Nice talk with Dr Ben Kibler of Scapular Retraction Test and Scapular Assistance Test fame, have followed and loved his work since chiro school, his work with Sciascia has become part of my standard examination procedure
Points
Discussion of early influence of training with clinicians from polio era, reminds me of Janda and the prague school approach being more neuro based, cultural effect of ortho vs neuro based emphasis on treatment, hardware vs software. Interesting club of game changing ortho practitioners influenced by severe neuro clinical experiences.
Gotta say i use the victim vs purpetrator analogy he references on a daily basis, dont punish the victim.
One leg balance assessment – half squat – his specification of 45 degrees hip flexion. Patient can stall out at 30 degrees, make then drop further to tease out the weakness at 45 degrees of hip flexion to tease out glute med weakness.
Asymmetry – Right/Left and Front/Back – what’s allowable? Hip strength should be symmetrical. Scapular asymmetry – use SRT and SAT to evaluate dynamically to see if the asymmetry is relevant – using empty/full can for instance. GH ROM – 20 deg IR or more cutoff.
He ends with some comments on the Physician/Therapist team being on the same page for diagnosis and treatment – training varies among professions, and having everyone on the same page helps get the patient in the right direction, having to contradict or re-educate a patient can show a disconcerting lack of continuity in case management.
SAT – More dynamic of the two
SRT – Static – Forearm on medial border of scapula – correlate to inferior scap and thoracic spine points in Vojta Reflex locomotion, at least in my opinion.
Thanks for reading
Pete
