Thanks to Christine Tuminello who prepared this flow chart from what was worked through on a recent Stretch Therapist workshop.
The flow chart is to be used in a similar way to the low back pain flow chart from the book Overcome neck & back pain. In the low back pain flow chart, we begin with the answer to the question, “Do you have sciatica?”
If the answer is, ‘yes’, then the Straight Leg Lifting Test is carefully done, responses noted, and exercises chosen according to the responses.
If the answer is, ‘no’, then the rest of the flow chart’s exercises are followed; at the conclusion of the interaction, you and the patient will have a map of the responses to that list of ‘challenges’, and the outline of the treatment plan.
Similarly the neck & shoulders flow chart: begin with the shoulder push-down, and the patient is asked, ‘where do you feel the effects? and follow the rest of the sequence, noting the responses. If your patient has TOCS (sometimes TOS), the effects of the shoulder pushdown will be felt in the front of the neck; most patients will feel the effects in the upper fibres of traps/levator scapulae. This difference serves a similar function to the ‘Do you have sciatica?’ question, but for the neck.
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