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On treating a stenotic patient with a PEC pattern…I have a 77 year old patient that has had an aortic valve replacement and left rib resection. He presents with bilateral adduction drop test, bilateral extension drop test and both IR and ER are very restricted. My questions centers around working with the hips in order to reduce stress on the lumbar/sacral spine or is it better to address the spine first? This sounds like a complex case! From what I read of this patient, it sounds like it would be best to address him initially as a PEC patient. I think it would make more sense to work on the hips to reduce the stress vs. starting with the spine. Once you get his adduction drop tests negative and increase rotation through his hips, it should take some of the stress away from his back because he is probably using his back for transverse motion. |
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