client in 1 hr has rib heads out!

[Sallow]

Hi everyone, sorry this's so urgent...

I have a new client coming very soon who was playing with his kids and threw out a couple of rib heads. This isn't the first time this's happened to him and he does see a chiropractor (who is not in the office today).

We learned something in NMT about putting rib heads back in using pressure in/near the axillary area but I cannot recall the whole procedure. Does anyone else have any ideas? SHould I gently work the intercostals with a small T-bar? Apply pressure to the axillary area where the ribs can be palpated? Approach it from the rib head site near the spine? Any ideas?

Thanks in advance!!
Hugs
~Jyoti

 

[trublu]

Yikes - sorry nobody was able to respond before your client got there. What did you end up doing? How did it go?

 

[Concorde]

client in 1 hr has rib heads out!

Hi everyone, sorry this's so urgent...

I have a new client coming very soon who was playing with his kids and threw out a couple of rib heads. This isn't the first time this's happened to him and he does see a chiropractor (who is not in the office today).

We learned something in NMT about putting rib heads back in using pressure in/near the axillary area but I cannot recall the whole procedure. Does anyone else have any ideas? SHould I gently work the intercostals with a small T-bar? Apply pressure to the axillary area where the ribs can be palpated? Approach it from the rib head site near the spine? Any ideas?

Thanks in advance!!
Hugs
~Jyoti

Jyoti,
I am guessing you probably do not want to hear this but I think, no, I know, you should REFER HIM OUT to another chiro.
He is putting you in a precarious position.

Although..yeah yeah..muscles move bones...muscles keep bones etc....this would be a straight out skeletal manipulation.


Robyn

 

[wuffer]

While I would never encourange anyone to TRY to make skeletal adjustments, there are some things you can do to induce the body to adjust itself.

Working the adjacent tissue and getting it to let go will sometimes allow the bones to go back into place on their own. I'd try to work the entire ribcage region (front and back) concentrating on the intercostals. Don't forget serratus (anterior and posterior.)

Perhaps by addressing the soft tissue issues, you can at least get him some relief until he can get in to see a chiro.

Sorry this didn't get posted in time to help.

Angie

 

[Paul]

I'm with Moogie, and don't forget to "put him on ice!" :wink:

 

[Dick Buttkiss]

Hi all

Thanks for responding anyway! It's good learning for next time

For the record, in TX, we're barred (with good reason) from doing HVLA (high-velocity, low-amplitude) adjustments...adjustments that are quick and shallow. We can, however, provide slow stretches or even compressions to neighboring tissue and if vertebrae (or any other bones) happen to realign themselves, we're still in the clear, because our intent wasn't to adjust anything. Gray area, I know...but that's us The rib head part of the NMT protocol we learned was also very slow and palpatory...it just involved pushing the rib back in very gently IF it would go.

Cool part was, I didn't even have to consult my protocol notes. The guy commented that last week he'd gone to see an MT (he kept calling her a masseuse lol...SO much public education left to do!..but he was nice anyway ) and she had given him a massage just to loosen him up before his chiro adjustment. She was gone today, so that's why he sought out another MT, and came across me (Yay!) So, that's really all I ended up doing. I tried to loosen the muscles as best I could. He's a big guy with lots of tissue, and the tissue was tight, so I applied a little hot stone to the erectors to at least loosen them up, ks once we were done he was gonna go from my house to his chiro just down the street. When I was done, the rib pain was obviously still there, but his back felt much looser, and hopefully that helped the DC get good movement during the adjustment, and hopefully the adjustment'll last longer.

But THANKS to everyone! And as usual, if anyone has anything more to add, by all means, spill It's a great learning experience that we can all consult when needed. (I love this board...I've had times where I've had a client coming in a half hour, I'll run a search on here for a condition they've mentioned they had, and sometimes know exactly what to do when they get here...hats off to all of us )

OK, done rambling, back to work Thanks for asking about it
Hugs,
~Jyoti

 

[Cheese is good.]

For the record, in TX, we're barred (with good reason) from doing HVLA (high-velocity, low-amplitude) adjustments...adjustments that are quick and shallow. We can, however, provide slow stretches or even compressions to neighboring tissue and if vertebrae (or any other bones) happen to realign themselves, we're still in the clear, because our intent wasn't to adjust anything. Gray area, I know...but that's us

re-alignment of vertebra with intent = adjustment
re-alignment of vertebra without intent = release

 

[Marissa Likeeee]

re-alignment of vertebra with intent = adjustment
re-alignment of vertebra without intent = release

Amen, mush

 

[Shazam]

i used to get shiatsu from this lady who would walk on my back and of course ribs would go back in. I know how to "adjust" necks purposefully, with a jerking action and also with very slow movements, the neck will just begin to adjust as it relaxes down. There are many ways to "adjust" or "realign" the SI Joints and hips. My point being that: A chiropractic style of "adjustment" is with a quick, jerking, intentful action. Whereas a massage therapist can still manipulate and gently "nudge", "push", or "apply pressure" in specific directions. The former is illegal for us, whereas the latter is legal.

A perfect example of this is carpal bones. From what I've known from most of the chiros I've worked with, it isn't even supposed to be possible to adjust carpal bones, a few chiros do, but most don't know about it. Yet, many NM Therapists do it all the time.

 

[Rev. Michael S. Margolin]

i used to get shiatsu from this lady who would walk on my back and of course ribs would go back in. I know how to "adjust" necks purposefully, with a jerking action and also with very slow movements, the neck will just begin to adjust as it relaxes down. There are many ways to "adjust" or "realign" the SI Joints and hips. My point being that: A chiropractic style of "adjustment" is with a quick, jerking, intentful action. Whereas a massage therapist can still manipulate and gently "nudge", "push", or "apply pressure" in specific directions. The former is illegal for us, whereas the latter is legal.

A perfect example of this is carpal bones. From what I've known from most of the chiros I've worked with, it isn't even supposed to be possible to adjust carpal bones, a few chiros do, but most don't know about it. Yet, many NM Therapists do it all the time.

Exactly. A manipulation is not an adjustment, no matter what a Chiropractor says. Chiropractors perform High Velocity Thrusts, and even in accordance to the statements of my association, High Velocity Thrusts are specifically out of our scope of practice. Manipulation and Mobilization techniques, regardless of audible release and assuming not performed as a high velocity thrust, is well within our scope of practice.

With safe manipulation, it isn't a question of scope of practice. If you are trained in the methods and are clear for safe practice, what is the problem? It comes down to a matter of protecting your trade, and that's about it.

In no way am I saying all massage therapists can perform manipulations. The majority of the ones I know would never try any, nor would I want them to do it on me. But the ones who do, practice very safe treatments, with every precaution.

And how many chiropractors do you know who perform Vertebral Basilar Insufficiency tests prior to Cervical adjustment?