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- “Usually, the best exercise is the one that creates the largest effect with the minimal risks” -Stuart McGill
1. It’s more than a chin-tuck and lift. “Elder women with cervicogenic headache had significantly reduced rCSAs of the rectus capitis posterior major and multifidus muscles compared to controls (p < 0.05). Larger amounts of fat infiltrates were also observed in the rectus capitis posterior major and minor and splenius capitis muscles in the cervicogenic headache group (p < 0.05). There were no changes in the size and fat infiltrate in the cervical flexor muscles (p > 0.05).”
2. This is a solid collection of exercises from the Prehab Guys for cervicogenic patients. I really like the cueing in the quadruped deep neck flexor exercise.
3. The neck influences the rest of the spine. “Head posture was found to significantly influence low back muscle endurance within subjects (p < .001), with extension yielding the highest endurance scores (boys = 186.6 ± 66.2 s; girls = 192.1 ± 59 s), followed by a neutral posture (boys = 171.3 ± 56.5 s; girls = 181.7 ± 57.3 s), and flexion (boys = 146.2 ± 63.8 s; girls = 159.8 ± 49.3 s).”
4. I had a patient who complained of bilateral hand numbness when she was washing her hair. The MD diagnosed her with bilateral carpal tunnel syndrome. She got better with treatment directed at her thoracic spine, shoulders, and neurodynamics. Moral of the story: the patient will give you the answer in the history and if something is bilateral you should probably look proximal.
5. The veins leaving the vertebral bodies are the only veins in the body that lack valves. They may act as hydraulic shock dampeners. Which is another reason why a healthy cardiovascular system is such an important variable in low back patients.
6. I see this all the time in the clinic. The hip and the back are always related. A recent study on LBP patients gives us research ammo for our empirical evidence, “On physical examination, 81 (80%) had reduced hip flexion; 76 (75%) had reduced hip internal rotation; and 25 (25%) had 1, 32 (32%) had 2, and 23 (23%) had 3 positive provocative hip tests.”
8. A picture is worth a thousand words. Or a postural assessment is worth a prediction regarding health and falls. “Forward-stooped or knee-flexion deformity relates to lower quality of life. Limited extension in the lumbar spine is a significant predictor of falling.” Continue reading “2017 Hits : Vol. 1 : Clinical Spine”