As my clinical knowledge and understanding of the nervous system continues to develop, I am finding that "muscle strength" is a relative term. In a previous post, Chris discussed how performing repeated movements can immediately improve an individuals strength. Similar to repeated movements, joint manipulation has shown similar results clinically. The exact mechanism by which a manipulation works is unknown. The most recent evidence suggests that it is multi-factorial.
Some proposed effects of manipulation include:
1) Mechanical- breaking up intra-articular lesions
2) Neurological- "resets" nocioceptive pathways and mechanoreceptors
3) Hydraulic- changes in synovial fluid viscosity
4) Relaxation- alter muscle tonicity & restore blood flow
5) Psychological- both laying hands on the patient & hearing a "pop" are strong influences
A clinical example you can test tomorrow is assessing lower trapezius strength, then performing different manipulations, and reassessing the strength after each manipulation. The three manipulations I recommend performing are a supine thoracic manipulation, a CT junction manipulation, and C3-C4 manipulation. I want to note that restrictions may not always be found in these regions. Remember: neurophysiological effects can have a profound impact on pain and function.
Why Perform These 3 Manipulations?
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|The Student Physical Therapist||
Always evolving, Always learning