Physio Charlie

http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=207...

M. J. Hancock, C. G. Maher, J. Latimer, M. F. Spindler, J. H. McAuley, M. Laslett, N. Bogduk

This is a good review suggesting just how hard it is for any test to accurately diagnose pathology.  It states that a combination of SI jt tests are relevant and that clinical reasoning is important...nothing we didn't already know really.

I have a new website!!

http://physiocharlie.vpweb.co.uk

I  had supervision on 20/12/06.  We discussed Lx ax and rx.  Very useful, especially for neurodynamics, only actively move one limb, distal to joint ie like the ULTT.

What is prolotherapy? from http://www.prolotherapy.com/prolodefine.htm

First, it is important to understand what the word prolotherapy itself means. "Prolo" is short for proliferation, because the treatment causes the proliferation (growth, formation) of new ligament tissue in areas where it has become weak.

Prolotherapy uses a dextrose (sugar water) solution, which is injected into the ligament or tendon where it attaches to the bone. This causes a localized inflammation in these weak areas which then increases the blood supply and flow of nutrients and stimulates the tissue to repair itself.

Historical review shows that a version of this technique was first used by Hippocrates on soldiers with dislocated, torn shoulder joints. He would stick a hot poker into the joint, and it would then miraculously heal normally. Of course, we don’t use hot pokers today, but the principle is similar—get the body to repair itself, an innate ability that the body has.

How long will it take to complete a course of treatments?

The response to treatment varies from individual to individual, and depends upon one's healing ability. Some people may only need a few treatments while others may need 10 or more. The average number of treatments is 4-6 for an area treated. The best thing to do is get an evaluation by a trained physician to see if you are an appropriate candidate. Once you begin treatment, your doctor can tell better how you are responding and give you an accurate estimate.

iCSP discussion:

Today I had a 69 yr old female with LBP come into the clinic.  I had Ax her previously and found on stork testing that the right SI jt was imobile and the left gave a "clunk".  I did an SI jt mob with the patient in supine, grasped her right leg between my legs and placed my hand over the right PSIS.  I gave her 3 mobs Gd IV++ then rested.  After the second lot of 3 mobs we noticed a dramatic improvement in right SI jt movement and no clunking on the Left.  Fantastic result!  I will r/v the patient in 1/52. 

I had a referal from an orthopaedic physio with a patient with a positive piedallu's sign.  I had heard of this but had to refresh my knowledge. (From Magee) The patient is seated and the physio stands behind the patient palpating the PSIS's. If one PSIS, usually the painful one is lower than than the other, the patient is asked to forward flex.  If the lower PSIS becomes the higher one, it is positive - hypomobile.  abnormality in the torsion movement at the SI jt.