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Animal Chiropractic Technique Manual

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Animal Chiropractic Technique Manual Animal Chiropractic Technique Manual HINDLIMB TECHNIQUES Equine ©ABPA 2015 revised 2006, 2007, 2008, 2015 5/03/2017 1 EQUINE HINDLIMB TECHNIQUES Hindlimb Hind Limb Dance Stance 3 1. Extension Restriction Of Coxofemoral joint 4 2. Flexion Restriction Of Coxofemoral joint 5 3. Internal/External Rotation Restriction of the Coxofemoral joint / Stifle 6 4. Femorotibial Extension Restriction 7 5. Medial/Lateral Patella Glide Deviation 8 6. Proximal Patella Glide Restriction 8 7. Hock Extension Restriction 9 8. Hock Flexion Restriction 9 9. Restricted Dorsal to Plantar Tarsal Glide 10 10. Internal/External Rotation of the Hock 11 Cautions: 1. With all hindlimb adjustments beware of being kicked, especially by fillies. If you feel at all uncomfortable or threatened don’t go there.! 2. Many techniques are long lever which can create a great deal of force – use due caution and be gentle. 5/03/2017 2 ‘Hind Limb Dance’ Stance Notes: 5/03/2017 3 1. Extension Restriction Of Coxofemoral joint Joint Coxofemoral joint Motion restriction Extension Doctor position Standing slightly behind and to ipsilateral side in ‘Hind limb Dance’ position facing cranial Facing cranially on the affected side in the “Dance” position, supporting the hindlimb with the inside leg and inside or caudal hand holding calcaneal or achilles tendon. Outside or cranial hand makes contact with the greater trochanter. Alternatively doctor may switch hands and stabilise the calcaneal tendon with the outside or cranial hand Animal position S.C.P Caudal aspect of the greater trochanter 1o C.P Hypothenar, Calcaneal, Palmar 2o C.P Hand grasping achilles tendon or calcaneal of hock L.O.C Cd>Cr Thrust Notes As thrust is delivered doctors inside heel is dropped and swung laterally, stretching out leg further and moving the distal femur from lateral to medial. These moves facilitate the adjustment. Do not jam femur into acetabulum – low force adjustment. Often associated with sacro-iliac flexion restrictions – treat first 5/03/2017 4 2. Flexion Restriction Of Coxofemoral joint Joint Coxofemoral joint Motion restriction Flexion Doctor position Facing Caudally on the affected side, supporting the hindlimb with the outside hand and inside hand makes contact with the cranial aspect of the greater trochanter Animal position S.C.P Cranial aspect of the greater trochanter or third trochanter 1o C.P Hypothenar, Pisiform Calcaneal (Palmar) 2o C.P Hand grasping Cannon/Fetlock L.O.C Cr > Cd, slight lateral to medial. Thrust Notes Often associated with sacro-iliac extension restrictions – treat first Beware horse doesn’t drop its weight onto doctor. greater trochanter greater trochanter third trochanter third trochanter 5/03/2017 5 3. Internal/External Rotation Restriction of the Coxofemoral joint / Stifle Joint Coxofemoral Joint Motion restriction Internal/External Rotation Doctor position Standing in ‘Hind limb Dance’ position facing cranial Animal position Supported hindleg in a partially flexed position S.C.P 1.Internal: Lateral aspect of stifle (lateral condyle of femur or proximo-lateral tibia 2.External: medial condyle of femur or proximo-medial tibia) 1o C.P Palm/Fingers 2o C.P Calcaneus or achilles tendon L.O.C 1.L>M 2.M>L Thrust Notes Use inside leg and secondary contact to stabilise lower leg as much as possible. Indications – toed in, out at hock or toed out, in at hock. Difficultly flexing stifle. **Loop 2 Note: You can also get Femorotibial rotation restrictions, which are a different thing entirely – work on these in the HLD position, using some traction through the FT joint, while manipulating the tibial crest medially or laterally as required – the position & traction seems to stabilize the femur well enough. – It is more a stretch than a thrust 5/03/2017 6 4. Femorotibial Extension Restriction Joint Femorotibial joint Motion restriction Extension Doctor position Standing slightly behind and to ipsilateral side in ‘Hind limb Dance’ position facing cranial Animal position Ipsilateral hindleg off ground supported by doctors inside leg S.C.P Proximal cranial tibia 1o C.P Fingers of cranial hand wrapped around horses proximal tibia 2o C.P Hand over hock or grasping achilles tendon L.O.C Cr>Cd Thrust More as a stretch, but can thrust if needed. Notes Drop heel to extend leg with inside leg as deliver thrust. Beware ligament and disc pathology. Generally more rotations than extension restrictions of the FT joint 5/03/2017 7 5. Medial/Lateral Patella Glide Deviation Joint Patellofemoral joint Motion restriction Patella glide deviation Doctor position Standing slightly behind and to ipsilateral side in ‘Hind limb Dance’ position facing cranial Animal position Ipsilateral hindleg resting on Doctors calf S.C.P Proximal Patella 1o C.P Digital grip for pull thrust 2o C.P Hand over Hock L.O.C Proximal to distal, lateral to medial, or medial to lateral, according to restriction. Thrust HVLA as approach full extension. Notes With upward fixation of the patella restriction usually lateral to medial 6. Proximal Patella Glide Restriction Joint Patellofemoral joint Motion restriction Patella tracking dysfunction or patellar glide deviation Doctor position Standing slightly behind and to ipsilateral side in ‘Hind limb Dance’ position facing cranial Animal position Ipsilateral hindleg resting on Doctors calf S.C.P Distal Patella 1o C.P Forearm 2o C.P Hand over Hock L.O.C Distal to Proximal Thrust HVLA as approach full extension. Notes With upward fixation of the patella restriction usually lateral to medial component. 5/03/2017 8 7. Hock Extension Restriction Joint Tarsocrural. Intertarsal and Tarso-metatarsal joints Motion restriction Extension Doctor position Standing slightly behind facing caudally and to ipsilateral side in Farrier stance Animal position Ipsilateral leg extended backwards S.C.P Over plantar side of calcaneus (fibular tarsal) 1o C.P Calcaneal , Palmar of inside hand 2o C.P Dorsal aspect of distal cannon or fetlock L.O.C Plantar to dorsal, proximal to distal with inside hand; proximal to distal and dorsal to plantar with outside hand on cannon Thrust Better as a gentle stretch. Notes Extend / stretch joint and thrust with knee at end of extension of joints 8. Hock Flexion restriction Joint Tarsocrural Motion restriction Flexion Doctor position Facing across with bent knees and straight back Animal position Affected leg raised in flexed posture S.C.P 1.Distal cannon, plantar aspect 2.Dorsal tarsus between tibia and MT3 1o C.P Fingers wrapped around plantar aspect of cannon 2o C.P Forearm of caudal arm L.O.C Distal to Proximal Thrust Gentle repeated distraction Notes 5/03/2017 9 9. Restricted Dorsal to Plantar Tarsal Glide (Loop 2) Joint Intertarsal and tarsometasal Motion restriction Dorsal to plantar glide Doctor position Facing caudally with bent knees and straight back, hoof cleaning stance. Animal position Affected leg raised in partially extended posture. Horse’s cannon on Doctors inside distal femur. S.C.P 1.Dorsal T3,4 or central tarsal bone 2. Plantar cannon below hock 1o C.P Web or index of outside hand 2o C.P Inside arm stabilizing hock via elbow and hand grasping plantar cannon immediately below tarsus L.O.C Dorsal to plantar. Thrust HVLA or gentle repeated motioning Notes Indications: discomfort on hock flexion and thus conscious resistance to hock flexion, reduced lift of hock at gait, reduced D>P tarsal glide. Beware hock arthritis. Variation: Kate's approach 5/03/2017 10 10. Internal/External Rotation of the Hock Joint Mainly Intertarsal Motion restriction Internal/ External Rotation Doctor position Standing slightly behind and to ipsilateral side in a modified Farrier stance Animal position S.C.P Hock, proximal metatarsals (L or M) or tarsal bones 1o C.P Calcaneal , Palmar 2o C.P Stabilise Tibia with upper arm L.O.C L>M, M>L Thrust Torque in upper arm Notes Beware of being kicked!!!! *Loop 2 Variation - Y axis translation of the hock - in farrier position, rest hock over inside thigh, which is your stabilization, traction through all 3 layers of joint, contact point being both hands on distal cannon, follow up with loose rotatory mobilisation – sometimes a good one to show clients Variation: Kate's below the hock approach 5/03/2017 11 .
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