KP: Ballet Dancer with Neck/Levator Pain and Scapular Winging: Visit 1 (3-25-18)

Exam Findings
- Pain localized to medial R scapular border
- Pain reproduced with looking down and turning head to the left more so then the right
- Sharp pain with rocking on hands and knees and with retraction of scapula in prone
- Significant scapular winging bilaterally
- Mild improvement in symptoms following chin tuck with thoracic ext and chin tuck with self sidebend to the right
Initial Program
- Do these movements alot throughout the day
  - 55) Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO
    - 10-15x throughout the day, pre post ballet
  - 3) Chin Tuck with Side Bending VIDEO
    - Focus on going to the right only
- do the movements above plus the movements below as a circuit 1-2x per day
  - 51) Prone Cervical and Scapula Positioning Drill VIDEO
    - Try this one, holding each 5 sec and repeating 10-15x
  - 115.1) Squat With Single Arm Support Progression VIDEO
    - Try this one at the sink
    - In a small squat, try to hold with one arm 5 sec then the other arm 5 sec then come up and take a brief break
    - Then try for R arm, L arm, R arm , L arm….for a total of 2x on each arm for 5 sec each
    - Then try 3 in a row…..until you feel somewhat tired and feel like you are unable to add another to the sequence
  - 31.1) Hands Elevated Variation VIDEO
    - Try this instead of the hands on the ground one we did in the office
    - Let me know if there is less pinch with this one
    - 8-15x