While in the Hamptons, my main man Cody Benz started developing some neck trouble.
We thought it might be helpful for y’all to see what I would do to help a cat like him.
Here you will see me go through an entire treatment session with Cody, while I do my best to explain every decision I make. A major kudos to Daddy-o Pops Bill Hartman for asking some great questions throughout the treatment.
Instead of the typical transcript I provide for these longer videos, I decided to write this up similarly to my neck pain with sitting case study format. I reflected on this case while editing the video, so you’ll see some added thoughts I had while you read through. I would recommend watching the video and reading the case study to get the most out of the material.
To me, the most important aspect of patient care is knowing who you can and cannot treat. Stratifying your patients based on who needs to be referred out, and who you can help is essential to providing the best care.
Quite simply, there are few better resources out there that outline how to do this than Scott’s ebook.
In it, he delves into what relevant questions to ask, tests to perform, and establishing a relevant diagnosis. Often underlooked, yet exceptionally important components of the clinical examination.
Again, I cannot recommend Scott’s ebook and site enough. It’s a great resource for many things PT, including many of his eclectic and unique manual therapy techniques. Definitely check this guy out.
Rehabbing a 5th Metatarsal Fracture to High Level Basketball
In this podcast, I outline a case I worked on back when I was in the NBA D League.
This kid suffered a distal 5th metatarsal fracture with only a couple minutes to spare in a game. It was a brutal injury after one of the worst games in my life that I experienced, namely because we had three guys go down in one game.
Talk about awful.
I outline my entire process and every detail of what I did to get this kid back to high level basketball. A process that started with a fracture and ended with him establishing a franchise rebounding record the last game of the season. Pretty spectacular to say the least.
I feel very fortunate to have worked with such a driven and hardworking guy, and ultimately that was what his success hinged upon. Though minor, it was an honor to be this guy’s guide back to high level performance.
In this podcast, we dive into the following topics:
“You gotta get those wisdom teeth pulled.” ~Ron Hruska
By virtue of the dentist I integrate with, the time came. And here are the results.
Zac B.E. (Before Extraction)
So at this point in my life the large HRV gains I initially had were dropping and I was still having some neck tension. Training was feeling so-so.
Test-wise, the videos below show what I look like.
Here’s my squat
And my toe touch.
Upper quadrant tests
And lower quadrant tests
And some cervical movements
My pelvis is consistently neutral and I can shift and squat with the best of ‘em. But I still present with restrictions in my thorax, neck, and mandible (BBC/RTMCC).
These limitations are likely present because of a bony block called wisdom teeth.
As you can see, the maxillary (top side) wisdom teeth limit the excurision of my lateral pterygoids for lateral trusive movements. My hope is by removing these guys I will get access to more frontal plane, which should clean, up my remaining tests.
Operation Extraction: 1/30/15
I enter the room to get prepped for surgery, and the worst possible thing occurs.
Country music is playing.
And I can’t have that!
So I politely ask one of the workers there if we can play something a bit more soothing prior to my surgery.
2pac “I ain’t Mad at Cha” begins playing.
That’s more like it.
I get the IV put in, hear some Juicy by Biggy, and pass out from the Mind Eraser anesthesia. Yes, it was actually called “Mind Eraser”, and yes, I remember nothing.
Like this happening
And definitely not this
But I do remember looking like Marlon Brando for a period of time
What was really cool about the whole experience is how little pain I felt. I probably took 2-3 pain pills at most. I think this is because I was actually excited about having this surgery done, and the reward I was hoping to get far exceeded the nociceptive information I would inevitably receive.
Just goes to show it’s all about threat perception.
Zac A.E. (After Extraction)
I waited to re-measure and assess until 6 weeks later. This way I had to some time to heal and adjust to this new sensory experience. My exercise program basically consisted of squatting, alteranting activity, and mandibular lateral trusion to feel my pterygoids.
The cons are I no longer looking like Marlon Brando, but the pro’s are the mobility gains. Check it out in the vids below.
Here are the standing tests
My upper quadrant tests
Lower quadrant tests
Here are my mandibular movements
And lastly, cervical
Since surgery I’ve been hovering between a right BC and superior T4. I consider myself no longer a TMCC patient because mandibular movement is now fully restored. The thorax position can limit cervical axial rotation.
In terms of how I feel, neck tension has been significantly reduced, especially with jaw movement. The only time I get the tension is when I am training hard or if I am reading/sitting for a real long time.
I also produce a crap-ton more saliva, which comes back to the very first question Ron asked me when I started this process. You don’t know what this stuff will affect.
Consequently, I have noticeably much more phlegm in my saliva and feel way more congested than ever. Sleep quality does not seem as good, as I have generally felt a bit more tired throughout the day.
So what gives? My thought was the wisdom teeth would be the final piece of my PRI quest, but I did not get all the changes I was hoping to get. Was Ron wrong? Did I get less wise for nothing?
The one consistent thing that I am still limited in is the cervical rotation and shoulder horizontal abduction. I am hesitant to perform any pec inhibitory activities because I have been neutral in the past. I don’t want to “stretch” something that doesn’t need stretching.
I look over my 3D CT scan that I got at the dentist office, and one thing stands out. I find my limiting factor: