The Ottawa Ankle Rules | Ankle Fracture Clinical Prediction Rule


In this video, I’m going to demonstrate the Ottawa ankle rules to rule out fractures of the ankle and mid foot in an acute situation. Hi, and welcome back to Physiotutors de Ottawa ankle Rules have been developed in order to reduce the needs of radiographs after an acute Trauma. review by Buckman et Al. from the Year 2003 Rated the sensitivity between 96.4 to 99.6 percent and the specificity at 26.3 to 47.9 percent. So if the Ottawa Ankle rules are negative, chances of a fracture are low. Now let’s imagine the following situation You are a physiotherapist at a sporting event and you see an athlete Getting injured at the ankle. you can use the following sequence to rule out an ankle fracture. first palpate for tenderness on the posterior edge of the Lateral and Medial Malleolus start distally and move six centimeters upwards. Then palpate for pain or tenderness over the navicular bone and fifth metatarsal. For the last criterion ask the patient’s to walk four consecutive steps It doesn’t matter how the patient is walking, he might as well be limping. now if one out of three items is positive There’s a 25 to 50 percent chance that there is a fracture, the patient should then get x-Rays done. But if all three items are negative there is close to a 100 percent chance of no fracture at all. All right That’s the end of the video if you like you can check out the Ottawa knee rules or the anterior drawer test of the ankle on the left. Don’t forget to like and subscribe. This is us on social media or on our website This was Andreas from Physiotutors. I’ll see you next time. Bye

Upper Trapezius Release – Trigger Point Release Neck Pain Relief


Your Upper Trapezius Muscle works to shrug
your shoulder and can cause neck pain due to having Trigger Points, more commonly referred
to as knots. To find these areas, feel around your Upper
Trapezius muscle until you feel a tender spot. Press down on this spot and tilt your head
to the opposite side. You progress this release further by rotating
your head up and down. Perform this technique until relief is felt. This is an incorrect way to perform this and
can lead to more pain! The same technique can be performed by your
healthcare provider. Once they locate the spot they will passively
move your head into position. It’s important to perform until relief is
felt. So we can continue to make these free educational
videos, please subscribe to our channel.

The Syndesmosis Squeeze Test | Syndesmosis Injury

The Syndesmosis Squeeze Test | Syndesmosis Injury


In this video I will show you how to conduct the Syndesmosis Squeeze Test in order to determine a Syndesmosis spring the Syndesmosis is the interosseous membrane that connects the tibia with the fibula and It can get injured with Inversion Trauma or extra rotational dorsiflexion trauma The estimated incidence is 1% of all ankle sprains according to the KNGF ankle sprain guideline according to an RCT done by De César et al. (2011) the squeeze test has a sensitivity of 30% and a specificity of 94% in the diagnosis of syndesmosis ruptures To perform the tests of your patient in supine lying position and squeeze the proximal fibula and tibia together Then apply the same compression at more distal places down to the Malleolus according to Nussbaum et al. (2001) the length of tenderness above the lateral malleolus Indicate severity so the more proximal pain is felt the more severe the injury Pain during these compressions may indicate Syndesmosis rupture, given that a fracture Confusion or compartment syndrome have been ruled out before Alright guys this was our video on the Syndesmosis Squeeze Test Make sure to also watch our video on the Anterior Drawer Test for injuries of the anterior TFL or watch our video on the External Rotation Stress Test which is another test for Syndesmosis injuries As always I hope this video is helpful to you if it was don’t forget to give it a like check us out on Facebook, Instagram Or on Physiotutors.com. This was Kai for Physiotutors. I’ll see you next time. Bye

5 Pressure Points for Pain Relief – Ask Doctor Jo


oh hey everybody it’s Doctor Jo and Princess
Remy, and today I’m going to show you five pressure point relief spots. so
let’s get started. so pressure points don’t always work for everybody, but it’s a really good easy thing to try
and it does work sometimes. if you’ve got some stress, a lot of times these help
with headaches, so depending on if you’re stressed, if you’re anxious, or maybe
you’ve got some headaches, or just new kind of stress in your neck here, these are
really good to try cuz again, they’re quick, they’re easy. it might not work for
you, but I think it’s worth trying. a couple of them have really worked for me.
so each hold do you want to hold it for about five to ten seconds. and with
pressure points you want to put a good amount of pressure in there. sometimes
with some acupressure points and stuff you’re just placing your hand on this,
but this is actually a pressure point where you want to put some pressure on
there. so the first one is over your clavicle area. so you can either do this
on the clavicle bones, some people like that pressure point, or slightly below it.
I like to do it slightly below it because I feel like pressure points do
well on muscle areas, and so you’ve got a little bit of your muscles right down
below that clavicle right there or that collarbone. so you can try it on the bone,
but I like it better just underneath because there’s just a little kind of
groove that you can fit your fingers there. and so I’m pushing into that area.
I’m putting some pressure where it’s slightly uncomfortable. it’s not painful,
but I can definitely feel the pressure point there. so really again just pushing
five to ten seconds, maybe if you’re in a clinic having a therapist do it for you
they might do it a little bit longer, but just starting off you probably just want
to do that five to ten seconds. you can do it a couple times. you can switch and
then do it on the other side. so again there’s my clavicle or my collarbone
kind of in the middle of it this it sits here kind of coming in the middle that
little groove and just putting that pressure in through there. if you happen
to feel some numbness or tingling in your hands, if it’s strong you might just
be pushing on some nerves through there, so you might want to slightly adjust
because you don’t want to irritate the nerves. you really want this to be in the
muscle kind of area and again that five to ten
seconds. so the next one I’ve used this several times for headaches. so not
migraines, but just maybe like a tension headache or sometimes a dehydration
headache. you want to come down to where your thumb and your pointer finger meet
kind of in this little meaty area in between there’s a muscle here a big
thick muscle called your thenar muscle, and you’re kind of pushing in there and
in here. so you can see on each side almost like I’m pinching that area but
don’t just get the skin, if you come low you’re just gonna get the skin you want
to feel some muscle that you’re pushing on in there, and I can kind of feel it
tingle into my fingers. Not tingling like nerve pain, but where I’m hitting like a
pressure point and that’s what you want to feel. and so again I’m pushing pretty
hard for that five to ten seconds. and I’m going to show you when I let it up
you can kind of see where my fingernail mark is right there. so you know that I’m
pushing pretty hard and again you can do both sides. you can do it a couple times
like if you want to do two or three on each side,
but I’d maybe alternate back and forth. and again you can see that I’m pushing
pretty hard. you can see where it gets a little bit lighter right there because
I’m pushing into that area and then releasing it. so again, a lot of times
even though I’m pushing here, if you have a headache those pressure points kind of
work out throughout your body, so it can help a referred area kind of thing. you
can also do a little pressure point it’s called kind of your tendon triangle,
a little bit higher up at your thumb joint up top here. and for some people if
you can get it right, there’s a tendon coming here and a tendon coming here and
sometimes there’s a nice little groove or a pocket almost where those wrist
bones are. so you can use your thumb in between there or your finger, I kind of
like to use my thumb because I get a little bit more here, but again I’m
pushing right into that triangle around those tendons. so not necessarily on the
tendons, but in between in that pocket and again five to ten seconds holding it
switching sides getting that five to ten second hold and really just kind of
getting that pressure in there and getting everything to relax. and a lot of
times that’s just helps relieve that anxiety helps relieve your,
if you’re kind of stressed out because it almost kind of resets those muscles,
resets the whole meridian in your body. so then the next ones are for your
temple. so again this is another good one if maybe you have some tension headache,
or maybe at that dehydration headache you feel in the front. tension headaches
in the back or on the side, so just kind of finding your temples. you can do both
of these at the same time or if you just want to do one at a time you can, but
again with this one I like to use my fingers instead of pushing it with my
thumb’s just cuz it’s up on my temple area sometimes this is a little more
tender. but again I’m putting some pressure on there so I can feel that I’m
pushing. I’m not just placing my fingers there, I’m really kind of pushing in for
that five to ten seconds and really getting that push really getting that
feel, and you can do that a couple times if you want to. and then the last one is
another big one where you hold a lot of stress. you hold a lot of anxiety.
especially if you have a desk job, you work on the computer a lot, if you’re
typing. back here is your levator scapulae muscle, and this is the one that
brings our scapula or shoulder blades up. and if you come down to where that
muscle attaches to that shoulder blade or that scapula, a lot of times you can
feel a knot. you can feel that pressure point and so sometimes this one again if
you’re doing it to yourself, it’s a little easier using your fingers but
maybe if somebody else is willing to do it for you, sometimes using the thumb or
even using the tool so you don’t have to wear out your fingers. but I’m almost
just grabbing with my finger kind of going like this, you can see .and a lot of
times if you are stressed out or you’ve got a lot of you know tension in there,
you’re gonna find it pretty easy. you’re gonna oh that’s the spot and then just
push inwards with those fingers. so again maybe that five to ten seconds. if a
therapist was doing it for you, when I’m working on patient, I usually hold it for
about sixty to ninety seconds. so I’m holding it a lot longer to try and get
those muscles to release, but sometimes it’s a little harder to do on your own
and again if you’re doing this for the first time, you might not want to go
quite that long because you’re going to be sore afterwards. a lot of times when
you’re getting those pressure points or those trigger points in there, after you push on it it gets really sore. but then the next
day it actually feels better because it almost reset everything. oh oh yes.
so there’s your five stress relief pressure points. if you’d like to help
support my channel, make sure and click on the link up there, and don’t forget to
subscribe, where Remy? down there. and remember be safe, have fun, and I hope you feel better soon.

Hip Pain Relief – Ask Doctor Jo

Hip Pain Relief – Ask Doctor Jo


Hey everybody it’s Doctor Jo, and today
I’m going to show you a seated piriformis stretch. so let’s get started. each stretch is going to be 30 seconds,
and we’re gonna do three on each side. before we get started, if you haven’t
subscribed already, make sure you click on the link over there. so I’ve got a
timer set up 30 seconds, and then there’s gonna be a 10-second break in between
them. so that’s just to kind of help the muscles reset and then switch over to
the other side cuz I like to alternate back and forth. so I’m gonna go ahead and get started, and I’ll talk you through it as we go. so here we go. so with the
seated piriformis stretch, bring your foot up and just cross it over almost
into a figure four position. that’s what we call the stretch a figure four, and
then keep your back straight and just lean forward at your hips. and so you
should feel the stretch right in that booty area underneath the leg that
you’re crossing over. now don’t curl your back because if I come over like this,
I’m getting less of a stretch than if I keep my back straight. so make sure you
keep that back straight and lean forward. so take a little break. sometimes you
might feel some tingling going down the leg, but that might just be that nerve
getting pressed a little bit. so crossing over to the other side, keeping that back
straight, and just leaning forward. so a lot of times if you have some sciatica
issues, that sciatic nerve runs underneath that piriformis muscles, so if
you’re sitting for long periods at your desk at work or if you’re doing a
Netflix marathon or something like that, you might get what we call monkey butt,
or that nerve pain going down your leg, so these are some great stretches to
do if you’re sitting for a long period and maybe your legs start falling asleep
a little bit. I think we’ve all had it happen to us once or twice, and so this
is a really good way just to stretch out that muscle and get it going.
so crossing over again, going back to the other side keep that back nice and
straight, and lean forward. so the stretches that I’m doing here is also a
part of an office stretching series that I have. so there’s a whole bunch of
different stretches, I kind of go from head to toe, so make sure you watch all
the way to the end so you can check out that
link there that I have. so again feel it kind of in that booty area hopefully
each time feels a little bit better. you can lean a little bit further and get
that stretch even more, then come on back up. shake it out a little bit, and then
get ready to go back to the other side. so again that piriformis muscle can
sometimes cause a lot of problems, so going back into that stretch. people who
have that sciatic pain sometimes it can be coming from your back, but sometimes it really is that nerve just getting pinched at that piriformis being too
tight, so this is one that you should do if you don’t do any other stretches, if
you’re sitting for long periods, this is a great one to do and it’s pretty easy
because you can do this and still work if you want to. you don’t even have to
take a break. so I know sometimes it’s hard to take that break, but this is one
that you don’t even have to stop doing your work. you can really continue to do
whatever you’re doing while you’re at your desk, so that’s why I really like it.
it’s easy to do, and if you say you don’t have time for it, you don’t actually have
to take the time for it. you can keep on working. so leaning forward again
and then just leaning in. some people ask about the foot. should I flex it, should I
relax it, it doesn’t really matter. I personally like you to be completely
relaxed. some people might feel more of a stretch if they flex that foot, but when
I’m stretching I want my whole body to be relaxed. that’s how you’re gonna get a
really good stretch. so I like it to be just relaxed and if you want more, just
lean in a little bit more. so stretches should never hurt, they shouldn’t be pain,
it should be that good kind of hurt. hurt so kind of hurt. so good kind of feeling.
so if you’re leaning in, and you’re just really really hurting, you’re having lots
of tingling and numbness going down your leg, try not pushing so hard. try maybe
reset yourself, but if you keep getting a lot of hurt the whole time,
then hold off on that stretch and you should probably get a check with the
doctor or your physical therapist and see if there’s something going on
because the stretching should always just feel really really good. and it does.
it feels like a very good stretch. so that’s it 30 seconds 3 on each side.
if you would like to check out that office series which has a whole bunch of
different exercises, it’s great. doesn’t necessarily have to be for the office, it
can be for anything, check out that link up there. and if you’d like to support my
channel click on the link to find out how up here. and don’t forget to
subscribe by clicking down here. and remember be safe (keep that booty happy),
have fun, and I hope you feel better soon.

NEXUS Criteria | Cervical Spine Fractures

NEXUS Criteria | Cervical Spine Fractures


in this video I’m going to present the Nexus criteria used in the assessment of the cervical spine to rule out possible fractures I’d welcome back to physio tutors in another video we discussed the Canadian C’s by rule used to rule out fractures of a cervical spine that would demand radiographic imagery the Nexus criteria are another tool for the same purpose of reducing the need for radiographs at the blunt trauma to the head in a review by Nicoletta doll from 2012 the reported sensitivity ranges from 83 to 100% and specificity from 2 to 46% if any of the following Nexus criteria are present imaging is recommended first there are focal neurologic deficits such as paralysis paresthesia speech or vision impairments and hearing problems secondly we have midline spinal tenderness sir–the is an altered level of consciousness the fourth criteria is whether the patient is intoxicated or not and the fifth is a distracting injury which doesn’t allow cervical spine active range of motion assessment an easy mnemonic to remember the rule is NSA ID okay this was our video on the Nexus criteria be sure to watch the video on the Canadian c-spine rule on the left and subscribe to our channel check out the link in the video description if you want to support us anyway you can for example by using our amazon bookmark to shop online follow us on various social media for daily updates this was on graceful physio tutors I’ll see you next time bye

Wrist Pain Relief – Ask Doctor Jo


Hey everybody it’s Doctor Jo, and today
I’m going to show you some stretches for your wrist flexors and extensors. so
let’s get started. before we start, if you haven’t
subscribed already, make sure and click on the button over there. so for the
wrist flexors and extensors, we’re gonna do two stretches each way for 30 seconds. so we’ll go up and then down and then up and down again. so I’ve got a timer set,
so it’s going to be 30 seconds and then we’re gonna do a little ten-second break
in between. so let’s go ahead and get started with the stretches for the wrist
flexors and extensors. so you’re gonna put your hands out in front of you, and
we’ll start with the stretching the wrist extensors first. so just going
downwards, so with this if you just hold it this way, you get a lot of stretch. if
this is too much stretch, put your fingers out and it’s just a little bit
less of a stretch. if you want even more of a stretch you can push in on your
hand and curl it in, and that will give you even more of a stretch. so after that,
little 10-second break. these are great if you’re working at a desk especially
on a computer for long periods. if you’re doing a lot of stuff with your hands,
these are really great to do. so now we’re going into the wrist flexors. so
this time is kind of opposite, if you have your fists in a fist, it’s not quite
as much of a stretch, but if you open up your hands you get even more of a
stretch and you feel it under there, so again if you want more stretch than that
you can just do a little pull, gentle pull, on each side, or you can put your
hand up on a wall. so any kind of work with your hands a lot these muscles get
really tired, so it’s great for these if you’re an artist or a guitar player that
works really well as well. and if you want a little bit more, you can stretch
three on each side, but this is just to kind of give you an idea. so again
curling down with your fingers to get a lot of stretch, opening them up if you
just want a little bit of a stretch and if you want a little bit of overpressure
you can push it into a wall or you can just kind of alternate
back and forth giving a little pressure with your other hand that way. but again
this is probably enough if they’re sore and tired. getting that good stretch in
there and then take a little break. sometimes you want to shake them out a
little bit because it feels like a big stretch in there, and then we’re gonna do
one more going upwards. so hands out, up almost into a stop sign position. so
getting that nice stretch and so when you’re up stretching out the wrist
flexors underneath and then when you’re down you’re stretching those wrist
extensors up on top. so stop sign getting that nice stretch in there. remember if
you don’t want quite as much, make a fist then more then over pressure. so there
you have it. those were your stretches for your wrist flexors and extensors.
this is actually a part of an office series where I give you a bunch of
different stretches from head to toe, and if you’re sitting in an office or even
if you’re working at home or doing something where you’re sitting for a
long period, these are easy stretches. you don’t need
equipment to do it so if you want to see some more, make sure and click up here,
and if you’d like to help support my channel find out how by clicking up here,
and don’t forget to subscribe by clicking down here. remember be safe
(loosen them up), have fun, and I hope you feel better soon.

Tinel’s Sign (Ankle)⎟Peripheral Nerve Injury


This is going to be a video on the Tinel’s or Percussion Sign at the ankle for peripheral nerve injury Hi and welcome back to Physiotutors, Schwieterman et al. include the Tinel Sign in their systematic review from the year 2013. The authors report a sensitivity of 58% but they could not provide any specificity percentage. The Tinel Sign can be elicited in two places around the ankle. First, there’s the anterior tibial branch of the deep peroneal nerve which you would assess by tapping anterior to the medial malleolus. Secondly, you may be able to elicit the Tinel Sign for the posterior tibial nerve by tapping behind the medial malleolus. In both cases tingling and paresthesia felt distally is a positive sign. alright guys, This was the Tinel Sign at the ankle joint. I hope you enjoyed this video. Subscribe to our channel if you haven’t yet, leave a comment down below, if you have further questions and you can check out two other special tests right here. This was Andreas for Physiotutors. I’ll see you next time. Bye!

10 Best Lower Back Stretches for Low Back Pain Relief – Ask Doctor Jo

10 Best Lower Back Stretches for Low Back Pain Relief – Ask Doctor Jo


oh hey everybody it’s Doctor Jo and Remy,
and today I’m gonna show you the top ten low back stretches. so let’s get started. A lot of you asked me how many should I do. generally with stretches you want to hold them for 30 seconds and do three on each side.
number one, pelvic tilt. so you might hear me say pelvic tilt for a lot of
different things, but it really is a great stretch. this one is really going
to loosen up those back muscles and it’s one of my favorites to do. for a supine
pelvic tilt, lie down on the ground with your legs propped up, feet flat on the
ground. and imagine that you’re trying to squish your hand if it was underneath
you. so push down rotate the hips and come back up. number two, the cat dog stretch. again
with the cat and the dog, my favorite because it’s animals it’s really really
great stretch for your low back. you can feel it stretching forwards and
backwards with those two motions and it really loosens up that low back. for the
cat dog stretch, get on all fours. you’re gonna arch your back like a cat and tuck
your chin in and then drop your back down and pick your head up. number three, trunk rotation in supine
or lying on your back. so this one’s really good just to start getting some
rotational movements and your back and your back is supported on the floor so
it’s a nice stretch. for a trunk rotation stretch, bend both knees up and keep your feet flat on the ground. then just rotate your knees to one side trying to keep
the upper part of your body flat and hold that stretch. number four, trunk rotation with a leg
crossover. if just the regular rotation isn’t quite enough stretch for you, if
you bring your leg up and over it’s going to give you an even bigger stretch
and sometimes you’ll feel a little pop in your low back because it’s
readjusting your spine. for a lower back stretch lying down, place one leg
straight out and pull the other one up to about a 90 degree angle and then pull
it across your body. number five, hamstring stretch with a
strap. using a strap or a rope or a dog leash to stretch out your hamstrings is
a great way to get that stretch and just keep those muscles nice and relaxed. for
hamstring stretch in supine with a strap, you can use a belt or a dog leash. take
the belt and put it at the ball of your foot, straighten out your leg as much as
you can. you want that knee to be straight, so if it bends then bring it
back down a little bit. pull your toes towards you and bring it up till you
feel a stretch and hold it. number six, hip flexor stretch off of a
bed. this is a great way to stretch out your hip flexors. if you have knee
problems and you can’t do it really well in a lunge stretch, if you just take your
leg and drop it off the edge of the bed, without falling off, it really stretches
out those hip flexor muscles. for hip flexor stretch off the bed, lie down on
your back on a bed and get close to the edge, but try not to fall off the bed.
bring one leg down off the edge, letting it hang, lie back a little bit and then bring the other knee up towards your chest and
hold that stretch. number seven, a prone press up. so if
you’re on your stomach and you’re pressing up, you get a nice stretch in
your low back in and your abdominals. this is sometimes contraindicated for
certain back conditions, so make sure this is something this is general pain
or maybe a disc issue, and if you’re not quite sure what it is, you might want to
hold off on this one. for a prone press up, lie on your stomach and then put your
hands flat on the ground, and press your upper body up. try and keep your hips
down. so you’re not coming up with the hips, but the hips are down and you’re bending just at your back and then hold it. number eight, a knee a chest stretch. it
does a great job of stretching out that low back, but make sure if you have some
knee problems, don’t put too much pressure on your knees when you’re
stretching. for a single knee to chest, bend both knees up. then take your
hands and grab underneath your thigh and pull towards your chest holding that
stretch. number nine, double knee to chest stretch. so after you do just the single knee, if you bring them both up together, it’s a
really good overall stretch on your low back as well as your upper back too. for a
double knee to chest stretch, prop both knees up. then grab underneath both thighs and pull your knees towards your chest
holding that stretch. number ten, a prayer stretch or Child’s
Pose whichever one you want to call it. this is just a great whole body stretch.
you can get your arms, you can get your upper back, your lower back, your hips, and your knees, so it’s a good one to finish with. for the prayer stretch, start off
sitting on your feet and then you’re going to push your arms straight out in
front of you on the ground, holding the stretch. so there you have it, those were your top
ten low back stretches. if you’d like to help support my channel, make sure and
click on the link up there, and don’t forget to subscribe by clicking down
there. and remember, be safe, yeah have fun, and I hope you feel better soon.