Discussion related to the musculoskeletal system - injuries, post-op, lameness, extremity issues (joint, muscle, tenon, fascia...), axial skeleton issues, etc., as it relates to canine rehabilitation.
I have attended 2 courses with you in Vienna, Austria some years ago and i am using so many of the techniques you showed us, also on horses
A great technique you taught us was treating the first rib, even finding pain and the origin of lameness there has improved my diagnostic tools a lot.
Since i see pain in the 1. rib often, i wonder if you have a theory, on what is causing pain and „subluxation“ there?
I tend to see it more often in bigger dogs, in IPO (protection) dogs, and labradors. Do you have an explanation why these dogs have, sometimes even recurring, problems in this area? And do you have had success with specific training/stretching etc of that area to prevent reinjury?
I ‘THINK’ that the problems at rib one are related to how the dogs use their bodies. Dogs that pounce on things or make hard stops, or dogs that jump down lots are common to have 1st rib issues. I see it more in sporting dogs than pet dogs. In pet dogs I see it more in small ones that jump off the bed or couch.
So the real question is a bit about ‘what is actually going on’. Is it actually a subluxation? (Human research is telling us that joints don’t so much ‘sublux’, but rather that there is a change in pressure within the joint and subsequently the tone in the adjacent soft tissues / muscles.) So the question might actually be about the Scalenes muscle, and what action / activities cause the dog to excessively use the Scalenes or stretch it, etc… and subsequently pull on the costvertebral / costotransverse joints, causing ‘pressure’ in the joints.
So… stretch scalenes. Routinely. Maybe add massage to scalenes. Maybe check for fascial dysfunctions along the entire cervico-thoracic-shoulder region.
I agree with what LEH said, AND would add my subjective opinion that 1st rib issues are also correlated with underlying shoulder pathology. ie: 1st ribs can be a primary problem, or can be secondary to abnormal muscle (pectoral????) engagement as a compensatory mechanism to cope with underlying glenohumeral joint pain.
The same sort of movement patterns listed above that predispose to 1st rib issues, are also hard on the shoulder joints. If you have a patient with recurrent 1st rib issues, consider getting that shoulder imaged (U/S or MRI).
Scalenes more likely than Pectorals.
Scalenes could be used to pull the whole of the side forwards and/or to create the head bob / off-loading of the limb.
From a manual therapy perspective then, what techniques do you prefer to target the scalenes? Or, instead of targeting scalenes, do you just assess the global shoulder geographic area and treat what you find?
Oh... ALWAYS a total shoulder eval.
I think scalenes as a mechanism to hike the shoulder up / forward and hence it is over used.
Manual techniques for scalenes: 1) Stretch: I like taking the dog's head into extension and then looking away (i.e. up and over) to the contralateral side. - See Video Training 143.
I am also finding that any of the shoulder cases tend to have scapular mobility restrictions particularly towards caudal glides and ventral glides or any combinations of those directions.
I find as well, that most of these dogs avoid active end range extension... and I've just invented an exercise to work on this... (stay tuned).
