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Hi John. How does the thoracic spine check out i.e. in terms of active but particularly passive accessory movements? Does the upper limb area of symptoms appear to be "dermatomal" i.e. re its area of demarcation or could it be caused by some autonomic disturbance that is linked to a thoracic dysfunction? Philip Newton MCSP > Hello list members, > > I have taken over the care of a 16 year old male rugby player who > plays hooker at a reasonable level and apires to professionalism at > his sport. He initially had right sided neck pain going over his > right scapular and into the right side of his occiput and over his > head towards his right eye. He has also got (and continues to have) > a heavy numb feeling in his right upper limb which is unchanging with > activity and runs approximately along the C6/7 dermatome. These > symptoms had a gradual onset at the same time. > > He has had an MRI which is NAD of C spine. > > On examination he has full RoM C sp with tightness at EoR right rot > and right LF, there is NAD on palpation of the musculature. ULTTs > are all R=L=normal. PAIVM, shows moderate stiffness and mild > tenderness of C6 and 7 locally. > > I was wondering if anyone has any good ideas about treating this > problem at present I am mobilisaing C6/7 as a PA but without a clear > objective marker this is difficult to assess immediate effect, it > does make arm feel more normal. Could this be a 'stinger' as per > Jonny Wilkinson? > > I have asked him to look at the relative heights/strengths of his > props as he has had a growth spurt recently and think it may be that > he is taking more of the scrums pressure than hookers normally take. > Any other constructive comments would be gratefully recieved, > > John >