# data[].attributes.headline
address beleifs and expectations re pain and injury - relay role of movement and restoring ROM through frequent ROM exercises with relaxed breathing 

# data[].attributes.subject
address beleifs and expectations re pain and injury - relay role of movement and restoring ROM through frequent ROM exercises with relaxed breathing 

# data[].attributes.headline
Specific MT technique where patient Adrian actively moves - MWM to flex in 4 pt kneel 

# data[].attributes.subject
Specific MT technique where patient Adrian actively moves - MWM to flex in 4 pt kneel 

# data[].attributes.body
reduce cognitive threat
plan for graduated return to meaningful actvities
Mobilisation with movement
start small exercises/movements that are seen as safe

# data[].attributes.body
- get them to move back
- LP dissociation
- graded exercise program

# data[].attributes.body
1. Advice and education- the spine is a really stable structure!
2. Passive ROM- reduce fear avoidance
3. Motor Control- 4pt kneel sit to heels

# data[].attributes.body
1. correct unhelpful beliefs and explain the complexity of nervous system and pain
2. encourage exercise, start with what patient is confident and gradually progress
3. give reassurance that our lumbar is stable and adaptable

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1. Education
2. Reassurance
3. Short term goals (reduce fear of movement)

# data[].attributes.body
1. Address any catastrophizing thoughts or misunderstanding
2. Pain management - heat, icing, soft tissue techniques
3. motor control exercises - lumbopelvic dissociation, finding neutral spine,

# data[].attributes.body
1. advice and education: explain how the nervous system works, disc bulge is very common and doesn't always correlate to symptoms; good prognosis for her condition
2. pain management exercises: cat cow and knee side to side exercises
3. graded re-exposure to functional tasks. Flare ups are normal and ok

# data[].attributes.body
1. address beleifs and expectations that flexion is harmful

2. sliders to reduce mechanosensitivity

3. encourage her to start exercising and moving again, asking her what sort of activities she enjoys doing/graded exercise

4. deep breathing to help decrease bracing?

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1-  A&E =  initial injury healed. Explain chronic pain

2- Teach patient 4pt kneel  motor control and possible progression

3- SLider with progression to possible tensioner.

# data[].attributes.body
1-  A&E =  initial injury healed. Explain chronic pain

2- Teach patient 4pt kneel  motor control and possible progression

3- SLider with progression to possible tensioner.

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1. Debunking myths, consider what they want to find out, who have they seen about it in the past
2. Ask if work is supportive, have they had time off? Show them statistics about people who don't return ASAP
3. Work together and listen to find easing strategies, breathing, exercises etc.

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Address findings on FABQ
Choose position that would be tolerated to start flexion
Breathing control on flexion in 4 point kneel
progress to sitting and standing

# data[].attributes.body
--> can get them to do what they can manage with already, and while doing that encourage

them to perform while being relaxed and not using maladaptive things

--> can get them to do directional perference, if you get centralization it shows that mvmt can be helpful

# data[].attributes.headline
Patient advice and education – address any catastrophizing beliefs using the FABQ questionnaire. Build confidence by getting the patient to do exercises they were able to complete instead of something way too challenging

# data[].attributes.subject
Patient advice and education – address any catastrophizing beliefs using the FABQ questionnaire. Build confidence by getting the patient to do exercises they were able to complete instead of something way too challenging

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Make patient aware of breath holding - breathing exercises before doing test

# data[].attributes.subject
Make patient aware of breath holding - breathing exercises before doing test

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1) Thumb on xiphoid process, pinky on belly button. Ask patient to bend and have the two come closer together

2) Patient education - Assurance that the spine is strong and stable. Bending it will not hurt the back

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MWM 4 point kneeling with breathing control
Get patient doing this reg at home
pelvic tilt in sitting as tolerated

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1. reduce cognitive threat: reconceptualise beliefs about pain levels and that it is important to keep back moving
2. enhance self-efficacy: you need to keep your back moving, we understand that youre having pain but we will start at a point where you are pain-free and progress from there.
3. Graded exposure

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1.Reduce it back to sitting or even 4 point kneeling to show him that he is able to move his back especially NWB

2. Lumbopelvic dissociation in sitting

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1. reassurance that he is not doing any harm to his back
2. forward lean in sitting to show him that it is safe to move

# data[].attributes.body
1. education regarding movements - his back is strong and is safe to move
2. controlled flexion (progressing in range) with relaxed breathing that is not painful to reassure him that it is safe

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1. regress the movement into a flexion in 4-point kneel

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1. regress the movement into a flexion in 4-point kneel

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2. reassure him on the resilient nature of the spine and that it was designed to move. avoiding movement by bracing all the time might actually by contributing to symptoms

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Advice and Education - mri/imaging findings and % of asymptotic patients. Spine stable and well supported structure safe to move. Return to work sooner have better prognosis
Manual therapy -

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Move his back passively --> as show him that it is not creating pain/injury
The back is very strong, resilient
Exercise is important
Pain does not equal damage

# data[].attributes.body
1. advice and education, reassuring the patient that the spine is a robust structure, designed to move, and that in fact moving the back will help rehabilitate it and reduce pain. explain how the NS system works and that the pain is not corresponding to damage
2. move his back passively to demonstrate that movement can be pain free

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MWM
-4 point kneel
-heel to bum
-therapist applies a glide
-progress by increasing range

# data[].attributes.headline
1. Advice and education about strength of spine, nervous system sensitivity and pain, reassure that is safe to move 

# data[].attributes.subject
1. Advice and education about strength of spine, nervous system sensitivity and pain, reassure that is safe to move 

# data[].attributes.body
2. Gentle movements of flexion to improve confidence and demonstrate the ability and safety to move the back into flexion

# data[].attributes.headline
1. Advice + Education - Reassure Adrian that back is safe to move, exercise may reduce pain & pain doesn't = tissue damage 

# data[].attributes.subject
1. Advice + Education - Reassure Adrian that back is safe to move, exercise may reduce pain & pain doesn't = tissue damage 

# data[].attributes.body
2. Regress exercise to sitting or 4-pt kneel (unloaded) to show he can flex his back without bracing and breath holding