![]() 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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1 Comment
impressed with your thought process. Better than most chiro's I know. But your extremely close segmentally, you're missing the big picture of supra segmental activation and interpose nucleus activation along with somatosensory activation. These guys will give you the long term response. That's why some get better then some get worse or no change at all.
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