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Showing posts from May, 2010

Chemical mediators of pain due to disc injury

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Authors such as McKenzie have emphasized distinct pain patterns attributable to mechanical & chemical origin within the scope of mechanical spinal disorders. It is easily understood that disc injury produces pain by mechanical effect. However, injured discs can produce chemical mediators of pain. Not only this, these chemical mediators can lead to degeneration of the disc itself. Interestingly biochemical events that occur with intervertebral disc degeneration and, in particular, the role of biochemical mediators of inflammation and tissue degradation have received sparse attention in the literature. Kang et al obtained herniated lumbar & cervical disc specimens from patients undergoing surgical discectomy for persistent radiculopathy. They found biochemical mediators of inflammation due to tissue degradation play a role in intervertebral disc degeneration and in the pathophysiology of radiculopathy. Herniated lumbar & cervical discs were producing spontaneously increased a

DTFM to infra-patellar tendon (Cyriax technique)

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This following technique is very effective in infra-patellar tendinitis. So may times it is associated with jumping injuries. The lesion: 1. Cause: It occurs nearly always as a result of overuse but occasionally over load is also responsible. 2. Site: Lies at the insertion of the tendon into the inferior pole of patella. The area is 1.5 cm long. How to identify it? 1. PROM- A full and painless ROM of knee. 2. No warmth or fluid is detected. 3. Resisted test- Resisted knee extension cause pain at the exact site. 4. Palpation- Tenderness is found at the insertion of the tendon into the patella. Patient cues: Supine lying with the knee fully extended and the quadriceps muscle relaxed. Therapist cues: Therapist arrange himself suitably facing the affected knee at the mid-thigh level. Stabilization of the upper pole of the patella (UE towards the head end of the patient): He presses downwards on the upper pole of the patella with the web of his

The crossed arm MFR & fascial connections that may explain it’s effect

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Crossed arm MFR is one of the most important myofascial release practiced today. Possible causes of the crossed arm stretch or bilateral rhomboids stretch leading to radiating pain in non-segmental pattern can be many. The possible explanations are 1. Each vertebra is connected on it’s sides to different muscles. Equal amount of pull keeps vertebral alignment normal. Normal alignment is required for normal functioning of spine during loaded phases. 2. Muscle and fascia are the active and passive tensors respectively. Both are structurally & functionally integrated. Increase in tension of active tensors can lead to increase tension of passive tensors and vice versa. Thus faulty tension transmission can affect function and later on dysfunction & derangement is produced. 3. One region of the spine is connected to the other end of the spine by nuraxis & through musculo-fascial system. Trespassing of the nuraxial system or contracture of the musculo-fascial system at on