11/01/2023
30 min manual therapy session for my client Ang distilled down to 5 minutes. Also shown are some isometrics of the shoulder and the neck.
We do a lot of manual therapy interventions for Ang for the simple reason that he feels each one has a cumulative effect on his health and helps him to perform better in the gym. One reason I can do this for Ang is because my fees are a flat rate, so getting “more” doesn’t put Ang at a financial disadvantage and because he enjoys all the bells and whistles and we have the time, why not do what he feels helps him?
Not shown here during this encounter is the brief (15 min) coaching interaction Ang and I had trying to narrow down the cause of his neck exacerbation. We narrowed it down to a few things. First is his very frequent implementation of face pulls with high intensity. Through trial and error of taking out and supplementing certain movements, we figured out that chest supported and seated variations of back movements such as t-bar rows and reverse flys don’t exacerbate his neck pain, but face pulls do even when modifying form, frequency, tempo, load and intensity. The movement also wasn’t very important to Ang so finding a variation to stimulate hypertrophy much the same way didn’t cause him any grief and we can arguably more easily load the chest supported/seated movements anyways.
Ang also has Achilles tendinopathy which he was given a HEP for. We don’t need to overload Ang with rehab, he works out 6 times a week. This is the perfect example of a patient who simply needs some reassurance, some temporary pain interruption and some exercise selection guidance so he can stay out of debilitating pain and keep himself healthy