I would say definitely a work conditioning (physical upgrading) programme
specifically addressing the deficits. From your description, only hands on
stuff would probably give you little joy. Sounds like a fairly vigorous
programme is needed and perhaps some pain management strategies.
Anna Lee.
Principal, Work Ready
Write to me at [log in to unmask]
Visit me at www.workready.com.au
Snail mail:
Suite 3, 82 Enmore Road
Newtown 2042
Australia
Phone: (02) 9519 7436
Mob: 0412 33 43 98
Fax: (02) 9519 7436
-----Original Message-----
From: Miller, Tricia <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: Saturday, 30 January 1999 7:55
Subject: sacral fracture
>I have an interesting and challenging case I could use some suggestions
for.
>An otherwise healthy 24 year old female came to the clinic 1 1/2 years
after
>a motor vehicle accident resulting in an L5-S1 transverse process fracture,
>and sacral fracturing x 3. She has a history of spondylolisthesis of the
>lumbar spine. 7 months ago she had her coccyx removed. She presents to
the
>clinic with complaints of constant pain in the sacral region and low back,
>and little/no tolerance for sitting or static standing. Examination
reveals
>nearly full trunk ROM with pain on extension. Strength findings are
>minimal, with minimal decrease in hip rotation and flexion muscle power.
>Flexibility of the hamstrings is good, hip flexors good. Special testing
>reveals pain with SLR, Fabers, long sit and prone knee bend. Neuro signs
>are negative. Palpation reveals significant severe pain with mild-moderate
>pressure over the central lumbar spine, paraspinals, and entire sacral
>region.
>This patient is facing spinal fusion surgery if conservative physical
>therapy is not successful.
>Please email any suggestions for effective techniques to decrease pain,
>increase stability, etc. to allow this patient to meet her goals for
>recovery.
>Thank you,
>Amy Corazzari, MPT and Tricia Miller, PT at MacNeal Hospital, Berwyn, IL
>
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