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87 Cards in this Set
- Front
- Back
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What is tennis elbow?
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lateral epicondylitis
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What is golfers elbow?
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medial epicondylitis
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What ligament is the primary elbow stabilizer?
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ulnar collateral ligament
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How does the radial head move in pronation?
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this glides posterior (Dorsal)
think about anitomical position |
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how does the radial head move in supination?
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radial head glides anterior (volar)
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how does the radial head move on a supine FOOSH?
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radial head moves anteriorly (to the side the palm faces)
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how does the radial head move on a pronated FOOSH?
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radial head will move posteriorly (to the side the back of the hand faces)
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What nerve root reflexes with the biceps?
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C5
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what nerve root reflexes with the triceps?
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C7
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According to greenman, what set of upper quarter muscles are chronically tight, and which are chronically inhibited?`
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flexion and pronation are chronically tight
extension and supination are chronically inhibited |
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What does the C6 nerve root reflex with?
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the brachioradialis
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Where does ulnar nerve entrapment typically occur?
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posterior to the medial epicondyle of the humerus
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What are the P's of compartment syndrome?
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pressure, pain, paralysis, paresthesia, pulselessness, pallor
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what are the treatments for tennis elbow?
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rest
forearm strap NSAIDs Roid's fasciotomoy |
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What nerve is compressed in carpal tunnel syndrome
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the median nerve
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how does the damage affect the median nerve over time?
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ischemia results in fibrous replacement of median nerve
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What does Tinel sign look for, and how is it performed?
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this is a carpal tunnel test, you tap the wrist the induce pain
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what does phalen's test look for?
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this reproduces signs of carpal tunnel syndrome
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how do you get bilateral carpal tunnel syndrome?
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some systemic diseases will cause this-
hypothyroidism DM pregnancy leukemia Gout vascular disease |
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How do you HVLA restricted elbow pronation (anterior/volar radial head)
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take into barrier (pronation)
now we want to drive the radial head posterior, so the distal radius may move anterior with its tetter-tottering over the ulna so apply posterior pressure on radial head, flex arm, and HVLA it |
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how do the ends of the radius move relative to one another?
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they move in opposite directions
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How do you do HVLA for restricted supination (posterior/ dorsal radial head)?
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attempt to drive radial head anterior,
elbow in full extension,supineation, and slight adduction thrust! |
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What is the counterstrain position for lateral epicondyle/radial head?
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full extension, fully supineated, and abduction
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What is the counterstain position for medial epicondyle/pronators?
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full flexion, pronation, abduction
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what is the counterstain position for the triceps?
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hyperextension of elbow- may adduct/abduct
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What is the counterstain position for the biceps?
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palm up, marked elbow flexion- looks like your swearing in
tenderpoint is on the coronoid process |
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What actions cause lateral epicondylitis?
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screwdrivers
painting a wall racquet sports |
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What motions cause lateral epicondylitis?
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extension and supineation
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What is the most common direction of radial head dysfunction?
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posterior radial head
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How long do you hold the position on Phalen's test for?
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one minute
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What is the HVLA technique for wrist dysfuctions?
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a wrist whip, localizing on the dorsal radiocarpal joint.
and hyperextends the wrist in the end |
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How do you treat the many palmar wrist retinaculum tender points?
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flex wrist to wrap around points, fine tune
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How do you perform the Flexor retinaculum stretch?
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this looks like a scene from evil dead.
strangle the pt's wrist with both your hands, over flexor retinaculum pt opens and closes their hand 5-10 times |
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How do you perfrom an Opponens Roll?
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pt has had supine, you grab the base of the thumb and pinky, and pull them apart (
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How do you perfom the self stretch for palmar flexion stretch?
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fully extended elbow, point fingers up, and place back of hand against the wall
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Other than treating carpal tunnel directly, what other regions can you treat?
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cervical, rib, and myofascial restrictions
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What is thoracic outlet syndrome
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pain numbness or weakness of the arm secondary to compression of the brachial plexus @ cervicobrachial junction
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what are the three sites of entrapment for thoracic outlet syndrome?
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anterior scalene
costoclavicular region pectoralis minor |
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What are the clinical signs of thoracic outlet syndrome?
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weakess, numbness, parathesia
cold swollen cyonotic arms |
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What is Adson's test? hows it done?
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this is for thoracic outlet syndrome
extend arm posterioly, with head turned away from affected side. + test is deminished pulse, or neuro signs |
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What does a positive Adsons test indicate?
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hypertonic anterior/ middel scalenes
OR nerve root impingement proxminal to brachial plexus |
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What does a positive military posture test indicate?
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inhaled 1st rib, or inferior clavical.
OR nerve root impingement distal to brachial plexus |
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How do you preform the pectoralis minor hyperextension test?
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arm is extended behind, and raised up to 90 degrees
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What does the axial compression test indicate?
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spinal impingement @ level of spine
due to: degenerative disks, stenosis, or bone pathology |
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On the neruo exam, where does this relate to C5
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lateral arm
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On the neruo exam, where does this relate to C6
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volar index finger
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On the neruo exam, where does this relate to C7
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volar middle finger
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On the neruo exam, where does this relate to C8
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volar 5th finger
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On the neruo exam, where does this relate to T1
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volar medial forearm
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On the motor testing exam, what action does this relate to C5
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biceps
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On the motor testing exam, what action does this relate to C6
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wrist extension
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On the motor testing exam, what action does this relate to C7
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Triceps
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On the motor testing exam, what action does this relate to C8
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finger flexion
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On the motor testing exam, what action does this relate to T1
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finger abduction/adduction
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What does the costoclavicular maneuver test for?
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tests vascular compromise of the subclavian artery*
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What does the hyper abduction test look for?
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tests for compromise of the subclavian artery (looks like the touchdown sign)
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What does Jacksons test look for, and how is it preformed?
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nerve root impingement.
side bend head toward affected side, then compression test |
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What does spurlings maneuver look for, and how is it preformed?
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tests for cervical nerve root dysfunctions.
extend, rotate, and then axial compression (rotate toward side in question) |
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How do you do Posterior rib 1 tender point counterstain? (for TOS)- exhaled rib
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doc's knee on table
drape pt's arm over on affected side sidebend head twoard- no rotation |
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how do you do muscle energy positioning for ribs one and two- exhaled dysfunctions?
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pt supine, put one of doc's hands behind their back, to apply anterior/caudal traction.
1st rib- woe is me postion, head neutral. lift head with inhale 2nd rib- woe is me position, head rotated slightly to side opposite dysfunction** |
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how do you position for 1st and second inhaled rib dysfunction muscle energy?
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pt supine.
flex/sidebend head toward rib on deep exhale, pt pushes head back into doc, while doc presses front of rib down |
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How do you treat a superior clavicular head with ME?
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pt supine
grab superior aspect of proximal claviular head. (penguin position) pt flexes (adducts) shoulder against the doc's outward resistance. (this uses pec's to pull the clavical inferior) |
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how do you treat anterior clavicular head with ME?
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pt supine
pt places outstretched arm on docs shoulder doc uses one hand to push the clavicular head posterior, and the other hand to pull the scapula (and thus out stretched arm) anterior |
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What shoulder muscles get tight? (3)
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shoulder capsule
L. scapula Latissimus dorsi |
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What shoulder muscles get weak (2)
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Mid/low traps
serratus anterior |
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What muscle substitutes for weak shoulder muscles?
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Pec major/minor
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what neck muscles get tight? (2)
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SCM
Scalenes |
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what neck muscles are inhibited?
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deep cervical flexors
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What somatic dysfunctions occur when inhibition of the lower trapezius?
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FRS in lower T spine
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what dysfunctions occur with serratus inhibition?
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alternating stacked ERS's in mid thoracics
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what does the cervical flexion test look for?
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inhibited deep flexors of the neck (longus coli)
and hypertonic SCM/scalenes |
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What are the 4 inhibited muscles in the bilateral shoulder abduction maneuver?
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serratus anterior
low/mid traps rhomboids supraspinatous |
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What are the 2 hypertonic muscles in the bilateral shoulder abduction test?
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levator scapulae
upper traps |
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What is the ideal firing sequence for unilateral shoulder abduction test?
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supraspinatous 1st
deltoid 2nd infraspinatous mid/low trap contralateral QL last* |
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what fires first a dysfunctional unilateral shoulder abduction manevuer?
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tight levator scapula fires first and messes up the pattern
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what muscle does the sacpular depression test look for?
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inhibited lower traps- monitors their firing pattern
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how do you position the head for L scapulae self stretch
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Flex
sidebend AWAY rotate AWAY lean AWAY |
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how do you position for the upper trap and SCM stretch?
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supine-
Flex SB away Rotate TO tuck chin |
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How do you position for scalene stretch?
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hold down trap.
sidebend AWAY rotate (either way) Tuck chin to tightness |
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how do you position for the posterior shoulder capsule stretch?
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lay affect side down
elbow at 90, use free hand to press wrist to table, then roll around on it |
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what is the order for strengthening and stretching?
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stretch tight first, then strengthen weak
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how do you retrain the inhibited deep neck flexors (longus capitis and longus coli)
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pt seated, nod head forward while monitoring SCM to make sure they arent firing
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how do you do lower trap retraining?
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prone, lift arm of table, and try to posteriorly rotate at the shoulder/elbow
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How do you SELF treat FRS thoracic dysfunctions
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on all fours, then go to sway back (hyper extension), like a downward dog
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How do you SELF treat ERS thoracic dysfunctions?
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get on all fours, and Cat back
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how do you SELF treat FRS cervical dysfunctions?
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grasp back of neck below restricted vertebe with hand on same side as dysfunction.
extend, rotate away, sidebend away then look down and to the dysfunction |
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how do you SELF treat ERS cervical dysfunctions?
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grab back of neck with opposite hand to dysfunctional side.
flex, rotate away, sidebend away then look up and to the barrier |
