October 2018 Links and Review

Every week, my newsletter subscribers get links to some of the goodies that I’ve come across on the internets. Here were the goodies that my peeps got their learn on in October. If you want to get a copy of my weekend learning goodies every Friday, fill out the form below.  That way you can brag to all your friends about the cool things you’ve learned over the weekend.

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The Sensitive Nervous System Chapter XIV: Management Strategies: Integration of Neurodynamics

This is a summary of chapter XIV of “The Sensitive Nervous System” by David Butler. The Big Picture Evidence Based Approach Here is the step by step patient care process that Butler advocates. 1)      Identify red flags and manage accordingly. 2)      Educate on the whole problem to include tissue health status, the nervous system’s role, and test results. 3)      Provide prognosis and make realistic goals. 4)      Promote self-care, control, and motivation. 5)      Decrease unnecessary fear and manage catastrophization. 6)      Get patients moving as early as possible. 7)      Help patients identify success and sense of mastery of a problem. 8)      Perform a skilled exam. 9)      Acknowledge that biopsychosocial inputs combine with the nervous system to produce pain and disability. 10)   Use any measures possible to reduce pain. 11)   Minimize number of treatments and contacts with all medical personnel. 12)   Chronic pain may need a multidisciplinary approach. 13)   Manage physical function and dysfunction. 14)   Assess and assist in improving general fitness. 15)   Assess how injury affects creative outlets and assist the patient with regaining creativity and discovering new creative outlets. Incorporating Neurodynamics There are several ways to incorporate neurodynamics into the patient’s plan of care which will be outlined below. Reassessment. Explanation. Passive mobilization. Active mobilization. Posture and ergonomics. Reassessment There are many evaluation protocols that warrant constant reassessment after applying an intervention. Be it a comparable sign or audit, neurodynamic tests can be utilized well within these systems. A word of caution with instant reassessment, as quick changes could merely be

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The Sensitive Nervous System Chapter XI: Neurodynamic Testing for the Spine and Lower Limb

This is a summary of Chapter XI of “The Sensitive Nervous System” by David Butler. Intro For today’s chapter, I have decided that the best way to learn these tests is to show you. I will write in any pertinent details you need for a good test performance. The Straight Leg Raise (SLR) SLR hacks. Add sensitizers (dorsiflexion, plantarflexion, etc) to determine nervous system involvement. Add cervical flexion or visual input to enhance responses. Be mindful of symptoms before and after pain responses. If this test is positive post-operation, it will likely be inflammatory in nature. You can preload the system further with cervical flexion or sidebending the trunk away from the test side. Here are some other ways to perform the SLR with sensitizers first. (I apologize for the way the camera shot in advance). For tibial nerve-bias. For fibular nerve bias. For sural nerve bias. Passive Neck Flexion (PNF) Here is how to perform the test. PNF Hacks. Add SLR to further bias the test. Be mindful of Lhermitte’s sign, which is an electric shock down the arms or spine. This is a must-refer sign as there is potential spinal cord damage. Slump Test Here is how to perform the slump. Slump Knee Bend In the book itself, Butler uses the prone knee bend as his base test. However, NOI does not teach this motion as much and now favors the slump knee bend. This movement allows for much more differentiation to be had. And the saphenous nerve

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