Chiropractic & Rehabilitation
© Copyright 2019 George K. Petruska, DC, DACRB
Sports and Rehab Performance

Articles

Post Surgery Elbow Rehab

This article descibes post surgery rehab of a successful elbow repair. The patient’s elbow was shattered when he fell from a roof. The concepts described in this article can be considered and applied to Post Surgery Rehab.

Evaluation of Gait and Station- Assessing and Treating Asymmetry

Often many health care providers perform orthopedic and neurological testing without functional assessment. In depth assessment of acute, and chronic conditions is paramount to forming an accurate diagnosis. Complete assessment is equally important in designing an effective treatment plan. Accurate assessment, and an effective treatment plan enhance the chances of a favorable outcome.

Functional Approach to the Assessment and Treatment of Acute Disc

Related Low Back Pain 

The patient presented with acute vertebrogenic disc related low back pain of biomechanical origin. There was complaint of associated sciatic pain as well as trunk and lower extremity muscle imbalances. The mechanism of injury was a work related torsion injury to the lumbar spine. Initial medical management consisting medication provided only palliative relief. A four- month program of in-office rehabilitation including gym ball stability exercises, endurance training, proprioception training and work conditioning was administered. Initially a brief course of Phase II rehabilitation including therapeutic modalities and Otis Ring protocol were utilized. During phase II & III rehabilitation manipulation was utilized to support the primary treatment as necessary. This program proved effective in providing long-term resolution of the patient's low back pain along with an early return to regular work functional requirements and activities of daily living.

A Functional Approach to

Cervicogenic Headaches

Patients often present with either acute or chronic vertebrogenic related headaches of biomechanical origin. There are usually complaints of associated neck and upper thoracic pain as well as muscle imbalances. The originating mechanism of injury is often a sprain/strain; however, this problem can present as either an acute or chronic condition. The presentation includes either an anterior or posterior head translation. Medication and/or passive therapy usually only provide palliative shortterm relief. An intensive program of in-office rehabilitation including gym ball stability exercises, endurance training, and conditioning was administered. Initially, a brief course of passive therapy including therapeutic modalities was utilized. The patient was quickly transitioned to a phase II rehabilitation program and eventually transitioned into a phase III rehabilitation program.  During Phase II and III of the rehabilitation program manipulation was utilized to address noted joint dysfunction as necessary. The cases reviewed proved effective in providing a long-term resolution of the postural deficits, provided long term resolution of the patient’s symptoms and most important, improved the patient’s capacity for occupational, recreational, social and daily activities. 

A Functional Approach to Scoliosis

Patients that present with idiopathic scoliosis usually have a combination of four areas of deficit. The areas of deficits are usually histologic, structural, endocrine and neurological. There are usually complaints of associated neck, upper thoracic and lower back pain as well as muscle imbalances. The presentation includes abnormally shaped vertebrae, increased growth hormone secretion, muscle imbalances including strength and neurologic deficits. The research indicates that for idiopathic scoliosis to occur, all four components must be present to some degree. The originating mechanism is usually genetic and therefore difficult to resolve; however, positive functional outcomes are possible based on a variety of factors. Age and curvature are important predictors when determining the potential for a positive outcome from treatment. The younger the patient and the greater the curve, the more likely the condition will progress negatively if untreated. With appropriate treatment, the potential for positive change is generally good.
Chiropractic & Rehabilitation
© Copyright 2019 George K. Petruska, DC, DACRB

Articles

Post Surgery Elbow

Rehab

This article descibes post surgery rehab of a successful elbow repair. The patient’s elbow was shattered when he fell from a roof. The concepts described in this article can be considered and applied to Post Surgery Rehab.

Evaluation of Gait and

Station- Assessing and

Treating Asymmetry

Often many health care providers perform orthopedic and neurological testing without functional assessment. In depth assessment of acute, and chronic conditions is paramount to forming an accurate diagnosis. Complete assessment is equally important in designing an effective treatment plan. Accurate assessment, and an effective treatment plan enhance the chances of a favorable outcome.

Functional Approach

to the Assessment and

Treatment of Acute

Disc Related Low Back

Pain 

The patient presented with acute vertebrogenic disc related low back pain of biomechanical origin. There was complaint of associated sciatic pain as well as trunk and lower extremity muscle imbalances. The mechanism of injury was a work related torsion injury to the lumbar spine. Initial medical management consisting medication provided only palliative relief. A four-month program of in-office rehabilitation including gym ball stability exercises, endurance training, proprioception training and work conditioning was administered. Initially a brief course of Phase II rehabilitation including therapeutic modalities and Otis Ring protocol were utilized. During phase II & III rehabilitation manipulation was utilized to support the primary treatment as necessary. This program proved effective in providing long-term resolution of the patient's low back pain along with an early return to regular work functional requirements and activities of daily living.

A Functional

Approach to

Cervicogenic

Headaches

Patients often present with either acute or chronic vertebrogenic related headaches of biomechanical origin. There are usually complaints of associated neck and upper thoracic pain as well as muscle imbalances. The originating mechanism of injury is often a sprain/strain; however, this problem can present as either an acute or chronic condition. The presentation includes either an anterior or posterior head translation. Medication and/or passive therapy usually only provide palliative shortterm relief. An intensive program of in-office rehabilitation including gym ball stability exercises, endurance training, and conditioning was administered. Initially, a brief course of passive therapy including therapeutic modalities was utilized. The patient was quickly transitioned to a phase II rehabilitation program and eventually transitioned into a phase III rehabilitation program.  During Phase II and III of the rehabilitation program manipulation was utilized to address noted joint dysfunction as necessary. The cases reviewed proved effective in providing a long- term resolution of the postural deficits, provided long term resolution of the patient’s symptoms and most important, improved the patient’s capacity for occupational, recreational, social and daily activities.