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Manual Therapy for Athletes Bryan Bourcier DPT, ATC, COMT, CSCS,

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Presentation on theme: "Manual Therapy for Athletes Bryan Bourcier DPT, ATC, COMT, CSCS,"— Presentation transcript:

1 Manual Therapy for Athletes Bryan Bourcier DPT, ATC, COMT, CSCS,

2 Outline Manual Therapy basics Contraindications Indications Spine Mobilizations for Athletes Upper extremity Peripheral Mobilization Lower extremity Peripheral Mobilizations

3 Manual Therapy Basics Grading Mobilizations Comparable Sign Resistance vs Pain – R1 vs R2 – P1 vs P2 Grades of Mobilizations – I – Small amplitude short of resistance – II – large amplitude short of resistance – III – Large amplitude midway between R1 and R2 – IV - Small amplitude midway between R1 and R2 – V- At R2 High velocity low amplitude +, ++, -, -- variations IV++ and III++

4 Contraindications (Red/Yellow Fracture (red) Hypermobility / empty end feel (Yellow) Pregnancy (yellow) Cord Compression (Red) Cancer (Red) Patient comfort (yellow) Open wounds (yellow) Fusions (Red and Yellow) Manipulation into spasm (Red)

5 Indications Stiffness Pain management Scar tissue management “locking” or “Pinching” (Spine) Evidence – When combined with exercise, speed up recovery – Not better if used without exercise

6 Common Cervical Spinal Mobilizations for Athletes Suboccipital Release – Concussions Traction MET Soft tissue

7 What are we treating ConcussionWhiplash neck pain and stiffness, headache, dizziness fatigue jaw pain activity intolerance postural weakness visual disturbances tinnitus increased symptoms with fatigue neck pain and stiffness, headache, shoulder and arm pain dizziness fatigue activity intolerance jaw pain postural weakness visual disturbances tinnitus back pain increased symptoms with fatigue

8 Subocciptial release Long sustained pressure on suboccipitals. – Can be done unitlaterally – Make sure knees are bent – If too painful, try traction first.

9 Common Cervical Spinal Mobilizations for Athletes Suboccipital Release – Concussions Traction – Manual Vs Mechanical MET – when and when not Soft tissue – positional release and first rib

10 Common Thoracic Spinal Mobilizations for Athletes Pistol Screw

11 Common Lumbar Spinal Mobilizations for Athletes Rotational Mobilization – Grade I-III – Manipulation Chicago Roll Shotgun SI / IS MET Leg Pull A/P

12 Upper extremity Mobilizations Shoulder – “Fish Flop” (Shoulder pain control) Elbow – Radial Head Wrist – Distal Radial ulnar distraction

13 Lower Extremity Hip – Lateral glides (FAI) – AP and PA Knee – Extension with ER and IR (post op and Hamstrings) Ankle – Lateral malleolus glides (Ankle Sprains)


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