CLINICAL DIAGNOSTIC ASSESSMENT by Crook Back Clinic

The complete, fitness centre based,

musculo-skeletal health program.

Clinical Diagnostic Assessment

Principles of musculo-skeletal dysfunction

Cardinal rules of joint and muscle pain

Musculo-skeletal dysfunction explained

Clinical diagnostic assessment

Visit the Global Back Care website to access the suite of ebooks:

Fix Back pain

Fix Neck Pain

Fix Shoulder Pain

Fix Wrist Pain

Fix Hip Pain

Fix Knee Pain

Fix Achilles and Foot

pain

It is our belief that bulging disks and lower back pain are symptoms that your pelvis and the bones above it are out of alignment.

Getting yourself back into alignment relieves the pressure on muscles, ligaments, tendons and disks. The pain goes away.

The good news is that you can relieve the pain yourself if you do the right exercises.

The bad news is that rubbing, heating and crunching around the area where it is painful does little to get you back into alignment. It's palliative, and while that's not a bad thing, it doesn't go far enough toward restoring poor function to good.

THE SYMPTOMS

Pain
Pain is a symptom that your skeleton is out of alignment. Get it back into alignment and there's a high likelihood the pain will go away.

Tight muscles
In a nutshell, your back pain is a symptom of tight and weak muscles elsewhere around your body.

In particular, tight calf, buttock and hamstring muscles will tilt your pelvis, backwards, which in turn will cause vertebrae further up to go out of alignment.

On top of that, the buttock and hamstring muscles on one side of the body may be tighter then those on the other side. This will cause the pelvis to twist, resulting in further misalignment further up your spine.

Weak muscles
Weak back and abdominal muscles exacerbate the problem. A lot of people aren't strong enough to keep their spinal column in correct alignment. They don't have a regular and systematic strength training program.

THE PRINCIPLES

This theory rests on three key principles

1.	Muscles take bones out of alignment.

2.	The cause of the pain is rarely at the site of the pain.

3.	Form (good skeletal alignment) follows function (the ability to do the postural exercises that people in good musculo-skeletal health can do.

POSTURAL DIAGNOSIS

Here is a selection of our clinical assessments.

1. Standing up straight

This fellow is leaning too far to one side. Muscles on one side of his body are tighter than the corresponding muscles on the other side.

In short, his skeleton is out of alignment.

2. Standing side on

This fellow's head is too far forward - symptomatic of hamstring and buttock muscles that are too tight. That would explain why he had a sore neck and a crook back.

TIGHT MUSCLES ATTACHED TO YOUR PELVIS

3. Tight calf and hamstring muscles

When you sit up against a wall with legs straight, see how close you can get your bottom to the wall.

You'll get a distinct impression as to which muscles are tight when you push your bottom closer to the wall.

Think calf and hamstring muscles.

Poor

Good

4. Tight buttock muscles

Can sit up straight with your legs crossed and your hands clasped behind your back?

Is one buttock muscle is tighter than the other?

Poor Good

5. Tight quadriceps muscles

Place one foot on the kitchen bench and lean back. Most people find that they have an excruciating quadriceps muscles and have difficulty keeping both knees together while doing the exercise.

If you can't keep your knees together your abductors -0 the muscles on the side of your thigh are too tight.

If quadriceps muscles are tight, chances are you're also experiencing knee pain.

6. Tight muscles at the front of your pelvis - the adductors (the muscles than bring your legs together).

This is a tough assignment for people with tight hip flexor muscles.

The starting position is resting on your hands with your knees as wide apart as you can get them and feet together.

Keeping your toes on the floor, lower your abdomen and chest to the floor and rest your head on your hands.

The distance between your abdomen and the floor is an indicator of how tight your hip flexors are. to the floor

7. Tight hip flexors - the muscles that lift your thigh bone.

When easing your way forward in this position you'll feel just how tight the hip flexor (groin) muscle is.

8. Tight abdominal muscles

You'll know if you have tight abdominal muscles by determining how far off the ground you can lift your chest.

GENERAL MOBILITY EXERCISES

AND MUSCLE TESTS

It is highly likely that in some of the stretch positions some muscles will be extremely tender. Here are the areas that are likely to be painful when given a firm finger massage by someone else.

It is likely that one side will be tighter than the other.

9. Tight muscles throughout the back side of your body

Can you put your socks on while standing on one leg?

If you can't, you've definitely tightened up - hamstring, buttock and back muscles.

10. Super hip and thigh stretch

Can you hold on to the toe of a straight right leg with the hand of your left arm - with right shoulder on the floor?

Most people can't do this because the muscles of their calves, hamstrings, buttocks and back are too tight.

11. Heels over head

Most people had no trouble doing this exercise when they were 10 years old.

Decades without doing it will reveal just how tight the muscles on the back side of your body have become.

12. Hip Crossover

Put the side of the heel of the right foot up toward the top of your left knee.

Then drop the knee and the foot down onto the floor. Push your right knee away from your body, opening up groin.

Repeat with the other side.

Do you find it easy to get your feet and knees onto the floor?

Is one side tighter than the other?

Does it hurt when someone gives you a vigorous massage on your buttock (see red spot)?

If you suffer from lower back pain chances are you'll find it painful when massaged in the red-spot area. One side will probably be tighter than the other.

13. Tight and painful hamstring muscles

If you suffer from lower back pain chances, when you are in the prone frog position, chances are you'll find it painful when massaged in the red-spot (buttock and hamstring) areas. One side will probably be tighter than the other.

14. Tight and painful buttock muscle

Start on hands and knees. Put your left knee over the right leg, so your left leg is extended and the left knee and the laces of your shoe are on the floor.

Then slide the left knee and foot back as far as you can on the floor.

You'll feel the stretch in the right buttock muscle. When massaged vigorously it may be painful.

SHOULDERS AND HEAD

15. Shoulder, wrist and hand test

Stand with your heels, backside and shoulders against the wall.

See if you can get the back of your forearms and hands comfortably against the wall when in the 'surrender' position.

If you can't there's a good chance your hamstring and buttock muscles are too tight - plus your shoulders need loosening up.

16. Head alignment

Stand with your heels, backside and shoulders against the wall.

Then place your head against the wall. Are you looking straight out in front of you or are you looking up at the ceiling?

GENERAL FLEXIBILITY TEST

17. General test of the flexibility of the muscles on the back side of

your body

With legs straight and back of knees on the floor, how far can you reach forward toward your toes. Do this with shoes on.

The scoring goes like this:

0.

Can't touch toes.

4.

Fingers just touch end of toes.

6.

First knuckle reaches end of toes

7.

Second knuckle reaches end of toes.

7.

Bottom of fingers reaches toes.

9.

Half way between bottom of fingers and thumb.

10.

Level with thumb.

11.

Wrists reach end of toes

STRENGTH TESTS

1. Situps, feet held - general test of front of body strength

How many situps can you do?

Start with feet flat (and held down) knees up, arms crossed and hands clasping shoulders.

Sit up so your elbows touch the your knees.

2. Pressups - general test of trunk, upper body and arm strength

How many pressups can you do - men on toes and women on thighs?

How many pressups you can do correlates highly and positively with lower back function.

3. Squats - general test of leg strength particularly quadriceps and

buttock muscles.

How many times can you squat up and down, with your backside at least midway between you knees and your ankles.

HOW TALL ARE YOU AND

WHAT DO YOU WEIGHT?

How tall are you?

What do you weigh?

What is your percent body fat?

Estimate how many kilos you are over your ideal weight.

Being over-weight can have a dramatic effect on musculo-skeletal health. If you are a man and your percent body fat exceeds 30%, or a women and your percent body fat exceeds 40% you have increased your risk of musculo-skeletal dysfunction.

Back in Alignment

7 Salvado Place Stirling ACT 2611

Australia