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Hip Mobility

If you ever have difficulty resolving a chronic lower back issue don’t forget to check for proper hip mobility issues. There is usually a lack of motion in unilateral and sometimes bilateral hips. Lack of motion cause inhibition to the gluteus medius and minimus with referred trigger point pain. Test for capsular mobility with Faber Test and compression you may see a lot of external rotation in the supine position. I find AIS (Active Isolated Stretching to be a great active way to loosen the hip with mobilization. Have patient foam roll or teenis ball at home to increase movement and break up scar tissue. You just might find that lower back come around when the Kinetic Chain improves.

Dr. Perry Nickelston

www.painlasercenter.com

drperry@painlasercenter.com

Open Up The Shoulder

One of the key secrets to freeing up cchroic shoulder probelms is by cncentrating on increasing thoracic spine and rib cage moblity. This is a key neglected area in a  lot of rehab programs. Below are two of my favorite ways to open up the spine with stretching and get your cleints on the fast track to feeling better. Don’t forget to submit for therapeutic exercise codes and the Foam Rollers. Thoracic spine soft tissue work. Using a Foam Roller lie back on the floor and put the foam roller under the thoracic spine. Have the patient hug themselves so their shoulder-blades shift to the side. Keep feet flat and glutes off the floor. Roll back & forth. Stay away from neck and lower back. Lean on the left and right sides to exert more pressure. This should be done on a daily basis. For patients that can’t tolerate the foam roller use ‘The Stick’ as a replacement therapy. Thoracic Spine Soft Tissue Work with Tennis Balls. Same exercise as the first one with the foam roller but using 2 tennis balls inside a sock or wrapped in athletic tape. Perform sit-ups with the thoracic spine between the 2 tennis balls. Head goes against the floor on each rep. Crossed-arm grip. Elbows up. Move the tennis balls up every 3 reps. Stay away from the lower back & neck.   Show patients how do these on a daily basis and watch the changes. Dr. Perry Nickelston, DC1-973-80-6570 www.painlasercenter.com drperr@painlasercenter.com