Has the term "clinical reasoning" become a cliche? In the video below, NAIOMT founding member, Erl Pettman, discusses the role of clinical reasoning with Brett Windsor, and shares his advice for young PTs.

"Clinical reasoning is much like puzzles. The people who love puzzles as a child, they're going to be the clinical reasoners of tomorrow."

Topics: lumbar spine, lumbopelvic spine, manual therapy, Clinical Fellowship Program, Clinical Reasoning, low back pain, tele-pt, telehealth

In the manual therapy video below, NAIOMT's Angela Gordon demonstrates a posterior shear test, which can be used to check for ligamentous instability.

The patient is asked to gently push into the table while the PT blocks the inferior vertebrae and feels for the superior vertebrae to slide backward. Over pressure can be applied to further assess ligamentous integrity. In a normal spine there should be little mobility here. You can compare various segments to determine where there is excessive mobility.

Topics: lumbopelvic spine, manual therapy, NAIOMT, Manual Therapy Videos, sacro-iliac joint

We don't have to tell you that low back pain is pervasive among patients. But as PTs, it can sometimes be a tough nut to crack. Here are a few insights gathered by our faculty of practicing clinicians over the years, that can help guide you in assessing and treating your patients who are struggling with it.

Topics: lumbopelvic spine, low back pain

In the manual therapy video below, NAIOMT's Valerie Coolman demonstrates a mobilization for bilateral stenosis or hyperlordotic lumbar spine unable to flex. This technique is taught at the C-611 Lumbopelvic Spine II course. For more guidance from Valerie in person, meet her over at our new Chicago course site.

Topics: lumbar spine, lumbopelvic spine, manual therapy videos, Manual Therapy Videos, Uncategorized, anterior sheer test

As the weather warms up in the coming months, trail running will be picking up too. In the manual therapy video below,  I discuss the functional use of the hip muscles, and demonstrate one of my favorite exercises that I use with patients who want to return to trail running after an injury. 

Topics: lumbar spine, lumbopelvic spine, manual therapy videos, Manual Therapy Videos, Uncategorized, anterior sheer test

It can be difficult to get enough speed to perform an effective lumbar gapping manip on larger patients. In the manual therapy video below taken during  our Manip Like a Girl: Work Smarter Not Harder course, NAIOMT's Stacy Soappman demonstrates ways to overcome that challenge .

 

Topics: lumbar spine, lumbopelvic spine, manual therapy videos, Manual Therapy Videos, Uncategorized, anterior sheer test

The manual therapy video below, NAIOMT's Dallas-based faculty member, Michael Lucido, PT, DPT, OCS, COMT, FAAOMPT demonstrates spinal engine with the goal of correcting sacral dysfunction. 

Topics: lumbopelvic spine, manual therapy, NAIOMT, Manual Therapy Videos, sacro-iliac joint

Do you see patients with SI joint pain? In the video below, NAIOMT faculty member, Stacy Soappman, discusses her approach to testing and treating a 27-year-old male who came into the clinic with SI Joint pain.

 

The lumbar scan was done to rule out neurological involvement and serious pathology. As part of her lumbar exam she did a biomechanical exam including joint and muscular assessment. What she found was the patient had a lot of muscular imbalance between sides. 

 

Since he experienced stability problems of the SI joint, she choose stability work that involved stance activities, as the SIJ is designed to be more stable in a loaded position. For example, she had him stand on the wobble board and balance, do squats on the flat side of the BOSU, and single leg activities while moving the non WBing leg. To wean him off the SI belt she had him start by doing short duration activity without it and gradually increased the time each day he was out of the belt. 

 

Topics: lumbopelvic spine, lumbopelvic spine courses, NAIOMT, treating lumbar spine

In the manual therapy video below, NAIOMT faculty member Stacy Soappman explains why it's useful to have three different muscle testing approaches for the lumbar spine. Essentially, each has a different intent:

Shortened Position

For neurological conductivity, fatiguing versus consistent weakness.

Mid-range Position

Looking at the power position, and giving it a manual muscle test grade to document in chart to use an objective measure to show how they've improved and gained strength over the course of physical therapy.

Lengthened Position

To pick up minor tissue damage, if looking for grade one strain.

Topics: lumbar spine, Lumbopelvic Spine, lumbopelvic spine, manual therapy videos, Manual Therapy Videos, Uncategorized

In the manual therapy video below, NAIOMT’s Stacy Soappman provides a brief review of Sacroiliac Joint assessment and treatment. 

In order to determine if gapping manip of the SI Joint is appropriate for a patient, she performs a standing weight bearing assessment. If the tests are symmetrical and patient presents with the same dysfunction both in standing and in non weight bearing tests, she moves forward with the manipulation. If there's a discrepancy between the two components of the test, she does not use manipulation, but instead employs another approach such as soft tissue, exercise or needling to help with the neuromuscular balance component.

Topics: lumbopelvic spine, lumbopelvic spine courses, manual therapy, manual therapy certification, treating lumbar spine