Lumbar

Question 1

How do you diagnose Lumbar SD?

Answer 1

TART:

• Look for asymmetry
• Palpate for Tenderness/tissue texture abnormalities
• Range of motion:
• Lumbar Flexion - 40-90
• Lumbar Extension - 20-45
• Lumbar Rotation - 3-18
• Lumbar Sidebending - 15-30

PTP Evaluation:

TONGO - Type One Neutral Grouped Opposite side

Type 2: Flexed/Extended, Singel segment, Same side

Question 2

How do you do a Direct Treatment for Lumbar SD?

Answer 2

MET

TYPE 1:

• Have pt seated
• Have pt grasp their neck with Ipsilateral hand to the PTP
• Examiner sitting at their side monitoring TP at the APEX of the group
• Other hand is on the Pt’s bicep ipsilateral to side of PTP by passing it beneath opposite arm first

Type 1 - Pass on top of 1 arm

• Move pt into restrictive barrier (Rotation and Sidebending)
• Have pt resist force into restrictive barrier for 3-5 seconds
• Find new barrier
• Repeat 2 more times
• Return to neutral
• Reassess TAT

TYPE 2:
- Same as Type 1, but Pass non-monitoring arm over BOTH biceps

Question 3

How do you do an Indirect Treatment for Lumbar SD?

Answer 3

Lumbar Prone Pressure MFR

“Feel hypertonicity in paraspinal muscles”

• Pt is prone
• Doc standing opposite side of dysfunction
• Place hands on paraspinal muscles
• Provide gentle ventral and lateral force using body weight
• Induce Perpendicular stretch repeat along the lumbar spine