This document presents a case review of a medial ankle sprain in a 16-year-old soccer player. It summarizes the player's history, assessment findings, diagnosis, and treatment plan. The assessment found tenderness of the deltoid ligaments and thickening of the anterior superficial deltoid ligament. The diagnosis was a grade 1 sprain of the deltoid ligament. The treatment plan focused on reducing swelling and pain through exercises and taping, restoring range of motion and strength over 3 phases of rehabilitation, and a gradual return to sport activities.
1. The document discusses making diagnoses for various causes of wrist pain through thorough history taking and physical examination.
2. Key aspects to examine include palpating the wrist to identify sources of tenderness, and performing stress radiographs and MRI to diagnose ligament injuries or fractures when initial radiographs are inconclusive.
3. Treatment options are discussed for various conditions, including cast immobilization for most scaphoid fractures and surgical fixation for displaced fractures, as well as joint leveling procedures for Kienbock's disease and salvage procedures for advanced cases.
La guía presenta una pauta de 3 fases para la recuperación de una rotura muscular en los gemelos (Tennis Leg). La Fase 1 (3-7 días) implica reposo, hielo y ejercicios de protección. La Fase 2 (7-14 días) añade estiramientos, fortalecimiento y ejercicios de núcleo. La Fase 3 (10-14 días) progresa a ejercicios más avanzados y la vuelta al deporte. El objetivo general es una recuperación gradual que evite reinjurias a través de
Tendon ruptures of the biceps brachii, one of the dominant muscles of the arm, have been reported in the United States with increasing frequency. Ruptures of the proximal biceps tendon make up 90-97% of all biceps ruptures and almost exclusively involve the long head.
Cyriax, a manual therapy technique, used to treat the soft tissue related pain. invented by James Cyriax who also coined the term "orthopedic medicine". There are various techniques described by Cyriax under the concept which are; infiltration, deep friction massage, manipulation and traction.
Cervical spondylitis & spondylosis by Dr.Bhavinbhavinchauhan36
Cervical spondylitis is an inflammation of the cervical spine joints that can occur in osteoarthritis, rheumatoid arthritis, or ankylosing spondylitis. Cervical spondylosis is a degenerative condition of the cervical spine that primarily occurs due to aging and affects the vertebral bodies, discs, facet joints, ligaments, and laminae. While spondylitis and spondylosis have overlapping symptoms, they are distinct conditions - spondylitis involves inflammation while spondylosis is a degenerative condition. Common symptoms include neck pain that may radiate to the arms, headaches, and nerve problems that can impact motor and sensory function.
Mulligan Concept for Ankle and Subtalar jointHemant Aggarwal
This document outlines 11 techniques for performing Mulligan concept mobilizations on the ankle and subtalar joint. The techniques target different aspects of the talocrural joint as well as the subtalar joint, with Techniques 1 through 5 focusing on the talocrural joint and Techniques 6 through 11 addressing the subtalar joint. Alternative approaches are also presented.
This document presents a case review of a medial ankle sprain in a 16-year-old soccer player. It summarizes the player's history, assessment findings, diagnosis, and treatment plan. The assessment found tenderness of the deltoid ligaments and thickening of the anterior superficial deltoid ligament. The diagnosis was a grade 1 sprain of the deltoid ligament. The treatment plan focused on reducing swelling and pain through exercises and taping, restoring range of motion and strength over 3 phases of rehabilitation, and a gradual return to sport activities.
1. The document discusses making diagnoses for various causes of wrist pain through thorough history taking and physical examination.
2. Key aspects to examine include palpating the wrist to identify sources of tenderness, and performing stress radiographs and MRI to diagnose ligament injuries or fractures when initial radiographs are inconclusive.
3. Treatment options are discussed for various conditions, including cast immobilization for most scaphoid fractures and surgical fixation for displaced fractures, as well as joint leveling procedures for Kienbock's disease and salvage procedures for advanced cases.
La guía presenta una pauta de 3 fases para la recuperación de una rotura muscular en los gemelos (Tennis Leg). La Fase 1 (3-7 días) implica reposo, hielo y ejercicios de protección. La Fase 2 (7-14 días) añade estiramientos, fortalecimiento y ejercicios de núcleo. La Fase 3 (10-14 días) progresa a ejercicios más avanzados y la vuelta al deporte. El objetivo general es una recuperación gradual que evite reinjurias a través de
Tendon ruptures of the biceps brachii, one of the dominant muscles of the arm, have been reported in the United States with increasing frequency. Ruptures of the proximal biceps tendon make up 90-97% of all biceps ruptures and almost exclusively involve the long head.
Cyriax, a manual therapy technique, used to treat the soft tissue related pain. invented by James Cyriax who also coined the term "orthopedic medicine". There are various techniques described by Cyriax under the concept which are; infiltration, deep friction massage, manipulation and traction.
Cervical spondylitis & spondylosis by Dr.Bhavinbhavinchauhan36
Cervical spondylitis is an inflammation of the cervical spine joints that can occur in osteoarthritis, rheumatoid arthritis, or ankylosing spondylitis. Cervical spondylosis is a degenerative condition of the cervical spine that primarily occurs due to aging and affects the vertebral bodies, discs, facet joints, ligaments, and laminae. While spondylitis and spondylosis have overlapping symptoms, they are distinct conditions - spondylitis involves inflammation while spondylosis is a degenerative condition. Common symptoms include neck pain that may radiate to the arms, headaches, and nerve problems that can impact motor and sensory function.
Mulligan Concept for Ankle and Subtalar jointHemant Aggarwal
This document outlines 11 techniques for performing Mulligan concept mobilizations on the ankle and subtalar joint. The techniques target different aspects of the talocrural joint as well as the subtalar joint, with Techniques 1 through 5 focusing on the talocrural joint and Techniques 6 through 11 addressing the subtalar joint. Alternative approaches are also presented.
Hand rehabilitation following flexor tendon injuriesAbey P Rajan
hand rehabilitation following flexor tendon injuries include introduction, clinical anatomy, tendon nutrition, tendon healing, post op. management, special cases, summary
Snapping hip syndrome is a condition characterized by a snapping sensation in the hip joint caused by tendons or muscles rubbing against the pelvic bone. It most commonly affects young athletes and women engaged in repetitive twisting motions. The three main types are iliotibial band snap, iliopsoas tendon snap, and hip labral tear. Treatment focuses on stretching muscles, strengthening hips, anti-inflammatory medications, and surgery as a last resort.
In this presentation, I have drafted the complete pulley system of hand.
Types of pulleys : Anatomical Pulleys & its types
Cruciate Pulleys & its types.
I have covered all the important things which is relevant.
El documento proporciona información sobre el esguince del tobillo. Resume que el tobillo está formado por tres huesos y varios músculos y ligamentos. Explica los tres grados de esguince del tobillo según la gravedad de la lesión de los ligamentos, así como los síntomas correspondientes. Finalmente, detalla el tratamiento no quirúrgico para los grados leves y quirúrgico para los graves.
Gait training Physiotherapy perspective.pptxSusan Jose
do you know what is gait?
lets know more this presentation.
can physiotherapist help you with your walking abilities. click on the above slide to know more.
The menisci are crescents, roughly triangular in cross section, that cover one half to two thirds of the articular surface of the corresponding tibial plateau. They are composed of dense, tightly woven collagen fibers arranged in a pattern providing great elasticity and ability to withstand compression.
This document provides an overview of how to evaluate the hand. It discusses the anatomy of the hand including bones, muscles, nerves and arteries. It describes taking a patient history and examining the hand for range of motion, deformities, palpation, observation, and functional assessment including grip strength and pinch tests. It also discusses evaluating the hand for conditions like edema and outlines tools used for various assessments.
This document discusses the management of acute ankle fractures. It begins with the incidence, clinical features, evaluation and initial management of ankle fractures. It then describes the radiographic assessment including different x-ray views. Classification systems for ankle fractures are discussed. The document outlines indications and techniques for surgical management of ankle fractures including fixation of the lateral and medial malleoli, posterior malleolus and syndesmosis. Post-operative care is also summarized.
This document discusses prehension, or gripping, which is made possible by the opposable thumb in humans. It describes two main types of grip: power grip, which involves the whole hand and is used to hold cylindrical or spherical objects, and precision grip, which requires finer motor control and pad-to-pad, tip-to-tip, or pad-to-side contact between the thumb and fingers. Specific grips like hook, spherical, and lateral grips are subtypes of power grip. Precision grips depend on intact sensation and muscles like the flexor pollicis brevis and opponens pollicis. The functional position of the wrist and fingers optimizes power and efficiency of grip.
Physiotherapy Management of the Rheumatoid HandSayantika Dhar
This document discusses hand deformities that can occur in rheumatoid arthritis. It defines rheumatoid arthritis and describes the immune response and genetic factors involved. Common hand deformities seen in late-stage RA are described such as swan neck, boutonniere, and MP joint ulnar deviation. Evaluation of hand deformities focuses on features like synovitis, nodules, crepitus, range of motion, strength and pain level. Management principles emphasize protection of joints through rest, activity balancing, pain-free exercise and avoiding positions of deformity.
Trigger thumb is a condition where the thumb develops a flexion deformity at the interphalangeal joint, causing it to snap or lock into place. It is usually caused by thickening or inflammation of the tendon sheath that forms nodules and impinges the tendon's movement. Symptoms include stiffness, popping, catching, and difficulty straightening the thumb. Treatment begins with rest, splinting, and NSAIDs, while steroid injections or surgery to release the tendon sheath may be needed in more severe cases. Surgery involves making a small incision to expose and release the tightened tendon sheath and remove any nodules present.
The document discusses common elbow injuries in athletes. It describes the anatomy and biomechanics of the elbow joint and how forces during overhead throwing can lead to injuries. Specific injuries covered include ulnar collateral ligament tears, valgus extension overload syndrome, and osteochondritis dissecans. Surgical treatment options for each injury are presented along with typical return to sport rates.
The document discusses several types of tenosynovitis disorders including intersection syndrome, De Quervain's tenosynovitis, trigger finger, and lateral epicondylitis. Intersection syndrome involves tendonitis of the first and second extensor compartment tendons from repetitive friction. De Quervain's tenosynovitis is inflammation of the tendons of the thumb from overuse. Trigger finger causes difficulty extending the finger due to thickening around the A1 pulley. Lateral epicondylitis, or tennis elbow, is a strain at the origin of the extensor tendons causing pain with wrist and elbow movement. The document provides details on symptoms, examinations, treatments including splinting, injections
complete Knee joint assessment from physiotherapeutic point of view. Includes observation , palpation , assessment, special test, differential diagnosis of knee joint .
Joint mobilization and manipulation are passive techniques used by physiotherapists to increase range of motion (ROM) and decrease pain in joints. Mobilization involves small, rhythmic movements within a joint's available ROM, while manipulation is a sudden, forceful thrust beyond a patient's control. Both techniques work to move synovial fluid, maintain joint tissue extensibility, provide sensory input, and stimulate mechanoreceptors to reduce pain. Precautions are taken with patients having conditions like hypermobility, inflammation, or bone fractures.
manual muscle testing by K Adhi lakshmi vapms copvrkv2007
Manual muscle testing (MMT) involves grading the strength of individual muscles or muscle groups on a scale based on their ability to perform movements against gravity or resistance. Key aspects of MMT include positioning and stabilizing the patient, demonstrating the movement, applying the appropriate grade of resistance, and documenting the results objectively. MMT is useful for assessing muscle weakness from various neuromuscular and musculoskeletal conditions and monitoring the effectiveness of treatment over time. Contraindications include certain neurological or orthopedic injuries or diseases that could be exacerbated by strength testing.
Trochanteric bursitis refers to inflammation of fluid-filled sacs located around the greater trochanter bone on the outside of the hip. It commonly causes deep aching pain on the outside of the hip and thigh that increases with activity and is worse when lying on the affected side. Risk factors include trauma, hip arthritis, back problems, obesity, and other conditions that alter gait or hip movement. Treatment focuses on rest, NSAIDs, physiotherapy, steroid injections, or occasionally surgery.
Post op rehabilitation pelvi acetabular fixationUday Bangalore
The document outlines post-operative rehabilitation guidelines following pelvic and acetabular fixation surgery. It recommends early mobilization following anatomical reduction and stable fixation. Exercises begin with static quadriceps exercises on day 1, progressing to dynamic exercises and passive range of motion by day 3. Toe-touch weight bearing with crutches is allowed by day 2-4, progressing to full weight bearing around 12 weeks once fracture healing is confirmed. The guidelines vary slightly depending on surgical approach and whether the fracture is unilateral or bilateral.
The document summarizes the glenohumeral joint and rotator cuff. It describes the anatomy of the joint and rotator cuff muscles. It then discusses rotator cuff pathology, symptoms, physical exam maneuvers, and special tests to assess the rotator cuff including the empty can test, lift-off test, and external rotation lag sign.
Hand rehabilitation following flexor tendon injuriesAbey P Rajan
hand rehabilitation following flexor tendon injuries include introduction, clinical anatomy, tendon nutrition, tendon healing, post op. management, special cases, summary
Snapping hip syndrome is a condition characterized by a snapping sensation in the hip joint caused by tendons or muscles rubbing against the pelvic bone. It most commonly affects young athletes and women engaged in repetitive twisting motions. The three main types are iliotibial band snap, iliopsoas tendon snap, and hip labral tear. Treatment focuses on stretching muscles, strengthening hips, anti-inflammatory medications, and surgery as a last resort.
In this presentation, I have drafted the complete pulley system of hand.
Types of pulleys : Anatomical Pulleys & its types
Cruciate Pulleys & its types.
I have covered all the important things which is relevant.
El documento proporciona información sobre el esguince del tobillo. Resume que el tobillo está formado por tres huesos y varios músculos y ligamentos. Explica los tres grados de esguince del tobillo según la gravedad de la lesión de los ligamentos, así como los síntomas correspondientes. Finalmente, detalla el tratamiento no quirúrgico para los grados leves y quirúrgico para los graves.
Gait training Physiotherapy perspective.pptxSusan Jose
do you know what is gait?
lets know more this presentation.
can physiotherapist help you with your walking abilities. click on the above slide to know more.
The menisci are crescents, roughly triangular in cross section, that cover one half to two thirds of the articular surface of the corresponding tibial plateau. They are composed of dense, tightly woven collagen fibers arranged in a pattern providing great elasticity and ability to withstand compression.
This document provides an overview of how to evaluate the hand. It discusses the anatomy of the hand including bones, muscles, nerves and arteries. It describes taking a patient history and examining the hand for range of motion, deformities, palpation, observation, and functional assessment including grip strength and pinch tests. It also discusses evaluating the hand for conditions like edema and outlines tools used for various assessments.
This document discusses the management of acute ankle fractures. It begins with the incidence, clinical features, evaluation and initial management of ankle fractures. It then describes the radiographic assessment including different x-ray views. Classification systems for ankle fractures are discussed. The document outlines indications and techniques for surgical management of ankle fractures including fixation of the lateral and medial malleoli, posterior malleolus and syndesmosis. Post-operative care is also summarized.
This document discusses prehension, or gripping, which is made possible by the opposable thumb in humans. It describes two main types of grip: power grip, which involves the whole hand and is used to hold cylindrical or spherical objects, and precision grip, which requires finer motor control and pad-to-pad, tip-to-tip, or pad-to-side contact between the thumb and fingers. Specific grips like hook, spherical, and lateral grips are subtypes of power grip. Precision grips depend on intact sensation and muscles like the flexor pollicis brevis and opponens pollicis. The functional position of the wrist and fingers optimizes power and efficiency of grip.
Physiotherapy Management of the Rheumatoid HandSayantika Dhar
This document discusses hand deformities that can occur in rheumatoid arthritis. It defines rheumatoid arthritis and describes the immune response and genetic factors involved. Common hand deformities seen in late-stage RA are described such as swan neck, boutonniere, and MP joint ulnar deviation. Evaluation of hand deformities focuses on features like synovitis, nodules, crepitus, range of motion, strength and pain level. Management principles emphasize protection of joints through rest, activity balancing, pain-free exercise and avoiding positions of deformity.
Trigger thumb is a condition where the thumb develops a flexion deformity at the interphalangeal joint, causing it to snap or lock into place. It is usually caused by thickening or inflammation of the tendon sheath that forms nodules and impinges the tendon's movement. Symptoms include stiffness, popping, catching, and difficulty straightening the thumb. Treatment begins with rest, splinting, and NSAIDs, while steroid injections or surgery to release the tendon sheath may be needed in more severe cases. Surgery involves making a small incision to expose and release the tightened tendon sheath and remove any nodules present.
The document discusses common elbow injuries in athletes. It describes the anatomy and biomechanics of the elbow joint and how forces during overhead throwing can lead to injuries. Specific injuries covered include ulnar collateral ligament tears, valgus extension overload syndrome, and osteochondritis dissecans. Surgical treatment options for each injury are presented along with typical return to sport rates.
The document discusses several types of tenosynovitis disorders including intersection syndrome, De Quervain's tenosynovitis, trigger finger, and lateral epicondylitis. Intersection syndrome involves tendonitis of the first and second extensor compartment tendons from repetitive friction. De Quervain's tenosynovitis is inflammation of the tendons of the thumb from overuse. Trigger finger causes difficulty extending the finger due to thickening around the A1 pulley. Lateral epicondylitis, or tennis elbow, is a strain at the origin of the extensor tendons causing pain with wrist and elbow movement. The document provides details on symptoms, examinations, treatments including splinting, injections
complete Knee joint assessment from physiotherapeutic point of view. Includes observation , palpation , assessment, special test, differential diagnosis of knee joint .
Joint mobilization and manipulation are passive techniques used by physiotherapists to increase range of motion (ROM) and decrease pain in joints. Mobilization involves small, rhythmic movements within a joint's available ROM, while manipulation is a sudden, forceful thrust beyond a patient's control. Both techniques work to move synovial fluid, maintain joint tissue extensibility, provide sensory input, and stimulate mechanoreceptors to reduce pain. Precautions are taken with patients having conditions like hypermobility, inflammation, or bone fractures.
manual muscle testing by K Adhi lakshmi vapms copvrkv2007
Manual muscle testing (MMT) involves grading the strength of individual muscles or muscle groups on a scale based on their ability to perform movements against gravity or resistance. Key aspects of MMT include positioning and stabilizing the patient, demonstrating the movement, applying the appropriate grade of resistance, and documenting the results objectively. MMT is useful for assessing muscle weakness from various neuromuscular and musculoskeletal conditions and monitoring the effectiveness of treatment over time. Contraindications include certain neurological or orthopedic injuries or diseases that could be exacerbated by strength testing.
Trochanteric bursitis refers to inflammation of fluid-filled sacs located around the greater trochanter bone on the outside of the hip. It commonly causes deep aching pain on the outside of the hip and thigh that increases with activity and is worse when lying on the affected side. Risk factors include trauma, hip arthritis, back problems, obesity, and other conditions that alter gait or hip movement. Treatment focuses on rest, NSAIDs, physiotherapy, steroid injections, or occasionally surgery.
Post op rehabilitation pelvi acetabular fixationUday Bangalore
The document outlines post-operative rehabilitation guidelines following pelvic and acetabular fixation surgery. It recommends early mobilization following anatomical reduction and stable fixation. Exercises begin with static quadriceps exercises on day 1, progressing to dynamic exercises and passive range of motion by day 3. Toe-touch weight bearing with crutches is allowed by day 2-4, progressing to full weight bearing around 12 weeks once fracture healing is confirmed. The guidelines vary slightly depending on surgical approach and whether the fracture is unilateral or bilateral.
The document summarizes the glenohumeral joint and rotator cuff. It describes the anatomy of the joint and rotator cuff muscles. It then discusses rotator cuff pathology, symptoms, physical exam maneuvers, and special tests to assess the rotator cuff including the empty can test, lift-off test, and external rotation lag sign.
The document provides an overview of the French digital ecosystem and key dynamics in 2016. It discusses the growth of the global digital ecosystem driven by internet players and device manufacturers. In France, the mobile market is very dynamic in terms of equipment usage and data consumption. Broadband subscriptions are also growing strongly, largely in the form of bundled plans. Telecom operators remain essential to the French digital ecosystem, however their revenues and employment levels have declined in recent years despite increased infrastructure investments to support demand for high-speed broadband.
Support d'intervention de Rémy Juston, Maître de conférence associé, département universitaire des sciences d'Agen.
Assises aquitaines du Très haut débit, organisées le 9 avril 2009 par le Conseil régional d'Aquitaine et AEC, en collaboration avec la Caisse des Dépôts.
http://www.aecom.org
El documento describe la quiropráctica y su aplicación a la rehabilitación física. Explica que la quiropráctica entiende que las subluxaciones vertebrales interfieren con la capacidad innata del cuerpo para mantener su propia salud, y que el ajuste quiropráctico corrige esta interferencia de manera no invasiva. Describe los procedimientos de evaluación, ajuste y seguimiento quiroprácticos, así como las técnicas de manipulación vertebral y sus indicaciones y contraindicaciones.
Diagnostico diferencial del dolor irradiado a miembros inferioresMiguel Mendez
Desarrollo del diagnostico diferencial entre 5 patologías principales (hernia discal, s.sacroiliaco, s.piramidal, s. trocanter mayor y meralgia) que producen irradiacion a MMII. Aspectos anamnesis, sintomatología y exploración física.
"Videos no incrustados", por separado.
Este documento trata sobre las fracturas de la columna toracolumbar. Describe la anatomía de la columna vertebral y sus curvaturas, los músculos dorsales y de los canales vertebrales, y los movimientos de la columna. Explica las causas comunes de fracturas toracolumbar, los mecanismos de lesión y las clasificaciones de A-O y Dennis. También cubre los grados de lesión, tipos de fracturas, correlación con daño neurológico y tratamientos como reposo, inmovilización ex
La columna vertebral está compuesta por vértebras que forman curvaturas como la cifosis dorsal y la lordosis lumbar. Las vértebras tienen cuerpos, procesos y apófisis que forman articulaciones con las costillas y entre sí. Los discos intervertebrales contienen un núcleo pulposo elástico y un anillo fibroso. Los ligamentos conectan las vértebras y limitan sus movimientos de flexión, extensión, inclinación lateral y rotación. Músculos como el iliocostal y el multifido ayudan
Clase de Dolor lumbar en Universidad de Chile. Se complementa con la clase de biografía del dolor lumbar. En estas se abordan detalladamente la HNP, dolor facetario, algunos casos de dolor visceral. Esta vez no se profundiza en la exploración articular sacroilíaca pues el enfoque fue la columna lumbar. En clases complementarias se abordarán problemas sacroilíacos y pélvicos además de la evaluación y estabilización del CORE abdóminoespinal.
El documento presenta una serie de pruebas funcionales para evaluar la movilidad de la columna vertebral lumbar y los nervios ciático y femoral. Incluye exámenes como la palpación de dermatomas, la movilización de tejidos blandos, la tracción lumbar en diferentes posiciones, y movimientos segmentarios de la columna como flexión, rotación y extensión. El objetivo es comprobar cambios en los síntomas del paciente y aumentar el rango de movimiento.
El documento describe los procedimientos para una evaluación manual ortopédica de la columna cervical. Incluye exploraciones subjetiva y física del paciente, así como pruebas de movilidad activa y pasiva de la columna y articulaciones cervicales para diagnosticar cualquier disfunción y establecer un plan de tratamiento.
"Apache JMeter, Java et Groovy sont sur un bateau" présentée au Paris JUGAntonio Gomes Rodrigues
Que ce soit d’évaluer le niveau de sécurité d’un captcha, chiffrer le coût en performance d’activation des logs GC d’une JVM ou d’activer/désactiver des fonctionnalités de notre application par JMX lors d’un test, l’outil de test de charge Apache JMeter offre un spectre de fonctionnalités avancées digne des meilleures solutions éditeurs. Venez découvrir les possibilités infinies qu’offre Apache JMeter associé à du Java et du Groovy
Atelier de Marc Messina sur les chaînes rotatoires du Membre inférieur lors des JFK2009.
Pour en savoir plus allez sur le site de la SFP:
http://sfk.kinemedia.fr/Pages/JFK2009.html
Actualisé: https://osteopathie-adhesiolyse.com/
les syndromes fémoro-patellaires ou rotuliens sont consécutifs à une subluxation de la tête de la fibula survenant souvent suite à une entorse de la cheville, décentrant les muscles s'insérant directement ou indirectement sur la fibula, ces muscles se contractent, sécrètent de la fibrine et se collent entre eux, décentrant la patella vers le haut et l'extérieur. L'adhésiolyse des muscles du membre inférieur permet la normalisation de la fibula. Le strapping ou la contention et l'auto-manipulation permettent de remuscler un genou centré pour solidifier la fibula et empêchant les récidives. www.osteomedsport34.com / www.adhesiolyse-manuelle.com
1. Orthopedic surgery has evolved significantly over the centuries from initially focusing on treating fractures, dislocations, and wounds to becoming a clinical science that utilizes modern technologies.
2. Major developments included Nicolas Andry establishing orthopedics as a field focused on preventing deformities in children, the introduction of anesthesia allowing less conservative and more minimally invasive surgeries, and advances in materials, antibiotics, imaging, and arthroplasty techniques.
3. Continued progress is expected in areas like computer-assisted surgery, real-time information integration, and tissue engineering as orthopedics works to solve problems like joint instability and seeks to operate robots in the future.
3. MANIPULATION
• Mobilisation passive forcée qui porte les
éléments de l’articulation au delà de leur
jeu volontaire et habituel (amplitude
extrême) sans dépasser les limites
anatomiques possibles de l’articulation.
• Docteurs en Médecine Manuelle,
Ostéopathes.
4. P. VAUTRAVERS & AL. Manipulations du rachis, EMC, Kinésithérapie-Médecine Physique-Réadaptation,
26-080-A-10, 2001, 15 p.
5. PRINCIPES
• Mouvement bref, unique, exécuté à partir de la
mise en tension. « THRUST »
• Règle de la non douleur et du mouvement
contraire (Maigne).
• Manipulation dans la restriction du mouvement
(Still, ostéopathie structurelle, USA) càd dans le
sens opposé à la dysfonction (lésion).
• « HVLA » (faible amplitude, grande énergie cinétique)
6. SCHÉMA en ÉTOILE de MAIGNE (DIM)
6 directions possibles
Manip <=> 3 directions libres et indolores
7. Placement du signe x ou des signes « / » ; « // » ;
« /// » par rapport à la longueur du vecteur
Début, milieu, fin d’amplitude
« / » faible limitation douloureuse
« // » limitation douloureuse moyenne
« /// » forte limitation douloureuse
« x » blocage sans douleur
8.
9.
10. BUTS
• Restaurer une amplitude articulaire
physiologique
-> Lever une barrière musculaire (spasmes)
-> Lever une barrière articulaire (restriction)
• Soulager les symptômes (libération du
mouvement).
11. MODES d’ACTION
• Corps vertébraux
• Disque IV
• AIAP
• Muscles para-vertébraux
• Voies supra-segmentaires de la douleur
• Système neuro-végétatif
• Placebo & psychologique
12. Action sur les corps vertébraux
• Mobilisation des CV
• Action sur mouvement intervertébral
• Action focalisée sur un étage V.
• Action sur plusieurs étages V.
• Pas de « remise en place »
• Action d’étirements des tissus (M. Tend. Ligam.
Annulus)
13. Action sur le disque IV
• Diminution de la pression intra-discale
(mesurée)
• Réintégration nucléaire (hypothèse)
15. Action sur les articulaires
postérieures
• Craquement par phénomène de cavitation
• Étirement capsulaire, effet inhibiteur sur la
contracture para-vertébrale
• Dégagement, frange synoviale, formation
méniscoïde (hypothèse)
• Débridage adhérences intra-A. (dépôts de
fibrine post poussées congestives)
16. Action sur les muscles para-vertébraux
• Structures « relais » de la douleur vertébrale
• Relâchement par étirement direct (Mev sur
Golgi, Emg)
• Relâchement indirect par étirement des
capsules
17. Action sur la douleur
• Inhibition par activation des syst. descendants
(inhibition au niv. de la substance grise péri-
aqueducale)
• Effet par contre-stimulation (étirement brusque des
structures innervées)
• Gate control système (Melzack et Wall)
18. Action par effet placebo
• Sensation de remise en place
• Craquement = vertèbre débloquée
• Soulager avant de faire de la science ?
• Évolution spontanée synd. douloureux vertébral
= favorable ++
19. Action sur le syst. nerveux végétatif
• Composante psycho-somatique végétative
plus ou moins importante
• Réactions viscérales non reproductibles
• Pas de preuve scientifique du mode d’action
20. MOBILISATION PASSIVE
• Mouvement réalisé par une force
extérieure (technique manuelle
exécutée par le kinésithérapeute)
sans participation musculaire du
sujet, mais avec sa conscience
(intégration réceptive).
21. PRINCIPES
• Mouvement exécuté soit :
-> dans toute l’amplitude permise (vitesse faible),
jusqu’à la mise en tension et non au-delà (position de
verrouillage articulaire physio. ou de fin de course
patho.),
-> autour de la position de moindre tension (position
de repos).
• « LVHA » (grande amplitude, faible énergie cinétique)
22. BUTS
• Restituer la mobilité du mouvement
physiologique (restriction de mouvement).
• Diminuer les phénomènes douloureux (gate
control).
• Lever les spasmes musculaires.
24. AVANTAGES
• L’amplitude, la vitesse, la
force, la durée des techniques,
la qualité du mouvement sont
directement sous le contrôle du
kinésithérapeute.
25. INDICATIONS
• Dysfonctionnements mécaniques d’origine
musculo-squelettique.
• Traitement de patients présentant des
symptômes articulaires (douleur plus ou
moins raideur) et des lésions des tissus
mous péri-articulaires (++ tensions
musculaires, fibrose, épaississement des
éléments anatomiques passifs, des plans de
glissements).
26. CONTRE INDICATIONS
• Pathologie inflammatoire ou infectieuse (PR,
PSR, compression radiculaire aiguë…).
• Traumatisme récent.
• Compression médullaire ou queue de cheval.
• Ostéoporose, Paget.
• Néoplasme.
• AEG.
• États dépressifs.
27. CONCEPT MÉCANIQUE
• Il existe des mobilisations passives
globales qui permettent un entretien du
mouvement articulaire.
• Elles respectent les axes et les plans
anatomiques conventionnels, le mouvement
physiologique classique.
28. • Il existe des mobilisations passives spécifiques
qui ont un effet localisé sur un segment articulaire
(périphérique ou rachidien = « arthron »).
• Elles permettent un gain du mouvement articulaire
(modelage tissulaire).
• Elles respectent la physiologie intime de
l’articulation (glissé articulaire), en s’appuyant
sur les composantes de roulement-glissement, de
pivotement, de décompression voire de
compression articulaire.
• Mouvements qui échappent au contrôle volontaire.
33. 6° de liberté
Klein P. Sommerfeld P. : Biomécanique des membres inférieurs, bases et concepts,
bassin, membres inférieurs, Elsevier-Masson, Paris, 2008.
34. Dispersion des locus CIR Harmonie Mvt Cervical
Klein P. Sommerfeld P. : Biomécanique des membres inférieurs, bases et concepts,
bassin, membres inférieurs, Elsevier-Masson, Paris, 2008.
43. BARRIERE ANATOMIQUE
POINT NEUTRE
Barrière élastique Barrière élastique
Amplitude totale
Barrière physiologique Barrière physiologique
Barrière Barrière
anatomique anatomique
44. DIFFERENCE
entre
MOBILITÉ PHYSIOLOGIQUE
MOBILITÉ PATHOLOQIQUE
• NOTION DE RESTRICTION
• NOTION DE DEPLACEMENT DU
POINT NEUTRE
45. BARRIERE PATHOLOGIQUE
cas d’une dysfonction somatique sévère
Point neutre
Barrière élastique
N pathologique
Perte de
mobilité
Barrière physiologique
Barrière
BARRIERE RESTRICTIVE
Barrière
anatomique anatomique
46. PRINCIPES GÉNÉRAUX des MPV
Feux vert des tissus sus-jacents :
-> Massothérapie,
-> Techniques Myofasciales,
-> Levées de tensions musculaires (techniques
myotensives analytiques).
47. Ne pas forcer les blocages :
-> Pas de mobilisation en force,
-> Règle de la non-douleur.
48. Bilan complet :
-> Évaluation continue avant pendant et
après le traitement (mesures reportées
sur fiche bilan),
-> Pose les bases techniques du traitement,
-> Permet la justification des gestes
techniques.
50. PRINCIPES TECHNIQUES des MPV
• Pas de notion de « thrust ».
• Mobilisations spécifiques « analytiques ».
• Lentes et progressives.
• Plus ou moins rythmées.
• Début ou fin d’amplitude (selon dominante douleur ou
raideur).
• Respiration libre
-> Pas de blocage en inspir. ou expir. (gêne à la réalisation du
geste technique).
51. • Les techniques par prises courtes sont utilisées
pour leurs précisions (++ mouvement spécifique).
Elles utilisent les mains du thérapeute.
• Les techniques par prises longues sont utilisées
pour leur grand bras de levier (++ mouvement
global).
Elles utilisent mains + membres sup. (les coudes
sont le plus souvent tendus) + tronc = 3ième appui
(notion d’étreinte avec le patient).
• Les prises longues et les prises courtes peuvent
être combinées en prises mixtes.
52. « JEU CORPOREL »
Position de départ rigoureuse :
« tout patient » - « morceau de patient »
« tout kiné » - « morceau kiné »
-> Toujours utiliser des fentes pour travailler, si
possible dans le sens du mouvement (permet
d’augmenter le polygone de sustentation du
kinésithérapeute ainsi qu’un verrouillage efficace de
son rachis lombaire).
53. Prévoir la stabilité permanente du sujet :
-> s’adapter à la taille et au poids,
-> utiliser des tables (tabourets) réglables en
hauteur,
-> éliminer les frottements (draps).
54. ÉLÉMENTS de BILAN
• Examen « subjectif »
-> Écoute du patient.
-> Son principal problème.
-> Histoire actuelle et ancienne.
-> Région des symptômes
-> Manifestation des symptômes.
• Santé générale.
• Médications (! Corticothérapie, AK !)
• Radiographies.
55. • Examen « objectif ».
-> Écoute de l’articulation.
-> But = trouver un mouvement ou une
combinaison de mouvements qui reproduisent
les symptômes.
• 3 temps :
-> mouvement actif physiologique,
-> mouvement passif global,
-> mouvement passif analytique, segmentaire
« accessoire ».
57. ÉVALUATI ON OSTÉO DATE EXAM I NATEUR
NOM PRÉNOM SEXE LATÉRALITÉ
AGE PROF COORDONNÉES
T/P
LOISIRS
HDM
DOULEUR
TYPE
EVA
I MAGES
TTT MÉDI CAL
MED TTT
MED SPÉC
AVQ (EVA FONCTION)
ATCD
D G
SG
Tabac
CLI NI QUE
PODO SURAL
LMI
PELVIS
RACHIS
SCAPULAIRE
CERVICO CÉPHALIQUE
PALPATION
MOBILITÉS
DDS
STABILITÉ LOMBAIRE PASSIVE
RCS
MUSCULAIRE
STABILITÉ LOMB ACTIVE
HYPOEXTENSIBILITÉ Ch. Ant.
Ch. Post.
NEURO
AMYO TESTING ROT SENSIB
LASSÈGUE IMPULS TOUX VERTIGES NAUSÉES
LÉRI
ATM MFR
OCULO-MOT Hypoconvergence OD OG
CONCLUSI ON & TRAI TEM ENT OSTÉO
TOG MFR RPI IP NEURO-MÉNING .
AUTRE(S)
70. CONVERGENCE : LATÉROFLEX° & ROT°
OPPOSÉES
Mise en tension Manipulation (thrust)
F. LE CORRE, E. RAGEOT, Manipulations vertébrales, Abrégés, Masson, 1992.
85. LOI n°1
NEUTRALITÉ VERTÉBRALE
(courbures physiologiques)
Latéroflex° et rotations se font en sens opposés
(découplage)
Vertèbres thoraciques et lombales
Vertèbres cervicales : loi n°2
86. LOI n°2
POSITION NON NEUTRE
(courbures en flex° ou ext°)
Latéroflex° et rotations se font dans le même sens
(couplage)
Vertèbres cervicales, thoraciques et lombales