tag:blogger.com,1999:blog-618639792837880710.post4982093992846046766..comments2023-09-09T06:30:57.710-04:00Comments on Dedicated to the High School Athletic Trainer: Dissociation?Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-618639792837880710.post-81328704218544706622009-10-20T18:47:05.456-04:002009-10-20T18:47:05.456-04:00right now i've got a patient that has an incre...right now i've got a patient that has an increase in apin when he tries to anteriorly tilt his hips. However sitting with "bad posture" seems to relieve his symptoms. he has a hx of bone spurs and may have a structural issue I can't fix.<br /><br />On the otehr hand, this past summer i had a person who had pain due to the lack of motion in her spine and hips. So what helped her? We added spinal rotation. I know, I know...I was taught that twisting an already pathologic spine is bad...not always. <br /><br />As joe says, "rehab it as you see it."JHhttps://www.blogger.com/profile/16644525315506312319noreply@blogger.comtag:blogger.com,1999:blog-618639792837880710.post-39381564946611432752009-10-20T18:08:45.835-04:002009-10-20T18:08:45.835-04:00Joe,
Thank you for continuing to write about this...Joe,<br /><br />Thank you for continuing to write about this topic in an intelligent fashion. As a long term low back pain sufferer (past 5 or six years), I have learned to move my hips and legs without moving my spine in order to avoid tirggering muscle spasms and pain. However, for the first 50 years of my life I did not not thnk about how I moved my spine when I moved. I just moved. Healthy backs just move. These is some flexion, rotation and extension, all taking place in multiple planes of motion. Unhealthy backs do not tollerate this motions.<br /><br />Learning good defensive movement skills is a good thing for a low back pain sufferer to do. But you can develop the best defensive movement skills in the world (move with minimum spine movement) and still not fix the underlying problem. <br /><br />I think the underlying problem is misinterpritaton by the central nervous system of normal feedback signals. These signals are seen as being threatening and the response is to generate pain and spasm so as to encourage the individual to minimize motion. Fatigue and stress seem (at least in my case) to lower the threshold between tollerated and untollerated activity. Increasing general physical preparedness seems to raise the threshold.<br /><br />I do not know what the solution is. Its not more bridging exercises or developing a better abdominal brace. You can minimize the problem by avoiding exacerbation but you are not sloving the underlying problem. Somehow, someway you must reprogram your brain. <br /><br />MarshallMarshallhttps://www.blogger.com/profile/03973282680426755315noreply@blogger.com