hi i need to straighten out my understanding of vertebral movement in order to isolate where the facet restriction is along the spine.
this will be very akward to describe in writing but anyhow i'lll give it a go
placing your thumbs over the transverse processes (TP) of the same vertebral level ask the patient to flex then arch backward. note the the side where the TP increases in prominence and which TP derotates.
if the the TP derotates during flexion the facet restriction is on the opposite side to the derotation
if the TP derotates during extension the facet restriction is on the same side of the derotation
also
during flexion the translation (side glide) will be blocked on the side of derotation
eg. patient flexes the derotation occurs of the left L3 facet and the right L3 facet increases in prominence. the facet resriction in on the right L3 facet. side gliding the left L3 facet is blocked in flexion and the patient is limited in left side flexion and left rotation
during extension the translation will be blocked on the opposite side of derotation
eg patient extends backward and the derotation occurs on the left side of L3 and the right L3 facet increases in prominence. the left facet is restricted. side gliding the left facet is blocked in extension and the patient is limited in left flexion and left rotation
this is important bcoz it allows us to identify the facet restriction so that more appropriate treatment can be given to rehabilitate the patient
Rx is directed so that the side of increased TP prominence is mobilised with an AP force
the side of derotation is mobilised with a side glide
this is my understanding could anyone confirm the above if i have it mixed up please correct
thankyou
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