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Definition + Etiology
- Exaggeration of the normal poserior curve of the spine. Often w/ head forward + protracted scaps.
- Caused by: Prolonged poor posture
- MM Str/length imbalances
- Senile osteoporosis
- DDD, DJD, Sheuermann's, Pott's, Hemivertebra, Anterior compression Fx
- Compensation to trauma injury
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CIs + Precautions
- Do not mobilize hypermobile jts
- Do not stretch stabilizing fascia
- Do not stretch hypotonic tissues
- Structural kyphosis = pillow for support, not correction
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S&S
- Exaggerated t/s curve
- Head forward, increased cervical lordosis
- Increased/decreased lumbar curve
- Possible TOS, TMD, Add Cap, impingement syndrome
- Short pecs
- Decr lung capacity
- Breast congestion + edema
- Decr RoM in GH, c/s, t/s, ribs
- Mild-severe pain from ligs and jts, taut ishemic MMs, or discogenic pain from vertebral wedging
-
H
- Location/timing of pain
- ADLs, postural habits (work, home, driving)
- Hx of disease, surgery, activity level
- Meds, other Tx received
-
O
- Postural assessment
- Assess by correcting posture (maybe supine, no gravity)
-
P
Hyper/hypotoned structures
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M
- All applicable RoM
- ADLs
- Respiratory pattern and voloume
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N
Possible impingement syndrome (brachial plexuse, intercostals)
-
R
- TrP
- Viisceral referrals from stomach, liver, pancreas
-
S
- Respiratory volume measurements
- Rib motion
- Regional tests?
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Tx Goals
- Decrease: Pain, adhesions, fascial shortening
- Increase: postural awreness/edu, functional abilities, segmental mobility in t/s, regional inspiration
- Improve MM balance
- Balance breathing patterns
- Remove cause if possible
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Tx
- Fascial release, NMT, frictions, passive RoM to scap, c/s, g/h.
- Jts mobes to GH, sternum/ribs, vertebrae
- Swedish, intercostal stripping, diaphragmatic release, rib springing, towel roll, SCM
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Hydro
- Heat to core if no CI before stretch
- DMH steam, bath
- Fascial steam (care w/ additives)
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RemEx
- Weighted and non weight-bearing exercises
- Pec stretch
- Postural wall work
- Str to involved MM (abs, glutes)
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