Physical Rehabilitation Medicine/Chronic Back Pain/ FCE Test

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Question
I recently had a functional capacity test done and wanted to see if you can give me an idea on what they mean exactly if possible.

Cervical Spine ROM:

Extension....Occiput 32, T1 12, my result 20, NORMAL IS 60

Lumbar Spine ROM:

Extension...T12 6, Sacrum 5, my result 1, NORMAL IS 25
Left Flexion....T12 26, Sacrum 11, my result 15, NORMAL 25

Right shoulder:

Flexion...164, NORMAL 180
Extension....70, NORMAL 50
Abduction...144, NORMAL 160
Internal Rotation....15, NORMAL 90

Hip ROM:

Extension...15, NORMAL 30
Abduction...37, NORMAL 45

Knees ROM:

Right: Flexion 137, NORMAL 150
Left: Flexion 133, NORMAL 150

I had a work related injury and felt a pop in the area between my shoulder blade and spine 2 1/2 years ago.  I have been to chiropractor, acupuncture, PT, electric stimulation and nothing has helped.  

I have also taken MRI's and CT-scan and everything is fine and my doctors don't know where my pain is coming from.  I have been diagnosed with chronic back pain.  Do you have any idea?

Need help!

Thanks

Mark

Answer
Dear Mark,

Sounds to me like a chronic entrenched muscle spasm in a deep muscle that controls movement around a joint between a rib and it's spine segment. Ribs have two joints that connect them to their respective vertebra, and they can get "stuck" in a part of their normal movement and not get unhitched very easily.

I will give you a link to an exercise I made up that remarkably gets to these little muscles. Try it for a week every day and report back to me if you'd like.  It is posted in my website under self help.  Hope you like the humor...I tried to keep it from being a bore.  

http://mindbodyphysicaltherapy.com/2013/02/magic-carpet-back-exercise-2/

I will skip comments on the FCE test...it's not particularly helpful....it doesn't look at how each spine/rib segment is really functioning...just the big picture.

I wish you well and welcome your feedback.

Rachel

Physical Rehabilitation Medicine

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Rachel Katz, PT, SEP

Expertise

I have expertise working with recovery from car accidents, RSD/CRPS, neck and back pain and chronic pain. I can answer questions about pain that is not responding to expected patterns of recovery. I can address pain issues that are associated with traumatic events, and veteran associated pain issues. If you have had abuse or periods of significant stress in your life, your pain issues may be more complicated. I authored A Consumer Guide for Recovery from Car Accidents which discusses many aspects of injury recovery as all as specific detail about PTSD, traumatic brain injury, and protective involuntary muscle spasm. The link is: http://mindbodyphysicaltherapy.com/car-accident/ I can't answer questions regarding pain medications, or some specifics related to surgical interventions.

Experience

I have over 30 years experience as a Physical Therapy clinician. I taught swimming in Michigan and skiing in Aspen. I have experience in analyzing movement patterns and muscle control. I treat all areas of pain in the body including headaches, neck pain, back pain, shoulder injuries, plantar fasciitis, nerve compression, and knee pain. I have had personal experience with chronic pain, RSD, car accident injuries, PTSD, and traumatic brain injury (TBI). Muscle spasm and pain is a common component of injury and response to traumatic stress. Posture patterns and habits of how your body is often used can also contribute to pain. Restoration of movement and the senses that enable you to feel it are key. Rachel developed and implemented a stress reduction program for inmates within the Boulder County jail's drug and alcohol recovery program in 2005-2006 based on trauma healing principles from Dr. Peter Levine.

Education/Credentials
Rachel holds a BS in PT from the University of Colorado Health Sciences Center. She has over 30 years experience as a clinician. She has over 1500 hours of post graduate continuing education in many Manual Therapy and Exercise approaches. She completed her training in Somatic Experiencing under Dr. Peter Levine in 2000. This 3 year program trains therapists in treating traumatic stress conditions. Rachel has developed a body of work integrating her training and unique insights into complex pain issues. She is the developer and instructor for Sensory-Motor Manual Therapy, which is a State approved 2 day work shop for Massage Therapists through the Boulder College of Massage Therapy.

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