Joint Mobilization

Joint mobilization or joint mob is a manual technique to improve joint accessory motion and to reduce joint pain by using specific oscillatory or sustained stretch technique. Mobilization is a manual therapy intervention and is classified by five grades of motion, each of which describes the range of motion of the target joint during the procedure.

Grade 1 - Activates Type I mechanoreceptors with a low threshold and which respond to very small increments of tension. Activates cutaneous mechanoreceptors.

Grade 2 - Similar effect as Grade I. By virtue of the large amplitude movement it will affect Type II mechanoreceptors to a greater extent.

Grade 3 - Similar to Grade II. Selectively activates more of the muscle and joint mechanoreceptors as it goes into resistance, and less of the cutaneous ones as the slack of the subcutaneous tissues is taken up.

Grade 4 - Similar to Grade III. With its more sustained movement at the end of range will activate the static, slow adapting, Type I mechanoreceptors, whose resting discharge rises in proportion to the degree of change in joint capsule tension.

Grade 5 - This is the same as joint manipulation. Use of the term Grade 5 is only valid if the joint is positioned near to its end range of motion during joint manipulation.

Knee joint mob

 Shoulder joint mob

I have uploaded videos of joint mobilization for each joint. Below is the link. So, happy studying...! =D

Hotfile - Joint Mobilization

Myotome

Myotome is a group of muscles innervated from a single spinal segment. The term myotome is also used to describe the muscles served by a single nerve root. It is the motor equivalent of a dermatome. Each muscle in the body is supplied by a particular level or segment of the spinal cord and by its corresponding spinal nerve. The muscle and its nerve make up a myotome.

Myotome testing can be an integral part of neurological examination as each nerve root coming from the spinal cord supplies a specific group of muscles. Testing of myotomes, in the form of isometric resisted muscle testing, provides the clinician with information about the level in the spine where a lesion may be present. During myotome testing, the clinician is looking for muscle weakness of a particular group of muscles. Results may indicate lesion to the spinal cord nerve root, or intervetebral disc herniation pressing on the spinal nerve roots.

Myotome distributions of the upper and lower extremity are as follows:

C3,4 and 5 supply the diaphragm (the large muscle between the chest and the belly that we use to breath).
C5 also supplies the shoulder muscles and the muscle that we use to bend our elbow .
C6 is for bending the wrist back.
C7 is for straightening the elbow.
C8 bends the fingers.
T1 spreads the fingers.
T1 –T12 supplies the chest wall & abdominal muscles.
L2 bends the hip.
L3 straightens the knee.
L4 pulls the foot up.
L5 wiggles the toes.
S1 pulls the foot down.
S3,4 and 5 supply the bladder. bowel and sex organs and the anal and other pelvic muscles.

*for further reading, you may go to this website:
           http://www.whiplash101.com/2009/11/myotomes-dermatomes-pain-help/

Clinical Practice - Transverse Myelitis

OK, today is my 3rd day of my clinical practice where I have learn how the physiotherapy department in hospital is managed. Besides, I can also see and learn how the physios are communicate and apply the hands on skill on the patient. I have been placed in Hospital Sungai Buloh and will be practising for 2 months and today is just my 3rd day. Hope I can learn more and more from this clinical practice. =)

For today, I have learn a disease call tranverse myelitis. A patient, female, 62 y/o come to the physio department with a weak right leg. She have been walking to the department by using the walking frame and accompanied by his daughter.

Transverse myelitis is a condition where the spinal cord especially the myelin sheath undergo inflammation. The causes is categorised as idiopathic which mean unknown and it can be related to the multiple sclerosis.

So, after she and I having some chats about the disease and collecting her personal details, i have done some objective assessment on her. Below are the list of a few assessments I have done on her::

1. sensation test using pin prick test.
2. Joint senses
3. coordination test, heel shin test.
4. functional test, rolling on bed, getting up from lyin, standing

The treatment I have done is just a few, some of them are,
Gait training
going up stair
standing up
dynamic and static balance

I hope, I can learn more about the disease and can manage well on this patient in the future. =)

*for more information about the transverse myelitis, below is the link for the website:

http://www.myelitis.org/tm.htm

Things To Do Before Exercise - Stretching

Below is the link for the complete guideline of stretching. Hope we all can use this guideline to have a better and proper technique of stretching and hope that any injury occurence can be minimised. Happy reading!! =D

http://hotfile.com/dl/118438387/a50df6a/Stretching.pdf.html

Things To Do Before Exercise - Warming Up

There has been some controversy in recent years about stretching before warm up. If you gonna stretch, will you injured if you stretch without specifically warming up first? NO...if you stretch comfortably and strenously. However I suggest that you do several minutes of general movement like walking, swinging arm to warm the muscles and related soft tissue before you stretch. This will get the blood moving.

Some runners have reported they are more likely to get injured if they dont warm up before stretching. It is possible to get hurt stretching if:
1) too much of a hurry, not relaxed
2) push too far, too soon, overstretching
3) not paying attention to the stretching

Here's my advice, if you are engaging in an activity such as running or cycling, warm up by doing the activity you are about to do, but at lower intensity. Example, if you are about to run, walk or jog for 2 to 5 minutes until become slightly sweat. This will increase muscle and blood temperature. Then stretch.

So, lastly from me, have a good health with a proper technique of exercise preparation so that injury can be prevented. Good luck!! =D

Joints

Now, we are going to next component in our body, that is the joints. You can learn more about joints from the link below.
Happy studying!!! =D

*credit to Gerard J. Tortora and colleague, Principles of Anatomy and Physiology

http://hotfile.com/dl/118412708/356ea3f/09_-_Joints.ppt.html

Anatomy or Body Structure - Bones

Next component that important for a physiotherapist to know is the skeletal system. Below are the links that describe more detail about skeletal system. Happy studying!! =)


 *credit to Gerard J. Tortora and colleague, Principles of Anatomy and Physiology.

http://hotfile.com/dl/118106148/1c96247/07_-_The_Skeletal_System_-_The_Axial_Skeleton.ppt.html

http://hotfile.com/dl/118107211/c6eaae5/08_-_The_Skeletal_System_-_The_Appendicular_Skeleton.ppt.html