08 Apr 2018
The story / blog goes on about a woman who is having thumb pain. She’s a massage therapist, but her pain is worse when driving! Pressure makes it feel better (pushing into the thenar eminence). There was also a complaint of inner arm pain – about where her bra wire would come in contact with her biceps (along the line of the median nerve). The patient had a paraesthesia along the line of the median nerve. Essentially, an abnormally sensitize neural area affecting the distribution of the median nerve.
Treatment ideas for the woman described in the podcast included increasing the surface area of the pressure. (disperse the force over a greater area). The clinician also did some neural tissue technique that also improves sensitivity and mobility of the median nerve, and the patient was instructed to find a way to pad the underwire of her bra in that area.
Okay… so a funny, and unique patient & PT interaction. And by now you are thinking… I’m not sure what this has to do with canine rehab!
Well, a number of years ago I had a German Shepherd patient (maintenance stuff mostly) but more to the point of this story, she hated her harness and would always bit at it and flinch along her back when it was put on. The harness fit well. Not too tight. Not too loose. Didn’t restrict motion. But when it was first put on, it drove the dog crazy along the same part of her thoracic spine. The area of irritation was right under where the harness clipped together, and she was a bit hypersensitive in that region… but not with firm pressure (i.e. to assess mobility of the vertebra or ribs), however with light pressure she was visibly irritated.
So, in listening to this podcast about the bra-lady, my head went immediately to my irritable harness patient. I think this too may have been a case of hyperaesthesia due to a persistent external stimulus. I advised the client to look into a different harness, and that did the trick! No more avoiding the harness, no more flinching in the region.
The point is that sometimes the little things we find and can ‘see’ with ‘outsider-vision’ may very well make a big difference!
And on that note, check your bras, and have a great week folks!
Tags: bra pain , neural sensitivity , mechanosensitivity , nerve irritation
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