LBRLP Activity

Question 1

Indications to use traction

Answer 1

• Hard neuro signs that you can’t centralize with usual stuff
• Every other thing I try makes them worse

Question 2

If pt comes in with DJD in Lumbar spine and they have leg pain below calf, what is calf pain?

What do the neuro sx indicate?

Answer 2

it’s not just joint, but is from “nerve root” compression

Question 3

If pt comes in with DJD in Lumbar spine and they have leg pain below calf…

Why is traction useful in this case?

Answer 3

• decrease pressure and compression on osteophytes (?)

- relieving the irritation/inflammation/swelling around the nerve root

Question 4

What should be done between traction sessions?

Answer 4

• want to augment results

minimizing agg factors and mechanical stressors you know are going to make the nerve root unhappy

Question 5

Teaching hip hinging

Answer 5

• start quadruped and show him what it is
• progress to tall kneeling
• then standing

Question 6

Why would you not want to start teaching hip hinging in standing?

Answer 6

too difficult to isolate hip motion and not involve the spine

Question 7

Why might lumbar rolls not be the best thing to use for a lot of pts?

Answer 7

• great in theory, not in practice
• takes more education than just placing it behind you
• use your judgment, be realistic

Question 8

Choosing where to start with extension progression (supine or standing)

Answer 8

• depends on how much centralization you get with both movements
• if you get it in standing, don’t need to go prone
• more difficult to do during the work day

Question 9

LBRLP algorithm: high score on LANSS

Answer 9

• indicates central sensitization/chronic pain

- need something else

Question 10

LBRLP algorithm takes into account these factors

Answer 10

• LANSS score
• hard neuro signs
• neurodynamics

Question 11

LBRLP algorithm: hard neuro signs present

what category?
what is the priority?

Answer 11

• denervation category

- priority is to find something that reduces sx

Question 12

LBRLP algorithm: no hard neuro signs

Answer 12

go to neurodynamic testing

Question 13

LBRLP algorithm: (-) neurodynamics?

Answer 13

MSK category like somatic referred pain causing leg pain