MMT Insiders Q&A March 2022

In this 58 min video, I answer the following questions from MMT Insiders
  • I had a patient that came in with an obvious lateral right shift (my first ever) stating she felt some left hamstring tightness while at the gym and tried to stretch it out. She didn't think anything of it but started noticing a few days later that she was shifted. She states she has scoliosis. Her pain is 4/10 in her back and left leg pain is 2/10. I did shift correction which was very painful taking her into overcorrection and backed off half way and back into overcorrect. Is this right? Did this about 8x of 2 bouts and not a huge change in her shift or lumbar extension as she still deviated right. I didn't know what else to do so I went to road kill on elbows and it hurt so I abandoned that. Then finished out with side glides against the wall and had her do 10 per hour. Can you share how you might treat this patient and did I jump around too much using different interventions? It has been awhile since I took part A. How many manual shifts corrections should I be doing per session and when should I add shift correction with combined extension. Is this still 10 per hour as a recovery plan?
  • I know we have talked a lot about leg length differences on this thread recently. I have been doing a lot of side glides in standing with patients who have a positive supine to long sit test. Since this changes so rapidly almost every time, is this lumbar or SI joint related or a mixture of both? Muscular? What is the most likely cause of these leg length differences? Is it related to asymmetrical differences such as the liver being on one side (PRI type mindset), or is it more of a matter of leaning towards one side while standing/crossing legs? How do you explain this to patients?
  • Do you still use the capnotrainer?
    • When do you incorporate breathing into your treatments?
  • I’d like to ask if you can clarify to us your clinical reasoning after discussions with patient (some key points that you follow). For example in sitting sx are worse=unloading is worse or standing is worse this mean issue loading?, after 4 hours of sleep pain is wakes me up etc.
    • I find sometime difficult to make clinical decisions based on patients information about pain and mechanical implication.
Here are resources on techniques I've talked about in the above Q&A