Integrative Manual Therapysm to the Shoulder Girdle Complex.
Author: John Alegi, PT, IMPC
Abstract: This is a case study on a 39 year old man with complaints of chronic low back and neck pain. The man was experiencing pain in standing, walking, driving, and other activities of daily living. The patient received treatment with Integrative Manual Therapy that focused on biomechanics and the vascular system. After treatment was complete, the patient presented with significant increases in spinal range of motion as well as improved posture.
Key Words: Chronic Pain, Low Back Pain, Neck Pain
Background
A 39 year-old male was evaluated for complaints of chronic, right neck, mid-spine, and left low back pain, related to weight lifting about 12 years ago. Other complaints include moderate stiffness, mild decrease in concentration/attention, mild short-term memory loss, mild allergies, mild sinus problems, mild bowel problems, and mild snoring. Functionally, he reports that standing, walking, driving, working, too much activity, bending, reaching, lifting, kneeling, and too little activity make his symptoms worse. He reports that lying down and sitting alleviate his symptoms. He also reports that driving, sitting in a car, walking, and running are difficult. His sport and leisure activities are compromised, and he states that his low back "goes out" when he ski’s.
Past Medical History
His medical history includes epiglotitis 3 years ago, two concussions, and a severe Strep infection and pneumonia that required hospitalization. Traumas include several neck injuries and a rollerblading injury to his left knee. Currently, he is not taking medication. During the past five years, he has taken antibiotics.
Examination
Objective findings are as follows:
Range of Motion: Limited lumbar range of motion: lumbar flexion and extension limited by 80%.
Posture: Left shoulder protraction, increased thoracic kyphosis, and moderate forward head and neck posture.
Integrative Diagnostics: Positive Myofascial Mapping of bilateral sacroiliac joints, the left S2 nerve root, and portions of bilateral sciatic nerves; positive Myofascial Mapping1 of the arterial kinetic chain2; Disruption of Membrane2 of the left brachiocephalic vein and sublcavian artery; Osseous Compression Syndrome3 of the left clavicle; Hypertrophy Motility4 of the left clavicle; Bone Bruise5 of the left clavicle
Treatment
Treatment consisted of Disruption of Membrane Technique of the left brachiocephalic vein and left proximal subclavian artery. Next, Resistance Therapy2 to the Hypertrophy Motility in the left clavicle was performed. Osseous Compression Syndrome Technique for the left clavicle was then used, followed by the Bone Bruise technique to the left clavicle.
Outcomes
Post-treatment results are as follows:
Decreased left shoulder protraction, kyphosis, and forward head and neck posture; full lumbar flexion. Subjectively, the client felt more mobile, taller, and noticed improved spinal posture. The patient presented with decreased, positive Myofascial Mapping of the arterial kinetic chain with elimination of positive Myofascial Mapping of bilateral sacroiliac joints, and of the neural tissue of the buttock and posterior thighs.
References
1. Weiselfish-Giammatteo, Sharon, Ph.D., P.T., DCR Course: Integrative Diagnostic Series 1.
2. Weiselfish-Giammatteo, Sharon, Ph.D., P.T., DCR Course: Diaphragm Compression Syndromes.
3. Weiselfish-Giammatteo, Sharon, Ph.D., P.T., DCR Course: Upper Extremity Compression Syndromes.
4. Desert Light Health Associates Intensive Program, Bloomfield, CT, 2000.
5. Weiselfish-Giammatteo, Sharon, Ph.D., P.T., DCR Course: Cranial Therapy Series 3.