Re: Iliopsoas strain [2 Attachments]

[Guest guest]

Amie,

Was looking at the discussion this morning an realized that a portion of my

response was way at the bottom of the message, below the normal ending lines.

You may have already read this but just wanted to post it again.

I also question, and would like discussion, regarding passive stretching of a

myalgic muscle that is shortened due to the presence of taut bands. If the

canine patient resists gentle stretching and manipulation are we accomplishing

anything? The attached .pdf is a series of pictures of a patient that

maintained a non-weight bearing state for considerable time postop CCL excap.

Some what unusual is that NWB posture was maintained by constant flexion of the

stifle rather than more common coxofemoral flexion. Since the caudal thigh

muscles never were able to relax numerous taut bands and MTrPs were formed in

stifle flexors (Cinderella Hypothesis). Initial stifle extension 106 degrees,

after 0.1cc (60 mcg/m2)Dexdomitor - stifle extension 119 degrees and then

following TrP-DN and before any stretching 131 degrees. My feedback is the

palpable feel of the muscle, the changes in resistance as the needle enters the

taut band and the local twitch response(s) from the needle entering MTrP.

In this same patient video of LTR observed by movement of a needle within same

taut band as the invasive therapy is performed distally in the same band. In

the m. psoas major I can only appreciate LTRs in a very relaxed animal.

Treatment was performed under sedation.

http://vimeo.com/34093639

One additional video using musculoskeletal ultrasound to visualize LTR.

http://vimeo.com/33599630

Rick Wall, DVM

Certified Canine Rehabilitation Practitioner

Diplomate, American Academy of Pain Management

Certified Myofascial Trigger Point Therapist

Center for Veterinary Pain Management and Rehabilitation

The Woodlands, TX

www.vetrehabcenter.com

1 of 1 File(s)

Snapshots_Maggie Dunbar.pdf

[Guest guest]

Rick - I can't get the 1st video to play.

Christie Carlo, DVM, CCRT

>

> Amie,

>

> Was looking at the discussion this morning an realized that a portion of my

response was way at the bottom of the message, below the normal ending lines.

You may have already read this but just wanted to post it again.

>

>

> I also question, and would like discussion, regarding passive stretching of a

myalgic muscle that is shortened due to the presence of taut bands. If the

canine patient resists gentle stretching and manipulation are we accomplishing

anything? The attached .pdf is a series of pictures of a patient that

maintained a non-weight bearing state for considerable time postop CCL excap.

Some what unusual is that NWB posture was maintained by constant flexion of the

stifle rather than more common coxofemoral flexion. Since the caudal thigh

muscles never were able to relax numerous taut bands and MTrPs were formed in

stifle flexors (Cinderella Hypothesis). Initial stifle extension 106 degrees,

after 0.1cc (60 mcg/m2)Dexdomitor - stifle extension 119 degrees and then

following TrP-DN and before any stretching 131 degrees. My feedback is the

palpable feel of the muscle, the changes in resistance as the needle enters the

taut band and the local twitch response(s) from the needle entering MTrP.

>

>

> In this same patient video of LTR observed by movement of a needle within same

taut band as the invasive therapy is performed distally in the same band. In

the m. psoas major I can only appreciate LTRs in a very relaxed animal.

Treatment was performed under sedation.

>

> http://vimeo.com/34093639

>

> One additional video using musculoskeletal ultrasound to visualize LTR.

>

> http://vimeo.com/33599630

>

>

>

>

>

> Rick Wall, DVM

> Certified Canine Rehabilitation Practitioner

> Diplomate, American Academy of Pain Management

> Certified Myofascial Trigger Point Therapist

>

> Center for Veterinary Pain Management and Rehabilitation

> The Woodlands, TX

> www.vetrehabcenter.com

>

[Guest guest]

Hi Rick, I am also very surprised that a dog would be sedated for an iliopsoas

strain problem. Although the iliopsoas may be contracted (different from a

" strain " ), given the original description of this case by , I would bet

all my Xmas presents that the contraction that this dog is experiencing in the

iliopsoas is due to an acute back problem. As far as the iliopsoas, although

many dogs will resist stretching the iliopsoas at first, I have never had a dog

that, over time, and with a skilled hand, would not eventually allow a gradual

lengthening, manually, of the muscle. In this way, the golgi tendon organs can

return to a more normal response pattern, and help to return normal tone to the

muscle.

In the case of a low back injury, this must be addressed first. Any pulling on

the iliopsoas will exacerbate the back pain, and given the description, this

seems to be the primary problem. Many humans have acute pain in the iliopsoas

when the lumbar spine/disc are in a state of injury and inflammation. The neuro

response of the muscle is upset when there is any compression of the nearby

nerve root...and there is the protective reaction of the muscle as well.

Certainly, a muscle will behave differently under sedation; this is not the

muscle's natural state, and it is not a good way to stretch a muscle, in my

opinion. There is no substitute for hands on manual therapy, and for getting a

sense of muscle tissue response to a whole host of techniques. That is why

there are SO MANY!!!!!!! classes offered to PTs in working with muscles.

Again...it seems that this dog should be assessed for a lumbar spine issue.

Liz Powers, MPT, CCRT

> >

> > Amie,

> >

> > Was looking at the discussion this morning an realized that a portion of my

response was way at the bottom of the message, below the normal ending lines.

You may have already read this but just wanted to post it again.

> >

> >

> > I also question, and would like discussion, regarding passive stretching of

a myalgic muscle that is shortened due to the presence of taut bands. If the

canine patient resists gentle stretching and manipulation are we accomplishing

anything? The attached .pdf is a series of pictures of a patient that

maintained a non-weight bearing state for considerable time postop CCL excap.

Some what unusual is that NWB posture was maintained by constant flexion of the

stifle rather than more common coxofemoral flexion. Since the caudal thigh

muscles never were able to relax numerous taut bands and MTrPs were formed in

stifle flexors (Cinderella Hypothesis). Initial stifle extension 106 degrees,

after 0.1cc (60 mcg/m2)Dexdomitor - stifle extension 119 degrees and then

following TrP-DN and before any stretching 131 degrees. My feedback is the

palpable feel of the muscle, the changes in resistance as the needle enters the

taut band and the local twitch response(s) from the needle entering MTrP.

> >

> >

> > In this same patient video of LTR observed by movement of a needle within

same taut band as the invasive therapy is performed distally in the same band.

In the m. psoas major I can only appreciate LTRs in a very relaxed animal.

Treatment was performed under sedation.

> >

> > http://vimeo.com/34093639

> >

> > One additional video using musculoskeletal ultrasound to visualize LTR.

> >

> > http://vimeo.com/33599630

> >

> >

> >

> >

> >

> > Rick Wall, DVM

> > Certified Canine Rehabilitation Practitioner

> > Diplomate, American Academy of Pain Management

> > Certified Myofascial Trigger Point Therapist

> >

> > Center for Veterinary Pain Management and Rehabilitation

> > The Woodlands, TX

> > www.vetrehabcenter.com

> >

>