Upload
quratulain-mughal
View
272
Download
6
Embed Size (px)
Citation preview
1
THE LUMBER SPINE
SNAGSSELF SNAGS
QURATULAIN MUGHALBATCH IV
DOCTOR OF PHYSICAL THERAPYISRA UNIVERSITY
2
INTRODUCTION SNAGS work directly on facet joints, that can
help a disc lesion. And assist Mckenzie response. During normal flexion of the spine the disc
distorts and becomes wedge shaped. The vertebral bodies proximate ventrally and
separate dorsally. BUT remain under the umbrella of above vertebra.
And facet joint must be mobile.
1.SNAGS
3
4
5
If the facet joints are hypo mobile, when the
flexion takes place, the vertebral bodies will be able to proximate anteriorly but unable to separate dorsally.
The disc may no longer under the above vertebral umbrella. And bulged posteriorly causing symptoms.
CONTINUE…
6
7
All techniques explanation must be given to
the patient. Their co-operation is needed. Tell patient your are going to move a vertebra
with your hand in such a way that the pain they feel with particular movt will disappear.
If you feel any pain they must tell you so that you can check your techniques or try another level.
PROCEDURES
8
Do not overdo the SNAGS. As soon as an improvement is brought about
on day one stop and see them two days layer. ‘’RULE OF THREE’’ ON DAY ONE WHEN treating a pt with marked
pain and thus distress we only use our pain free techniques three times as a precaution.
On subsequent visit you may choose to SNAG 10 times.
PROCEDURES
9
You should use McKenzie approach when a pt
has lumbar 4/5 lesion with a lateral shift. To SNAG lumbar(middle) and thoracic(lower),
we require a plinth and a belt that can adjusted in length.
Belt should be 2.6meters(8feets) in length and made up of car seatbelt material.
PROCEDURES
10
In sitting and standing.
If problem with movement are only present when standing then snag are only in done in standing.
If they have movement problem when sitting as well then your initial therapy would be in sitting and would progress to standing.
ACTIVE MOVEMENTS
11
(1).To increase flexion and/or decrease the pain associated with his movement.(a) In sitting: The pt sits on a plinth with his legs over the side. You stand behind and place a belt around him
and yourself. tn placing the belt around the pt’s lower
abdomen keep it below the ASIS for comfort. The belt below your hip joints. Depents on your stature.
DESCRIPTIONS
12
The ulnar border of your right hand is now
placed under the spinous process of the vertebra above at the suspected spinal segments.
Your other hand should placed on the bed to the left of the pt.
The pt flexes forward until the pain is felt.. He now back off a little from his position.
13
You now apply a gliding force with your right
hand up along the facet treatment plane as he again flexes.
If treatment is indicated, you are on the right segment and the direction of force is correct, he will painlessly flex to almost full range.
If there is pain try another level. Sustain flexed position for a few seconds and
maintain your facet glide until yhe pt is again erect.
14
When there is no pain, repeat just three times
and that would be all that you would do on the pt first visit.
15
16
17
B. IN STANDING
18
19
20
21
SELF SNAG
22
23
24
MULLIGAN :MOBILIZATION OF SPINE VOL:II
REFERENCE
25