Hi all,

these are my latest finding which I somehow thk the pt is'amazing'.
I must apologize that it'll sound kind of bored as it's bit long.


Hx
off physio for 6/12 & back again now.
previous history taking was imcomplete d/t manage by other PT.
back pain since 12 yrs ago

Observation
trunk flx/ext severely limited; flx from hip
Low. Tx - Lx spine mobility: poor, mvt : poor quality
trunk rotation: bilat. limited at outer range with TRP
bilat wide area of muscle bulging -
2 noticeable lumps inf. to Lt. Scap; 1 smaller lump inf. to Rt. Scap

Kyphotic posture with rounded shd, no imbalance in both shd height; poked-chin

Palpation:
trigger points at Lt. T5-T8 & Rt. T6 tender on palpation, VAS : 7/10
, crepitus produced on palpation.
broad area of muscles spasm all the way down from bilat. upp traps
to bilat. Iliac crests. width about 4in' on each side.
deep palpation revealed spasm +++

PPIVMs: (P-A glide)
Level & Pain at
C2-C5 G II
C6-C7 G I
T1-T3 G II
T4-T9 G I
T10 - L2 G II
L2 - SIJ G III

A-P on clavicle & costocondral joints
-pain at G II

Inf. glide of 2nd - 4th ribs
- pain at G II

it seems her Lt. chest problem is of Tx origin.

As Jerry suggested, mobilising with rubber ball slightly reduced her Lt chest heaviness, but done in supine.
I was unable to progress further than G II glide, be it P-A, A-P, or inf. glide d/t pt claims to feel highly 'sensitive' if i increase the pressure.

By the way, sharileedahl, trigger points release is done in every rx.
her feedback: ' it helps me a day or two; last longer IF i stretch sometimes'
(pt. doesnt keep up exercise; dont involve in any sport at all)
anyhow, I continue it to ease her pain a little bit to give her some good sleep.

stretching was taught as home prog.
focusing on trunk rotation & flx stretch and ext. of upp. back. in std.

hopefully next week,she comes with some improvement.
thanks for all the replies guys, i appreciate that.
Hope to hear more opinion from everyone, problem yet to be solved


sincerely,
jacinta