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Clinical presentation and manual therapy for lower quadrant musculoskeletal conditions

journal contribution
posted on 14.11.2013, 00:00 by Carol A. Courtney, Jeffrey D. Clark, Alison M. Duncombe, Michael A. O’Hearn
Chronic lower quadrant injuries constitute a significant percentage of the musculoskeletal cases seen by clinicians. While impairments may vary, pain is often the factor that compels the patient to seek medical attention. Traumatic injury from sport is one cause of progressive chronic joint pain, particularly in the lower quarter. Recent studies have demonstrated the presence of peripheral and central sensitization mechanisms in different lower quadrant pain syndromes, such as lumbar spine related leg pain, osteoarthritis of the knee, and following acute injuries such as lateral ankle sprain and anterior cruciate ligament rupture. Proper management of lower quarter conditions should include assessment of balance and gait as increasing pain and chronicity may lead to altered gait patterns and falls. In addition, quantitative sensory testing may provide insight into pain mechanisms which affect management and prognosis of musculoskeletal conditions. Studies have demonstrated analgesic effects and modulation of spinal excitability with use of manual therapy techniques, with clinical outcomes of improved gait and functional ability. This paper will discuss the evidence which supports the use of manual therapy for lower quarter musculoskeletal dysfunction.


Publisher Statement

This is a copy of an article published in the Journal of Manual and Manipulative Therapy © 2013 Maney Publishing. The final publication is available at http://maneypublishing.com/index.php/journals/jmt/


Courtney CA, Clark JD, Duncombe AM, O'Hearn MA. Clinical presentation and manual therapy for lower quadrant musculoskeletal conditions. The Journal of manual & manipulative therapy. Nov 2011;19(4):212-222. doi: 10.1179/106698111x13129729552029


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