Ted German – Manual Therapy for Low Back Pain: Hands-on Treatment for Lumbar, Sacroiliac, & Pelvic Dysfunctions

Outline

PRINCIPLES OF ORTHOPEDIC EVALUATION

• Goals of the first visit
• Empathy vs sympathy
• Establishing consistency
• Avoiding clinical blindness
• Who should be referred to therapy
• Red flags
• Keys to subjective and objective evaluations

EPIDEMIOLOGY OF LOW BACK PAIN

• Predisposing factors
• Bony Anatomy of the Lumbar Spine
• Soft tissue anatomy of the Lumbar Spine
  • Ligamentous support
  • Muscular support
  • Intervertebral disc
• Biomechanics of the Lumbar Spine
• Common Diagnoses
  • Degenerative Joint Disease
  • Spondylosis
  • Spondylolysis
  • Spondylolisthesis
  • Disc protrusion
  • Herniated Nucleus Pulposis

EVALUATION OF LUMBAR SPINE DYSFUNCTION

• The key to subjective history
• Posture assessment
  • Sitting, Standing, dynamic, lordosis, lateral shift
• Movement loss
  • How much
  • Quality of the movement
  • Willingness to move
  • Lateral deviation
• Repeated Movements
  • What happens during movement
  • What happens because of the movement
• Static tests
• Neurological
  • Motor/sensory deficit
  • Reflexes
  • Dural signs
• Other considerations
  • Hip/SI joint clearing tests
  • Spondylolisthesis
  • Intermittent claudication tests

TREATMENT OF LUMBAR SPINE DYSFUNCTION

• Treatment of the acute patient
  • Modalities
  • Mid-range movement techniques
• Sub-acute/chronic patient
  • Postural syndrome
  • Dysfunction syndrome
  • Adherent Nerve Root
  • Derangement
• Treatment
  • Reduction
  • Maintain
  • Recovery of function
  • Prevention
• Manual Therapy techniques
  • Prone extension with manual overpressure
  • Prone Lumbar extension mobilization
  • Flexion Rotation mobilization