Well having not had good results with S-CS it's kind of fallen off my radar of late, but this was flagged up during my CCA feed back as one of my Tutors was Jo Holmden the S-CS lecturer.
She commented that she hadn't seen much S-CS from me and was curious as to why. I explained that the real reason was because I've be concentrating on techniques that I would likely use in a CCA and that S-CS wasn't one of them as I would really struggle to justify the physiology as to how the technique works. She appeared to understand my point of view, however suggested strongly that I made the most of the tutors whilst I still had them at my disposal.
One morning whilst in clinic a gentleman presented with pain and muscle hypertonicity around his first rib among other things. Having previously had a diving accident and an X-ray showing spondyloarthoris and spondylosis it was agreed that HVT to allow the first rib to rise in inspiration more smoothly wouldn't be the most appropriate technique .... what was I to do?? Well the answer was to see Miss Holmden and ask her to demonstrate S-CS for the first rib. Miss Holmden was more than pleased to show me the technique.
After the obligatory 90 secs the pressure was released from the tender point and the patient was unwound from his position of ease and then pressure was reapplied in order for the patient to report how tender it was now, the answer was "it wasn't tender at all". Still dubious that the disappearance wasn't due to the application and reapplication of some inhibitory pressure I was keen to objectively reassess the inspiration of his first ribs, to my delight they were moving bilaterally.
I was looking forward to this gentleman returning next week to see if this movement had been maintained. Next week soon came around and I was pleased to find that the ROM had been maintained and that the patient reported a 80% improvement in his symptoms.
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