Last week I was called in to pitch in and help in one of the make up’s for one of S.O.M.A.T.I.Cs mentoring session about the lower extremity which was about how to assess and treat the lower extremity. It was one of the most common things to be able to do for a manual therapy seminar the only problem is that I was only supposed to do a 2 hour lecture for the lower extremity. Pondering about what to do and as to what type is a good way of teaching manual therapy, I went to one of the constant things that I do when working with the lower extremity. The thing about the lower extremity is that most people actually use their lower extremity as their primary way of moving around. As such one of the things commonly used in treating the lower extremity is movements.
The problem about movements is that while it is pretty simple. I mean everyone is able to move and also since everyone is able to do it is it a viable modality for the treatment of the lower extremity? If your answer happened to be no that might be counter intuitive since if everybody has been doing this since birth and has been using this as a way to improve oneself since birth the changing this is pretty much counter intuitive. Also if I happened to have decided in the no answer this article would not exist. Seeing that I have decided that it is a viable way of treatment, can I be able to teach a system of assessment and treatment in just 2 hours given that there are no set number of participants? The best thing to do so that I can teach everyone and be able to impart enough knowledge so as to be able to use the technique so as to treat the lower extremity the nest day is to teach them the principle of how to analyze the movements so as to be able to single out the problematic muscles and be able to treat the muscles and be able to give the appropriate exercises for it.
This article is going to be a short one as such I will not be giving a broad description and will just be trying to give you a picture as to how a therapist can treat the lower extremity using movement. The first thing you have to do is to see if the problem appears during movement or during certain stances. The thing you have to realize is when the lower extremity moves it moves in a cyclic pattern if one leg moves one leg supports the body as such you should note at which leg the problem appears also if the problem is a limitation in movement or if there is pain. This is important since to be able to solve the problem you should first understand the problem. The thing to note is that the problem usually has a problem and the trigger is important so that the symptom of the present problem can be solved. Once the problem is noted the next thing to do is to find which configuration in which the problem at hand is lessened as such it is essential to constantly communicate with the client. This is one of those times in which good customer relationships can be built and you talking skills is essential for the treatment of the condition. After finding the problematic position and the position in which the problem is lessened or the problem disappears. The next thing to do is that to figure out what is causing the problematic position of the limb. For ease of discussion we will only be talking about 2 things the position of the bones and the muscles. The thing to remember is that when the problematic position is found you should look at the possibility whether the muscle is tight or a muscle might not be firing adequately. The thing to know if the muscle is tight or problematic is to test it on the condition. If the muscle is tight a release of the soft tissues of the muscle will be enough so as to cause some change either to lessen the pain or change the position to a more stable position as to be able to do the movements better. If the problematic part is the bone then the best thing to do is to have the therapist which position would be best so as to teach the body the proper positioning of the bone by using the muscles so as to be able to stabilize them in position. The changes themselves will probably be only for a short while so the thing to do is for the client to learn to do the exercises by their own correctly for a set number of times. By going with the text book definition of things we are going by three sets of five repetitions and if it is trying to impose a position it might be beneficial for the client to be able to hold it for a period of five minutes. The thing is if the exercise is a tad hard for the client to hold for five minutes break it down to small chunks preferably in 1 minute per set and just increase the repetitions. The goal of this exercise is to bring the client to a state that he will be able to do the exercise at a basic five minute mark as it is the time usually needed by the body so as to be able to adapt and react to the position.
I believe you guys would like to ask me right now why will you give the client the treatment as a home exercise as the client might not return since you just gave them the exercise already and that they can do the exercise themselves. The thing is the body will not adjust to things so quickly it needs some time and repetition of the activities. It is basically like learning a new move in sports or a new technique once you learn it you usually are not able to do it properly after doing it once. The thing is for the body to integrate it the position or the muscle state to the body it will try to integrate it to the body after a few repetitions. This is the reason why after repeating an activity a number of times it is much easier than the first time the activity is done. Also it is important to note that at every session you will not be repeating the same exercise or it might be a sign that the client might be doing the exercise quite wrong or might not be doing it at all.
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