In order for an effective manual therapy treatment programme to be chosen and instigated there has to be accurate clinical assessment of the patient’s condition or injury. This article discusses how the spine functions according to its structure, enabling the therapist to visualise the normal movement processes as well as how dysfunction can lead to injury. This improved understanding of the living spine allows a more accurate clinical assessment of any spine-associated impairments, permitting creation of an individually tailored treatment plan. This article has been adapted from chapter 6 ‘Spinal motions: structure and function’ from the author’s book Clinical Assessment For Massage Therapy: A Practical Guide.
Register below to read the key points and discussion topics for this article as well as the first third of the article.
This is the thirteenth and final article from our Manual Therapy Student Handbook (see the ‘Contents panel’ for further details) and it describes how to assess and treat common complaints involving the thoracic spine. As... Read More
This is the twelfth article from our Manual Therapy Student Handbook (see the ‘Contents panel’ for further details) and it describes how to assess and treat common complaints involving the lumbar spine. As well as... Read More
This is the eleventh article from our Manual Therapy Student Handbook (see the ‘Contents panel’ for further details) and it describes how to assess and treat common complaints involving the cervical spine. As well as... Read More
This content consists of a 7 minute video presentation professionally produced and presented at the Fisic Conference 2015.
Dr Glyn Towlerton trained as an undergraduate in Medicine at St Bartholomew's Hospital, London and commenced training in postgraduate medical specialities at the Royal Brompton Hospital and Hammersmith Hospital before gaining Membership of the Royal College of Physicians in 1992.
Dr Towlerton further specialised in Anaesthetics and Pain Medicine and was awarded Fellowship of the Royal College of Anaesthetists in 1995. He undertook fellowships in Sydney, Australia and Seattle, USA prior to taking up his substantive NHS appointment at Chelsea and Westminster Hospital in 2000.
Dr Towlerton lead the Clinical Pain Management team involved in acute post-operative and chronic pain conditions. He is also a Consultant to the Royal Brompton Hospital. Dr Towlerton specialises in non-surgical treatments for the back, neck and leg. He has particular expertise in treating lumbar, sciatica, neck and shoulder pain. He has treated many elite athletes from a wide range of sports for over a decade.
Dr Towlerton's special interests include spinal interventional procedures and injections and spinal cord stimulation. He is also a member of BMA, British Pain Society and British Association of Spinal Surgeons.
This content consists of a 11 minute video presentation professionally produced and presented at the Fisic Conference 2015.
Mr Jason Harvey specialises in neck pain and back pain, as well as nerve pain related to these conditions.
Mr Harvey's training took place at St Georges Hospital London, qualifying in 1992. His orthopaedic training was within the Wessex regional orthopaedic training programme. His further training in Spinal Surgery was at the Spinal Centres at Southampton and Bristol. He also completed a twelve month AO Spinal Fellowship in Brisbane, Australia, learning new techniques in both adult and paediatric spinal surgery. He also worked within the regional spinal injuries unit, treating spinal emergencies.
Mr Harvey was appointed as an NHS Consultant in 2004 to develop the adult spinal services within a large and rapidly expanding orthopaedic unit in Portsmouth. His practice involves all aspects of spinal care where he performs spinal surgery within the neck, lower back and thoracic spine, as well as performing pain relieving injections of the spine where appropriate. He has a special interest in management of back and neck pain as well as cervical disc replacement surgery.
Queen Alexandra Hospital has been appointed as the national training centre for Prodisc C Cervical disc implantation. This provides Mr Harvey with the opportunity to teach this new and exciting technique to consultant colleagues from other hospitals. Mr Harvey is a member of the British Orthopaedic Association, the British Association of Spinal Surgeons and AO Spine International.
This content consists of a 20 minute video presentation professionally produced and presented at the Fisic Conference 2015.
Mr David Harrison is a Spinal Surgeon now based in Windsor, Berkshire, UK.
Mr Harrison studied medical science and theology at Kings College an then qualified in medicine at St Georges Hospital, University of London in 1978 and did his Higher Surgical Training at King's College Hospital becoming a Fellow of the Royal College of Surgeons in 1983. In 1987 Mr Harrison was International Fellow in Spinal Deformity at the Royal National Orthopaedic Hospital, Stanmore and in 1990 was appointed as consultant at Frimley Park Hospital, Surrey.
Over 12 years, Mr Harrison established the Spinal Service and served as Head of Department before moving back to RNOH, Stanmore as Consultant in Spinal Deformity with a large practice and active involvement in paediatric and adolescent spinal disorders. Mr Harrison is now retired from the NHS and continues to practice in Windsor with a particular interest in adolescent lumbar spine disorders, especially stress injuries in elite athletes.
Mr Harrison also has 24 years continuous experience in lumbar disc arthroplasty in adults.
This content consists of a 13 minute video presentation professionally produced and presented at the Fisic Conference 2015.
Dr Jonathan Rees graduated from the Royal London Hospital in 1995 and had postgraduate training at five London teaching hospitals. Between 2004 and 2012 he was a Consultant at Headley Court, the Defence Medical Rehabilitation Centre and Honorary Consultant Rheumatologist at Guy's and St Thomas' Hospitals.
Since 2012 Dr Rees has been Consultant in Rheumatology and Sports Medicine at Addenbrooke's Hospital, Cambridge. He is Honorary Senior Lecturer in Sport and Exercise Medicine at Queen Mary College, University of London.
He has worked in sports including Professional Football, Rugby Union and Disability Sport. Dr Rees was Medical Officer to the Great Britain 2008 Paralympic Team in Beijing. He was a member of the LOCOG Sports Medicine Advisory Group between 2008-2012 and a Consultant at the 2012 London Olympic Games.
Dr Rees' Medical Doctorate from University College London won the British Society of Sport and Exercise Medicine 2008 Basic Research Prize. He has published around 20 articles in peer review journals including highly cited articles in particular on tendinopathy.
Dr Rees regularly lectures nationally and internationally and has been interviewed by both BBC and ITN news. He is a Fellow of the Royal College of Physicians and a Founding Fellow of the Faculty of Sport and Exercise Medicine. He is a former President of the Royal Society of Medicine Sports and Exercise Medicine Section.
This content consists of a 12 minute video presentation professionally produced and presented at the Fisic Conference 2015.
Professor H. Michael Mayer is an Orthopaedic surgeon and Neurosurgeon specializing in Spinal Surgery.
He graduated from Johannes-Gutenberg University in Mainz, Germany, in 1981. He started his clinical career as a research fellow at the Department of Neuropathology (1982 – 1983) and then completed his Neurosurgery as well as his Orthopaedic Surgery residencies at the Free University in Berlin. In 1991 Professor Mayer accomplished his PhD in Neurosurgery with an experiential and clinical study on endoscopic disc surgery. He started his specialization in Spine Surgery in 1987 and became Chief Staff Surgeon and Deputy Chairman of the Department of Orthopaedic Surgery of the Free University of Berlin in 1992.
Since 1998 Professor Mayer has been Chairman and Medical Director of the Spine Centre at Schön Klinik München, one of the major Spine Centres in Europe, and a FIFA centre of excellence.
He is currently a Professor of Neurosurgery at the Paracelsus Medical School in Salzburg/Austria. His special areas of interest include sports medicine, rehabilitation, physical therapy and special orthopaedic surgery. Professor Mayer's current scientific interests are Spine and Soccer, Microsurgery/Endoscopic Surgery in Disc Herniations in Athletes, Causes of Low Back Pain in Soccer Players, MIS and Total disc replacement.
Professor Mayer has been President of the European Spine Society as well as of the German Spine Society (2006). He has published more than 150 papers in scientific journals, edited / co-edited seven books and organized more than 40 International Congresses and Workshops. Professor Mayer is a member of the editorial/advisory boards of the European Spine Journal, Operative Orthopedics and Traumatology, The Asian Spine Journal, The Open Spine Journal and The Open Bone Journal. He is also Deputy Editor of The Global Spine Journal.
Dr Ranju Dhawan is a dual specialty cross-sectional radiologist and nuclear medicine physician with extensive experience in both diagnostic specialties. She specialises in Hybrid Functional Imaging, combining her skills in both diagnostic specialities.
Dr Dhawan founded the Hybrid Imaging [SPECT-CT and PET-CT] Unit at Wellington Hospital, London in 2008, a service since utilised by elite sports organisations, spinal and orthopaedic surgeons throughout the UK.
Within hybrid Imaging, one of her niche interests is in Orthopaedic and Spinal SPECT-CT. She has developed focused methodology, techniques and expertise in this field and works closely with sports physicians and surgeons involved in management of elite sportspersons from professional football, cricket and rugby leagues and with British Athletics.
She is well published in her field and collaborates closely on clinical and research themes with Spinal Units at the Royal National Orthopaedic Hospital (RNOH), Stanmore, the National Hospital for Neurology and Neurosurgery and the Wellington Hospital, London.
Dr Dhawan is on teaching faculty for undergraduate and postgraduate programmes at Imperial College and Kings College, London and lectures at several national and international Hybrid Imaging conferences.
This content consists of a 16 minute video presentation professionally produced and presented at the Fisic Conference 2015.
Professor Francis W. Smith is a graduate of the University of Aberdeen. After residencies in medicine and orthopaedics, he completed his radiological training at the Hospital for Sick Children in Toronto in Canada.
He pioneered the clinical application of MRI, starting the world's first clinical trial of MRI in 1980 and the world's first diagnostic MRI service at Aberdeen Royal Infirmary in 1981. Between 1980-91, Professor Smith published the first clinical applications of MRI for musculoskeletal radiology, abdominal and pelvic disease, as well as in pregnancy. He has over 250 publications, 32 book chapters and 5 textbooks.
In 1982, Professor Smith became President of the Society of Magnetic Resonance Imaging. In 1990, he received the Gold medal from the International Society for Magnetic Resonance Imaging. 1984-91, he became Editor in Chief of Magnetic Resonance Imaging. In 1999, Prof Smith received the Barclay Medal from the British Institute of Radiology and in 2009 gave the Sir Godfrey Hounsfield Memorial lecture. He is currently Clinical Director of Medserena Upright MRI.
Professor Smith is also a qualified Sports Medicine Physician. Since 1996, he has been an examiner for the Faculty of Sport and Exercise Medicine (UK), and is currently the external examiner in Sports Medicine at the University of the West Indies.
Dr Gajan Rajeswaran has been a Consultant at Chelsea & Westminster Hospital since 2011. He completed his undergraduate medical training at Imperial College London in 2001 and his radiology training at Chelsea and Westminster Hospital in 2009.
Dr Rajeswaran completed two post-CCT fellowships in Musculoskeletal Imaging at Chelsea and Westminster Hospital and the Royal National Orthopaedic Hospital, and worked as a Locum Consultant at Imperial College Healthcare NHS Trust and North West London Hospitals NHS Trust.
He has special interests in all aspects of musculoskeletal imaging, including the full range of image-guided musculoskeletal intervention / injections.
Dr Rajeswaran has several peer reviewed publications and lectures regularly at national and international conferences, including the European Society of Skeletal Radiology, the British Institute of Radiology, the UK Radiology Congress and the Royal Society of Medicine. He is actively involved in medical education and has completed a Postgraduate Certificate in Medical Education. Dr Rajeswaran is joint Training Programme Director for the Chelsea & Westminster Hospital Radiology Scheme and has an active role in radiology training.
Mr Nick Allen is the Clinical Director of the Birmingham Royal Ballet Company's Jerwood Centre and External Consultant to the LTA's High Performance Centre in Edgbaston.
Mr Allen has a post graduate degree in Sports Medicine and completed his epidemiological based Doctoral dissertation in 2011. He has worked as an external Consultant to the Great Britain Gymnastics, England and Great Britain Hockey, and the Lawn Tennis Association's High Performance Centre, as well as providing a second opinion for a number of the National Governing Bodies on complex cases. Prior to moving to Birmingham Royal Ballet, he was Head of Medical Services for a Premiership rugby club.
As well as having a PhD in epidemiology, his research interests lie in optimising performance through screening, the relationship of vitamin D to injuries and performance, cardiac risk in dancers, and the management of tendinopathies.
He has been invited to present at a number of conferences by various organisations, including the British Association of Sports Medicine, the Royal Society of Medicine, British Rheumatology Society, UK Sport, England Rugby, UK Strength and Conditioning Association and the English Institute of Sport.
Mr Allen is an Honorary Lecturer for Queen Mary's University London and lectures on the MSc in Sports Medicine QMUL and Nottingham University. He is Birmingham Royal Ballet's representative on the National Institute of Dance Medicine and Science's Steering Committee, and is on the Sports Advisory Group for ARUK's Centre of Excellence in Sports, Exercise and Osteoarthritis.
This content consists of a 14 minute video presentation professionally produced and presented at the Fisic Conference 2015.
This content consists of a 15 minute video presentation professionally produced and presented at the Fisic Conference 2015.
Ms Lesley McBride is a Physiotherapist for the Rugby Football Union, as squad physiotherapist to the national England men's U20 squad and as a consultant physiotherapist to the senior England squad for cervical spine screening, treatment and rehabilitation programmes.
Ms McBride graduated from Nottingham School of Physiotherapy and is currently a Senior Lecturer at Coventry University, which has a national and international reputation for excellence and innovation. She lectures on the MSc Manual Therapy course as well as the MSc Strength and Conditioning course. Until recently she was also lead physiotherapist at the sport and recreation centre for Coventry University, where she offered physiotherapy support to over 60 sports scholars. Ms McBride has special interests in sports injuries, manipulation, manual therapy, and her research is into cervical spine proprioception.
International conference presentations include the WCPT. She delivers postgraduate courses throughout the UK and has had a publication in the Archives of Physical Medicine and Rehabilitation. She was part of the London 2012 Olympics physiotherapy team working in the Athletes Village and will be match official physiotherapist for 3 matches at the RWC2015.
Mr Peter Hamlyn gained a Bachelor of Science in Neuroscience and went on to qualify with a Bachelor of Medicine, Bachelor of Surgery degree from University College London in 1982. He completed a Medical Doctorate and undertook further neurosurgical training at The Royal London Hospital and Bart's and the London NHS trust.
He has been a Neurological Spine Surgeon for twenty years. During this time, he has led several neurosurgical teams in some of London's elite teaching hospitals such as St Bartholomew's Hospital and The Royal London Hospital. He has been an Honorary Consultant Neurosurgeon at University College London Hospital since 2009.
Mr Hamlyn's clinical activity consists currently of some 3,500 outpatient consultations and just over 300 operations per year. His passion lies in spinal disorders and sports injury - the majority of his work involves minimally invasive / keyhole and restorative, reconstructive surgery. He has substantial exposure to elite level sports from Premiere League football and rugby, National team members in several different sports, UK sponsored athletes, jockeys and even the Royal Ballet.
Mr Hamlyn's cranial work now focuses on head injury in sport, for which he has been awarded Fellowship of the Institute of Sport Medicine. He has worked as a current or past Medical Advisor to the Society of British Neurological Surgeons (first Safe Neurosurgery working group); General Medical Council; Trigeminal Neuralgia Association of Great Britain; British Olympic Association; British Boxing Board of Control; The Jockey Club of Great Britain; UK Sport; Royal Ballet; GB rowing team; England Rugby, and numerous Premier League football and rugby clubs.
He was a founder and remains Vice Chairman of the Brain and Spine Foundation .
Mr Richard J. Nelson graduated from Cambridge University School of Clinical Medicine in 1978, and gaining FRCS Edinburgh in 1982 and FRCS England in 1983.
He had a broad-based surgical training in Cambridge, Oxford and London, before completing his neurosurgical training and research in Wessex Neurological Centre, Southampton. Mr Nelson joined the Neurosurgical Department at Frenchay Hospital in 1990.
Mr Nelson's specialist interests include the management of spinal problems in elite sportsmen and women, minimally invasive spinal surgery and the management of complex neurovascular and skull-base disorders. He has played a major role in the development of the Clinical Neurosciences in Bristol as a Clinical Director. He has also been closely involved in several strategic developments affecting neurosurgical standards, training and selection at a national level. He has served as Chairman of the Specialist Advisory committee in Neurosurgery, Secretary to the Neurosurgical National Selection Board, President of the Society of British Neurological Surgeons and Chairman of the Neurosurgical National Audit Programme.
Mr Nelson is the immediate past President of the Society of British Neurological Surgeons, having previously served as Vice-President of the SBNS, Secretary to the Neurosurgical National Selection Board and Chairman of the Specialist Advisory Committee in Neurosurgery.
This content consists of a 10 minute video presentation professionally produced and presented at the Fisic Conference 2015.
Mr Tim Hems is an experienced Hand and Orthopaedic Surgeon working at the Victoria Infirmary, Glasgow since 1997. He is now based at the new Queen Elizabeth University Hospital. He is also the lead clinician for the Scottish National Brachial Plexus Injury Service.
Mr Hems attended medical school in Cambridge and Oxford. He undertook training in Orthopaedic Surgery in Glasgow and Oxford, with specialist fellowships in Hand Surgery in Manchester, Wrightington, London and Bern, Switzerland. He was awarded the European Diploma in Hand Surgery by the Federation of European Societies for Surgery of the Hand in 1997.
Mr Hems has a special interest in peripheral nerve and brachial plexus injury and reconstruction for paralysis of the upper limb. He is an member of Council of the British Society for Surgery of the Hand, lectures regularly on National Courses, and has written chapters for books on hand Surgery. He has undertaken extensive research on aspects of Hand Surgery including nerve repair and wrist fractures with over 40 publications.
This patient information leaflet covers exercises and advice for stretching the neck and shoulders and trunk. The leaflet includes a short overview, along with specific strengthening and stretching exercises and repetition guidelines (which can be changed by practitioners where appropriate). Each exercise includes an image and description.
The double sided A4 (prints as a 4pp folded A5) full colour leaflet in PDF format is designed to be printed out and handed to your clients and can also be used on your website as part of a "call to action" document download (for more information read our article "Physical therapy website design: 10 homepage essentials for getting new clients"). You can purchase the leaflet individually, as part of the patient information section or as part of a full site subscription. To see a sample of the leaflet please click on the image icon in the media contents box.
Our Co-Kinetic patient advice leaflets are written and reviewed by a multi-disciplinary team of medical and fitness professionals. Every leaflet is peer-reviewed at the very minimum by a professional in each of the following disciplines: physical therapy, manual therapy and exercise/fitness. Where appropriate we may also ask a recognised national charity to review and approve the content.
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