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ch14assignment

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1
Dr. Struble
Madison Moore
Ch. 14 Critical Thinking
1.
A positive Ober’s Test indicates a tight IT band and Tensor fascia la1tae (TFL). A
good stretch for the IT band: sit with legs extended out, cross the hurt leg over your
other leg, bend the knee and place your foot flat on the floor, rotate your body to look
over the shoulder on the involved side until a stretch is felt. Do this for 10 minutes on
and off for 30 seconds. The therapist can stabilize the patient by holding the flat foot
stable on the table or place a hand on the shoulder that is rotated to prevent
bouncing/movement during the stress.
2.
For the first home band exercise, the patient will have the band around their
wrists and pull the wrists apart with forearms parallel. (Protract the shoulder blades by
pushing the upper back away from the wall to activate the serratus anterior) Walk the
forearms up the wall in a controlled manner to around eye level. Return back to the
starting point in a controlled manner and repeat 10 times for 3 sets. For the second
exercise, the patient will perform a bow and arrow exercise with the bands. This can be
done by either tying one end of the band down or holding it with the unaffected arm,
then with the other shoulder the patient would horizontally abduct (pull back as if
drawing a bow) and elevate the shoulder, all of this should be done while
retracting/squeezing the scapula. Do this for 3 sets of 10. For the third exercise, the
patient will hold a resistance band in front of them with their arms extended straight
out. There should be 4-6 inches of band left at the ends where their grip is (but they can
adjust to make it harder or easier). Pull the band apart by bringing shoulder blades
together so that the band touches their chest. Then, slowly return to the starting
position by bringing your arms back down in front you at eye level. Do 3 sets of 10.
I chose these exercises because the first one focuses on the serratus anterior, the
second one focuses on the lower trapezius, and the third one focuses on the rhomboids. I only
prescribed that the patient does 3 sets of 10 because she will be performing these exercises for
a full week.
3.
I would tell the patient that, when in doubt and choosing a Swiss ball, it is always
safer to go with a slightly larger ball because you could deflate it if needed. However,
since the patient is 70 in tall, I would recommend 65 cm or 26 in ball.
4.
I would recommend that the patient uses machine weight if they are new to
lifting, had a recent injury they are overcoming, or do not yet have the proper form.
Free weights are good for more dynamic exercises as well as more experienced or
stronger patients.
Alternating Exercises:
1. Seated cable Row = Dumbbell row
2
2.
3.
4.
5.
Leg extension machine = One leg seated dumbbell extension
Leg curl machine = lying dumbbell curl
Leg press machine = barbell squat
Pulldown machine = Two-hand Bent-Over Dumbbell Row
5. Following my patient’s ACL surgery, I would use graston as my chosen soft tissue
mobilization tool. The reason I chose this is because it will help to loosen/break up scar tissue
or muscle tender points, which will make it easier to stretch and increase range of motion in
the joints. It will also help quicken the healing process, increase the strength of muscle, and
reduce pain. It can also help to move and alleviate swelling in the area.
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