김&장 척추 크리닉  김일환 MD DC
   Neurogenic pain:pain that initiated or caused by a primary lesion or dysfunction in the nerve and surrounding structure
3 Pathodynamics of neurogenic pain1.   Mechanical interface dysfunction2.   Neural structural dysfunction3.   Innervated t...
1.    Mechanical Interface Dysfunction     surrounding structures of nervous      system(joints, muscle,disc,ligaments,Etc...
1. Mechanical Interface DysfunctionClosing dysfunction-hypermobilityOpening dysfuntion-hypomobilityPathoanatomical Dysfunc...
2. Neural structural Dysfunction neural structure exhibit reduced excursion /  abnormal tension or abnormally sensitive to...
3. Innervated tissue dysfunction muscle dysfunction(Motor control  dysfunction) neurogenic inflammation(SP, CGRP)
Neuropathodynamics of neurogenic painpressure on nerve->reduced venous return- >further increased pressure->hypoxia- >inc...
   ULTT 1(Median nerve)Supine, no pillow, contralateral neck flexionshoulder depressionglenohumeral abduction 90-110 degr...
ULTT 4 (ulnar nerve)supine ,shoulder depressionwrist/finger extension forearm pronationelbow flexionglenohumeral external...
Indicationunilateral cervicoscapular painunilatral root pain with neurological changepost surgical symptoms
Mechanical interface dysfunctionLevel 1progression 1supinecervical flexion/contralateral side flexion and slight contrala...
    Level 2    progression 1    supine    cervical flexion/ipsilateral flexon(mid-range)     and slight ipsilateral rotat...
 Neural structure dysfunctionsupineipsilateral arm ULTT 1 positionfirst lateral glide to ipsilatreal direction with elbow...
    Tension dysfunction    level 1    progression 1    general off-loading position    supine    shoulder elevation arm b...
    Progression 2    ipsilateral scapula upward mobs    contralateral arm ULTT 1 position    ipsilateral SLR
    Progression 3    ipsilateral ULTT 1 in small amount    (shoulder depression or shoulder abduction     or elbow extens...
    Level 2    progression 1    supine    contralateral ULTT1    ipsilateral ULTT 1    progression 2    ipsilateral ULTT ...
   Level 3ipsilateral ULTT 1 with contralateral cervical flexionipsilateral ULTT 1 with contralateral cervical flexion mo...
감사합니다
Cervical spine neural tension technique
Cervical spine neural tension technique
Cervical spine neural tension technique
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Cervical spine neural tension technique

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Cervical spine neural tension technique

  1. 1. 김&장 척추 크리닉 김일환 MD DC
  2. 2.  Neurogenic pain:pain that initiated or caused by a primary lesion or dysfunction in the nerve and surrounding structure
  3. 3. 3 Pathodynamics of neurogenic pain1. Mechanical interface dysfunction2. Neural structural dysfunction3. Innervated tissue dysfunction
  4. 4. 1. Mechanical Interface Dysfunction surrounding structures of nervous system(joints, muscle,disc,ligaments,Etc) produce abnormal forces(pressure) on the neural structures
  5. 5. 1. Mechanical Interface DysfunctionClosing dysfunction-hypermobilityOpening dysfuntion-hypomobilityPathoanatomical Dysfunction-stenosisPathophysiological dysfunction-inflammation
  6. 6. 2. Neural structural Dysfunction neural structure exhibit reduced excursion / abnormal tension or abnormally sensitive to normal excursion(sliding) / tension
  7. 7. 3. Innervated tissue dysfunction muscle dysfunction(Motor control dysfunction) neurogenic inflammation(SP, CGRP)
  8. 8. Neuropathodynamics of neurogenic painpressure on nerve->reduced venous return- >further increased pressure->hypoxia- >increased mechanosensitivity of nervemechanical irritation of nerve->nociceptive stimulation of nervo nevosum->perineuronal inflammation->endoneuronal edema->reduced venous return->hypoxia-> increased mechanosensitivity of nerve
  9. 9.  ULTT 1(Median nerve)Supine, no pillow, contralateral neck flexionshoulder depressionglenohumeral abduction 90-110 degreeglenohumeral external rotationforearm supination/wrist,finger extensionelbow extension
  10. 10. ULTT 4 (ulnar nerve)supine ,shoulder depressionwrist/finger extension forearm pronationelbow flexionglenohumeral external rotationglenohumeral abduction
  11. 11. Indicationunilateral cervicoscapular painunilatral root pain with neurological changepost surgical symptoms
  12. 12. Mechanical interface dysfunctionLevel 1progression 1supinecervical flexion/contralateral side flexion and slight contralateral rotationprogression 2contralateral side flexion mobs
  13. 13.  Level 2 progression 1 supine cervical flexion/ipsilateral flexon(mid-range) and slight ipsilateral rotation progression 2 ipsilateral side flexion(end-range) mobs
  14. 14.  Neural structure dysfunctionsupineipsilateral arm ULTT 1 positionfirst lateral glide to ipsilatreal direction with elbow extensionsecond lateral glide to contralateral direction with elbow flexion
  15. 15.  Tension dysfunction level 1 progression 1 general off-loading position supine shoulder elevation arm by side slight cervical flexion/ipsilateral flexion/ipsilateral rotation elbow flexion/forearm pronaton/wrist&finger flexion
  16. 16.  Progression 2 ipsilateral scapula upward mobs contralateral arm ULTT 1 position ipsilateral SLR
  17. 17.  Progression 3 ipsilateral ULTT 1 in small amount (shoulder depression or shoulder abduction or elbow extension..)
  18. 18.  Level 2 progression 1 supine contralateral ULTT1 ipsilateral ULTT 1 progression 2 ipsilateral ULTT 1 without contralateral ULTT 1
  19. 19.  Level 3ipsilateral ULTT 1 with contralateral cervical flexionipsilateral ULTT 1 with contralateral cervical flexion mobsipsilateral ULTT 1 with ipsilateral myofascial release (upper trapezius, levator scapula, scalene..)
  20. 20. 감사합니다

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