1. SNAGs work directly on facet joints and can help disc lesions by assisting the McKenzie response. They involve applying a gliding force to the facet joint plane to increase flexion and decrease pain.
2. The procedure is done either sitting or standing, with a belt placed around the patient and therapist. The therapist applies a gliding force as the patient flexes forward, helping to move the vertebrae into proper alignment.
3. Patients are only SNAGged three times in the first session as a precaution. On subsequent visits, more repetitions may be done if there is no increase in pain. The goal is to flex painlessly to full range of motion.
2.
INTRODUCTION
SNAGS work directly on facet joints, that can help a
disc lesion. And assist Mckenzie response.
During normal flexion of the spine the disc distorts
and becomes wedge shaped.
The vertebral bodies proximate ventrally and
separate dorsally. BUT remain under the umbrella of
above vertebra.
And facet joint must be mobile.
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1.SNAGS
5.
If the facet joints are hypo mobile, when the flexion
takes place, the vertebral bodies will be able to
proximate anteriorly but unable to separate dorsally.
The disc may no longer under the above vertebral
umbrella. And bulged posteriorly causing
symptoms.
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CONTINUE…
7.
All techniques explanation must be given to the
patient.
Their co-operation is needed.
Tell patient your are going to move a vertebra with
your hand in such a way that the pain they feel with
particular movt will disappear.
If you feel any pain they must tell you so that you
can check your techniques or try another level.
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PROCEDURES
8.
Do not overdo the SNAGS.
As soon as an improvement is brought about on day
one stop and see them two days layer.
‘’RULE OF THREE’’
ON DAY ONE WHEN treating a pt with marked
pain and thus distress we only use our pain free
techniques three times as a precaution.
On subsequent visit you may choose to SNAG 10
times.
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PROCEDURES
9.
You should use McKenzie approach when a pt has
lumbar 4/5 lesion with a lateral shift.
To SNAG lumbar(middle) and thoracic(lower), we
require a plinth and a belt that can adjusted in
length.
Belt should be 2.6meters(8feets) in length and made
up of car seatbelt material.
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PROCEDURES
10.
In sitting and standing.
If problem with movement are only present when
standing then snag are only in done in standing.
If they have movement problem when sitting as well
then your initial therapy would be in sitting and
would progress to standing.
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ACTIVE MOVEMENTS
11.
(1).To increase flexion and/or decrease the pain
associated with his movement.
(a) In sitting:
The pt sits on a plinth with his legs over the side.
You stand behind and place a belt around him and
yourself.
tn placing the belt around the pt’s lower abdomen
keep it below the ASIS for comfort.
The belt below your hip joints.
Depents on your stature.
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DESCRIPTIONS
12.
The ulnar border of your right hand is now placed
under the spinous process of the vertebra above at
the suspected spinal segments.
Your other hand should placed on the bed to the left
of the pt.
The pt flexes forward until the pain is felt..
He now back off a little from his position.
12
13.
You now apply a gliding force with your right hand
up along the facet treatment plane as he again flexes.
If treatment is indicated, you are on the right
segment and the direction of force is correct, he will
painlessly flex to almost full range.
If there is pain try another level.
Sustain flexed position for a few seconds and
maintain your facet glide until yhe pt is again erect.
13
14.
When there is no pain, repeat just three times and
that would be all that you would do on the pt first
visit.
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