Hey Shaelyn

Are you still working with your client that you wrote about here in August?

I have 2 disc issues and even though I’m quite a bit younger then your client what I find helps most is daily awakening of tva and multifidus, even if it’s just for 2 or 3 minutes. My favorite is the one we did in Napa where you lie on your back on the ground, knees bent, feet flat on the ground. Place your hands underneath the lumbar spine, in the gap between the spine and the ground. Try to swell multifidus and engage tva so that your back touches your hand. From there I personally go to table top and re-do all of that if I’ve lost it, and then I tap one heel at a time to the ground. I’ve recently showed this to a teacher friend of mine and she’s starting to teach it a lot in her classes too. Also could be helpful to do the prone exercse, where you put your fingers on the multifidus especially in the area of the disc issue and see if she can swell the multifidus. I don’t know how helpful this would be for your client – I also don’t know but can imagine if those muscles have been dormant for such a long time, how much effort it would take to turn them back on… ?

Would love to hear how you’re going with your client if you’re still working with her.

Hey Alice!

Here’s an assortment of thoughts for you…

I happened to be flipping through my spine module notes today as I was preparing for a meeting with a patient and I did write down “if they say pain is in a whole area, probably should refer out” – which is in agreement with Joy.

Is he able to point to the pain with two fingers? this could help narrow in on the pain area as oppose to a big general area like “bottom of the back”

Have you done an Active Range of Motion test with him? It could be useful to know where that might be restriction in his movement or how the pain shows up in flexion/extension/rotation. For example – When there’s irritation in the disc for example flexion can potentially be harder because the disc is more compressed or on the other hand when there’s irritation in facet joints extension could be potentially harder.

What is his static posture like? If he has poor posture to begin with plus a back injury then sitting all day puts a lot of compression on the discs.

One big take away I got from the spine module is when you’re not sure where to start, 2 great places to start is with the breath and with the deep stabilisers which would be TVA and multifidus.

Hope some of this is helpful to you.

Dana xx