Chapter Seven Principles and progression of combined movements
Notation
• The direction of movement that reproduces pain suggests whether the pain is an anterior or posterior stretch pattern.
• Patients finding it difficult to move towards the side of pain have anterior stretch dysfunction whilst pain produced by movement away from the side of pain is a posterior stretch dysfunction. This information ensures that the three movements that stretch either the anterior or posterior structures are examined and ranked for importance.
• The presence of two lines on the box diagram signifies that the movement not featuring was the least provocative.
• The bolder of the two arrows signifies that this is the most provocative movement, or ‘prime movement’.
• A two-headed arrow simply emphasizes that this was the second movement of the primary combination, whilst a one-headed arrow shows that it was the first.
• The order of the primary combination signifies that this order has been established by comparing both combinations and ranking them.
Treatment progression
RELEVANT HISTORY
Symptoms developed over a 6-day period following a mild, rear shunt whiplash injury, a week ago.
The most appropriate treatment to induce greatest change in dysfunction was established to be:
Rx1 IN: right lateral flexion, extension
DID: unilateral AP glide of C5 on C6, Grade III, 1 × 1 minute