Lewitt and Janda addressed this very well from a sensorimotor context. i.e.,
upper and lower crossed syndrome or tight weak link syndrome. The
literature and personal experience seems to implicate that one effects the
other.
Isolating one area by either loading or mobilizing is temporary at best in my
experience.
One of the problems with alot of the of PNF and sensorimotor movements is
that they are too low in intensity (boring) and take to much time which lowers
compliance. They just don't seem to illicit high enough torque to the mm
spindles
and other proprioceptors to create the engrams and ownership. I have seen
remarkable response using high intensity modified PNF principles, with intense
coactivation being the key. I call it eliciting the OH OH OH or wow response.
I have the patient load (with reflex ballistic impulse coactivation on balls) in
what
appears to be the weakest links. For the upper cross the patterns are (1)
scapular
depression with a kinesthetic aid in the arm pits because, for these people it
is
impossible to do without scapular pro or retraction.(2) Head forward posture
from
weak deep anterior cervicals. The anterior cervicals are loaded along with
coactivation of the scapular depressors.
Movements are intense and the patient attempts to reach a peak coactivation
intensity within 30-40 seconds. Most people start to sweat after 1 or 2 rounds.
The most remarkable thing (and it sure peaked my interest) is the reflex relax-
ation of the scalenes, levator and upper trap. When the patient stands up
they automatically shift to a more upright posture and they want to do it again.
This is getting long winded so I'll stop. The lower cross is addressed
coactivating
the abs and glut masses in specific patterns. When there is a tight residual
area
I use intense antagonist activation while performing vibro, electro, by hand, by
tool soft tissue release. Of course manipulation is an invaluable tool at the
right
place at the right time.
Best regards
Keith
Keith Zenker D.C.
Santa Cruz, CA
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w-831-462-3344
h-462-0720
Sood wrote:
> Dear friends,
> Opinion of the list is invited in the
> management of thoracic kyphosis with lumbar Hyperlordosis in the
> 32yrs female who was diagnosed and treated for osteomalacia.She was so week
> that she could hardly stand or walk .She developed the symptoms after an
> abortion and prolonged unnecessary recumbency with some psycho-somatic
> overlay.She has improved with calcium & calcitrol and Lot of psychotherapy
> and motivation to live life with more positive toughest.All the
> investigation including MRI were normal.and she had pain almost every where
> .Now she has no pain or any complain except the deformity thoracic kyphosis
> with lumbar Hyperlordosis due to posture adopted most of the times during
> the time she was not moving around.
> How to rectify the residual deformity.I
> have put her on extension exercises
> of upper back.with scapular muscle stretching.Any corrective Brace if used
> can it help ?I seek
> to correct the element of Kyphosis without increasing lordosis.
> Thanking you all,
> Dr.Sarveshwar Sood
>
> Orthopaedic Surgeon & Head Department of Physical
> Medicine & Rehabilitation,
> Member American Academy Of Pain Management.
> S.B.L.S.Hospital
> 812/1,Housing Board Colony
> Model Town,Jalandhar city
> Punjab State.India
> E-mail [log in to unmask]
> http://personal.vsnl.com/sarveshwar
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