e.g. placing the phone and papers further away from the body. What is happening at the Thoracic spine with repetitive motion e.g. is there a type 1 or type 2 restriction in movement.
A strategy could be, every 45 minutes, doing some motion. The key is to go deeper in the range e.g. more flexed position, then opposite e.g. to expode and then unload e.g. traction motion. The goal is to create a buffer for the body to manage the next period of compression. It is like brushing your teeth. Keep regular motion in the body to keep pain away.
To manage hypermobile joints I want to first know what is causing the hypermobility. What parts of the body are pissing off the joint? I can assess from bottom up and find the major rocks. If the shoulder is hypermobile I might find the hip is not loading correctly and I must get a better load on the buttock to take the need for increased load off the GHJ. I should not treat at the GHJ. I should treat other areas in the chain, get these areas strengthened to take load off the GHJ. Remember the body is chain reaction and the body can heal itself. It is not the therapists job to heal, but to create the environment to heal.
Tip: Spodylolithesis is often created by a lack of motion in the TX and hips in the transverse plane, form the bottom up.
If the neck painful look at the Thoracic spine and the scapula. If the low back is painful, look at the Thoracic spine and the hips.
The main rocks on the body are the feet and ankles, hips, Thoracic spine and the head/ eyes moving the head.