IAOM-US Media Gallery

Dr Main describes and performs a specific treatment and manual therapy to reduce pain and unload facet joints. This technique is mainly used to diagnose hypermobilities in the lumbar segments. Dr Main emphasizes manual therapy approaches to achieve better mobility in the patient's trunk and lumbar segments.
Want to learn more? www.iaom-us.com and info@iaom-us.com #lumbarspine #lowbackpain #lumbar #manualtherapy #musculoskeletal #painmanagement #lumbarinstability #livecourses #specifictreatment #lumbarstenosis

23 0

Dr Main describes and performs a specific treatment and manual therapy to reduce pain and decompress nerve roots in the lumbar spine aiming to facilitate healing and function. By decompressing the nerve root and reducing tension and load from surrounding tissues, Dr Main emphasizes manual therapy approaches to achieve better mobility in the patient's trunk and lumbar segments.
Want to learn more? www.iaom-us.com and info@iaom-us.com #lumbarspine #lowbackpain #lumbar #manualtherapy #musculoskeletal #painmanagement #lumbarinstability #livecourses #specifictreatment #lumbarstenosis

43 3

Dr. Haley Main explains describes how to perform specific lumbar segmental mobilization to improve extension in the lumbar spine while considering the hypermobile segments which could be leading to functional instabilities and consequent pain.
Want to learn more? www.iaom-us.com and info@iaom-us.com
#lumbarspine #lowbackpain #lumbar #manualtherapy #musculoskeletal #painmanagement #lumbarinstability #livecourses #specifictreatment

13 0

Dr. Haley Main explains describes how to perform specific lumbar segmental mobilization to improve flexion in the lumbar spine while considering the hypermobile segments which could be leading to functional instabilities and consequent pain.
Want to learn more? www.iaom-us.com and info@iaom-us.com

#lumbarspine #lowbackpain #lumbar #manualtherapy #musculoskeletal #painmanagement #lumbarinstability #livecourses #specifictreatment

16 0

Main goal is to address the patient's capacity to sustain proper posture of a specific joint when being overloaded with external forces or "body bumps". How well does the patient react to the external loads? Change the angle of the elbow (flex/ext or pron/sup) and challenge the proprioceptive system to maintain its current status.
Want to learn more? www.iaom-us.com and info#iaom-us.com

#elbow #shoulder #wrist #certification #livecourses #onlinecourses #dpt #physicaltherapy #occupationaltherapy #handspecialist #motorcontrol #handtherapy

9 0

Postural control reactions with emphasis in loading/weight-bearing. Focus on elbow joint proprioceptive dysfunctions. Great way to increase body awareness and capacity to adapt to external forces. Performed in different angles of elbow flexion/extension. it can be done with different pronation/supination angles.
Want to learn more? www.iaom-us.com and info@iaom-us.com

#elbow #shoulder #motorcontrol #physicaltherapy #occupationaltherapy #handtherapy #handspecialist #upperextremity #proprioception

3 0

2 different ways to assess for joint position sense and relocation with emphasis on the elbow joint. Incorporate these functional/objective measurements to guide your progression.

Tennis elbow, elbow joint, shoulder, hand therapy, certification, assessment

Want to learn more? www.iaom-us.com and info@iaom-us.com

5 0

What we know about minimum toe clearance (MTC)…
- MTC: distance between the ground and the toe when the foot is at the lowest point during swing phase.
- cognitive dual-task walking, aging and neurological diseases decrease the average value and increase the variability in MTC (leading to a higher risk of falls!).
- reduction in both the joint mobility in lower extremities and the afferent feedback from the soles of the feet alter rhythmic gait pattern and lower limb muscles activity, altering the overall balance.

We can treat MTC variability…

The science behind it:
- non-noxious stimulation to innervate or directly stimulate mechanoreceptors at the soles can modulate lower limb muscle reflexes and fine tune the motor control system during walking.
- proper cutaneous stimulation increases the inflow of sensory input to the CNS to better localize joint position and movement.
- decreased MTC variability may also be related with enhanced gait automaticity.

1. Range of Motion:
- the largest proportion of MTC variance is explained by changes in the sagittal plane angle (at ankle and hip joints).
- ensure that the structure is ready for the function!

2. Avoid walking barefoot:
- research has shown that walking with (at least) minimalist shoes, as compared to walking barefoot, is associated with better gait performance - explained by improvements on stability and MTC variability.

3. Vibration:
- supra-threshold vibration (determined in a sitting position) reduces the variability of three-dimensional joint angles at hip, knee, and ankle.
- use vibrating shoes insoles with vibrating stimuli directly applied to the heel and metatarsal heads.

4. Taping:
- elastic tapes applied to the Achilles and Tibialis Anterior tendons significantly reduce MTC variability by mainly modifying joint angles during automatic gait.
- applied the tape to the (A) tibialis anterior (Front) and (B) Achilles tendons (Rear) with the ankle positioned at an angle of 90◦.

Use different sensory stimuli to decrease the MTC variability and to promote a more stable gait pattern.

Pathak P, Moon J, Roh SG, Roh C, Shim Y, Ahn J. Application of vibration to the soles reduces minimum toe clearance variability during walking. PLoS One. 2022 Jan 4;17(1):e0261732.
Pathak P, Ahn J. Taping-induced cutaneous stimulation to the ankle tendons reduces minimum toe clearance variability. Heliyon. 2023 Jan 6;9(1):e12682.
Petersen E, Zech A, Hamacher D. Walking barefoot vs. with minimalist footwear - influence on gait in younger and older adults. BMC Geriatr. 2020 Mar 4;20(1):88.
Carter SC, Batavia MZ, Gutierrez GM, Capezuti EA. Joint movements associated with minimum toe clearance variability in older adults during level overground walking. Gait Posture. 2020 Jan;75:14-21.
Hamacher D, Hamacher D, Müller R, Schega L, Zech A. The Effect of a Cognitive Dual Task on the Control of Minimum Toe Clearance While Walking. Motor Control. 2019 Jul 1;23(3):344-353.
Illustrations/Pictures: open access articles under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

5 0

What we know about bone marrow edema …
- it is now called Bone Marrow Lesion (BML)
- well-known by provoking disabling pain and for representing a negative prognostic factor of progression of knee osteoarthritis with increased structural deterioration, cartilage damage, and reduced function.

What we know about the anterolateral ligament (ALL) …
- it contributes to rotational stability.
- injury always occurs at the tibial insertion (between the Gerdy tubercle and the fibular head).

The TESTS…

1. Painful palpation of the ALL
- manual palpation of both ALL insertions.
- positive if palpation of the injured knee elicits pain but palpation of the contralateral knee does not.
- excellent diagnostic accuracy: sensitivity and specificity are significantly higher than 80%.
o pain on clinical palpation of the ALL tibial insertion correlates with ultrasonographic findings of an ALL injury.

2. “Percussion Test” (PT)
- manual percussion (performed with two fingers) of the bony prominence (medial and lateral femoral condyle, and medial and lateral tibial plateau)
- positive if there is asymmetry of the pain perceived between the painful knee (more painful or pronounced) and the healthy one.
- good diagnostic accuracy: specificity (85–96%), sensitivity (60–79%)


These 2 simple screening tests should be included in every assessment of acute knee injuries

Murgier J, Thomas P, Reina N, Sylvie R, Bérard E, Cavaignac E. Painful Palpation of the Tibial Insertion of the Anterolateral Ligament Is Concordant With Acute Anterolateral Ligament Injury. Orthop J Sports Med. 2020 Jun 26;8(6):2325967120930200.
Sansone V, Galluzzo A, Maiorano E, Polatti MB, Pascale V. Percussion test: description and diagnostic accuracy of a new manual test for bone marrow edema of the knee. BMC Musculoskelet Disord. 2022 Jan 18;23(1):68.

6 1