We're going to do some joint play of the cervical spine in a prone position.
We're going to do
rotation first on the spinous process where we'll locate
C6. I'm going to take by thumb and I'm going to move it in a rotation or
a lateral direction, moving this way,
which will turn the vertebra
in this direction.
Remember the vertebra are on an angle, about a 45 degree angle
shaped in this direction here.
So what I want to do,
find the spinous process.
Get on
the lateral side or where the lamina groove is, approximately
on the edge of the spinous process, and do a rotational movement or a lateral movement
so it rotates the vertebra. So you're testing for joint play,
movement, pain, discomfort, hypomobility.
So that's rotation.
So I'm rotating it this way. So the spinous process is here and I'm pushing like this.
I can do a unilateral on the transverse process. So if I want to create
movement this way, the opposite direction on the transverse process,
I find the spinous process,
come down,
find the transverse process
and do a unilateral movement,
which creates a rotational force in this direction.
So that's unilateral.
If i want to go bilateral,
find the spinous process, come off the spinous process onto the transverse processes
and do a posterior-anterior glide
bilaterally on the transverse processes.
Find the spinous process again.
Locate
and I'm going to do a posterior-anterior glide
in this direction.
Again testing for hypo, hyper,
pain
related to the joint movement.
I'm going to demonstrate
some joint movement on C1, the axis and atlas.
I'm finding the transverse process of C1.
So I can find it just below the earlobe here,
bilaterally.
I'm taking my thumb. I'm going to apply a
rotational force, so a unilateral, so the joint is moving this way.
The majority of movement of the axis and atlas is rotation,
but 50 percent of the range of motion of rotation,
left and right rotation, is at the axis and atlas.
So I'm just testing for joint movement. I can also do
a transverse movement,
again, finding the
transverse process.
And this time I'm moving in this direction,
testing the movement
for hypermobility or hypomobility or pain.
And, again, I can come in behind
and apply a rotational force.
I can also go on both sides
and do a little
bilateral
anterior movement testing for
hypomobility, hypo, hyper or
pain.
We've got Meghan in a supine position and we're doing joint play again.
You can do it prone or supine, it depends on what your comfort is and
what the client's comfort is and how well you manage the cervical spine.
So, what I'm doing, I'm palpating the spinous processes.
I'm getting a feel, I usually like to get a feel of the vertebra doing this
kind of a motion. This is a general motion getting a sense of the overall feel.
Usually this way you can find the hyper/hypo mobile
vertebra fairly quickly.
Just a general sense.
Now finding the spinous processes, I can, just like I did in the prone position,
I can do this in a supine position. I'm going to do a posterior-anterior
sustained grade two on C6,
feeling the movement. And then I can slowly move up to each vertebra
doing an anterior glide or a posterior-anterior glide.
I can also
turn the head a little bit
and do a
movement on the
transverse processes with my thumb,
a unilateral applying pressure.
So it's a rotational, it's moving the vertebra
in this direction.
So I'm applying pressure here
and it's rotating the vertebra
in a clockwise direction.
That's on the transverse processes
coming up, all the way up. I can also come up to
C1 transverse process here
and do a rotational movement.
So that's rotating in a clockwise direction, going this way.
We can also take the web of the hand
in between, I can feel the spinous processes on
this part of my finger,
on the
pip and
on the metacarpophalangeal.
I'll put the transverse processes approximately here. So I'll just
demonstrate that.
So this is what you're going to see, the movement.
So I'm doing a
rotational force on the transverse process, it's rotating it.
And I can move up the vertebra in this way
as well.
So we've showed you posterior-anterior on the spinous processes.
We've showed you the,
I can do
on both transverse processes a posterior-anterior movement using both fingers on
either side of the
spinous process, on the transverse processes.
I can rotate the head a little bit, take my thumb,
go on the transverse process and do a rotational force
all the way up.
I can take my web of my hand, again,
right in through here
on the transverse processes and do a
rotational force.
And I can take my thumb or I can take the web of my hand
on C1 transverse
process.
So we're doing some
joint play immobilization of the lumbar spine.
So you just want to get a sense, a feel where the lower ribs are, the iliac crest are,
so you know where
L4 is and so on.
So what I want to show is posterior-anterior rotation,
bilateral and unilateral joint play at the lumbar spine for testing.
So again the same things apply.
You want to
make sure the person's comfortable, make sure the back is not in an extended
position.
And so I'm just going to just start off with L4 here
and I'm going to do a
posterior-anterior. And that's applying pressure on the spinous process
and you're moving in a direction like this
that matches the angle of the facet joints of the lumbar
spine.
So again you're looking for hyper, hypo or
pain related to the joint play you're doing. So that's posterior-anterior at L4.
If I want to do a rotational
I find the L4 again and I'm on this spinous process.
I'm doing a rotational. So the rotational
moves the vertebra
in this direction, that's a clockwise direction,
testing again for the same things.
And you should do this, when you're doing testing you should do it with all
orthopedic testing of whatever region you're doing. Always do joint play with all your testing.
It helps to find out if there's problems with the joints.
So that's
posterior-anterior rotation.
Now bilateral, again I find the spinous process, roll off,
come on
to the transverse processes, applying a posterior-anterior force,
looking for the same things.
As well you can also do a unilateral, which is going on the transverse
processes
on the one side and doing a rotational force, that's a rotational force
this way again.
And looking for the things I mentioned earlier.