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Manual Therapy for Athletes

Manual Therapy for Athletes. Bryan Bourcier DPT, ATC, COMT, CSCS, . Outline . Manual Therapy basics Contraindications Indications Spine Mobilizations for Athletes Upper extremity Peripheral Mobilization Lower extremity Peripheral Mobilizations. Manual Therapy Basics.

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Manual Therapy for Athletes

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  1. Manual Therapy for Athletes Bryan Bourcier DPT, ATC, COMT, CSCS,

  2. Outline • Manual Therapy basics • Contraindications • Indications • Spine Mobilizations for Athletes • Upper extremity Peripheral Mobilization • Lower extremity Peripheral Mobilizations

  3. Manual Therapy Basics • Grading Mobilizations • Comparable Sign • Resistance vs Pain • R1 vs R2 • P1 vs P2 • Grades of Mobilizations • I – Small amplitude short of resistance • II – large amplitude short of resistance • III – Large amplitude midway between R1 and R2 • IV - Small amplitude midway between R1 and R2 • V- At R2 High velocity low amplitude • +, ++, -, -- variations • IV++ and III++

  4. Contraindications (Red/Yellow • Fracture (red) • Hypermobility / empty end feel (Yellow) • Pregnancy (yellow) • Cord Compression (Red) • Cancer (Red) • Patient comfort (yellow) • Open wounds (yellow) • Fusions (Red and Yellow) • Manipulation into spasm (Red)

  5. Indications • Stiffness • Pain management • Scar tissue management • “locking” or “Pinching” (Spine) • Evidence • When combined with exercise, speed up recovery • Not better if used without exercise

  6. Common Cervical Spinal Mobilizations for Athletes • Suboccipital Release • Concussions • Traction • MET • Soft tissue

  7. What are we treating

  8. Subocciptial release • Long sustained pressure on suboccipitals. • Can be done unitlaterally • Make sure knees are bent • If too painful, try traction first.

  9. Common Cervical Spinal Mobilizations for Athletes • Suboccipital Release • Concussions • Traction – Manual Vs Mechanical • MET – when and when not • Soft tissue – positional release and first rib

  10. Common Thoracic Spinal Mobilizations for Athletes • Pistol • Screw

  11. Common Lumbar Spinal Mobilizations for Athletes • Rotational Mobilization • Grade I-III • Manipulation • Chicago Roll • Shotgun • SI / IS MET • Leg Pull • A/P

  12. Upper extremity Mobilizations • Shoulder • “Fish Flop” (Shoulder pain control) • Elbow • Radial Head • Wrist • Distal Radial ulnar distraction

  13. Lower Extremity • Hip • Lateral glides (FAI) • AP and PA • Knee • Extension with ER and IR (post op and Hamstrings) • Ankle • Lateral malleolus glides (Ankle Sprains)

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