Sports Medicine 8 ISSUES only Gateway to the Future SUBSCRIBE TODAY ! $2400 (GST $25.20; QST/HST $27.12) • US $35.00 (USD) • Foreign $50.00 (USD) Name: ___________________________ Clinic Name: ______________________ Address: _________________________ City: ____________________________ Prov: ____________________________ P.Code: ___________________________ Tel: _____________________________ Fax: _____________________________ e-mail: ___________________________ PLEASE CHECK ONE: Doctor of Chiropractic Chiropractic or Student Educational or Research Inst. Other ______________________ Please Specify TYPE OF PRACTICE Solo Group Chiropractic Integrated Disciplines Other ______________________ Please Specify Not in Practice - Student ARE YOU? (SELECT ONE) Owner ❏ Assistant ❏ Other ______________________ ❏ Please Specify Associate ❏ Employee ❏ PAYMENT: Cheque - Payable to Annex Publishing & Printing Inc. Amex Visa MC Account #: ____________________________ Expiry: ___________________________ Signature: ____________________________ Date: ________________________________ TO SUBSCRIBE: Tel: 866-790-6070 Fax: 877-624-1940 Mail: Canadian Chiropractor c/o Annex Publishing & Printing Inc. P.O. Box 530 Simcoe, Ontario N3Y 4N5 e-mail: [email protected] www.canadianchiropractor.ca GST#867172652RT0001 34 • CANAdiAN ChirOPrACTOr | JUNE 2009 0609CC Picture 4: ART for teres minor, finish point. • Doctor: On affected side. • Patient: Prone or seated while actively moving affected arm. • Contact: Thumb pad at adhesion site. • Stablilization Hand: On thumb contact. • Active Patient Movement: Patient motion starts with the humerus ❏ ❏ ❏ ❏ ❏ ❏ ❏ ❏ ❏ Picture 3: ART for teres minor, starting point. A Child’s First Check-up Strategies for Shoulder Injuries using Active Release Techniques (ART). ART was born out of Dr. Michael Leahy’s observations of the myo-fibrotic changes associated with macro and micro trau- matic injuries. Dr. Leahy noted that in- jured tissue tended to become shortened, denser and coarser than adjacent non-in- jured tissue upon palpation. Due to in- jury, adhesions form within the muscle. The goal of ART is to remove these adhe- sions by actively lengthening the muscle, while simultaneously working through the grain of the muscle fibre. Once the adhesions are removed, the muscle is restored to a balanced state. The teres minor arises distally from the superior lateral border of the scapula and traces superior laterally toward the humeral head, where it attaches inferior to the greater tubercle. Step 3: ART for teres minor (Applied to adhesion site or entire muscle. See Pictures 3-4.) fully adducted with the elbow bent to 90 degrees. Doctor takes his/ her contact. Patient slowly reaches the humerus forward (into flexion), extends the elbow and internally rotates the humerus by turning the thumb toward the floor. The finish position is reached when the hu- merus is in full flexion, the elbow is fully extended and the humerus is internally rotated with a thumb down position. • LOC: If the doctor is attempting to treat the scapular portion of the muscle, tension is drawn along the muscle from distal to proximal, moving toward the humerus along the fibers of the teres minor. When attempting to treat the humeral end of the muscle, line of drive is toward the scapula. Always apply non-com- pressive tension. By using a combination of adjust- ments with muscle procedures, as in this case, shoulder injuries can be treated more effectively. As usual, I have only scratched the surface with these indi- vidual techniques. If you would like to learn more, please visit www.active- release.com, and www.ThompsonChiro- practicTechnique.com. If you would like to see a specific technique featured in a future edition of Technique Toolbox, please email me at [email protected]. Until next time…Adjust with confi- dence! • REFERENCES 1. Daniel, DM. Diagnostic Corner. An overview of the scientific literature relating to the diagnosis and treat- ment of shoulder impingement syndrome. DC Tracts. 2008. 20(2): 9-12. 2. Will, LA. A conservative approach to shoulder impingement syndrome and rotator cuff disease: a case re- port. Clin Chiropractor. 2005 Dec;8(4):173-178. 3. Atkinson, M. A randomized con- trolled trial to assess the efficacy of shoulder manipulation vs. placebo in the treatment of shoulder pain due to rotator cuff tendinopathy [clinical trial; randomized con- trolled trial]. JACA Online. 2008 Dec; 45(9):Online access only p 11- 26. www.canadianchiropractor.ca
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