Manual Therapy Techniques to Resolve Headaches

On November 30th, 2016, posted in: General, Manual Therapy by 0 Comment

There are a variety of different types of headaches, and every one of them can be incredibly debilitating. Luckily, many types respond very well to hands-on manual therapy techniques.

We make a ton of training videos for our staff as well as other PTs around the world. Occasionally we post them on our blog so those out there suffering needlessly can get an idea of our approach to hands-on physical therapy, and see how we help others to get back to living the active lifestyle they want and deserve.

Below is one such video showing an example of treatment techniques for certain types of headaches.

If you are dealing with headaches and would like to know if we can help, call us at (512) 693-8849.

If it’s after hours and you’d like to schedule a phone call with one of our doctors of physical therapy, Click Here.

Or you’d rather not speak on the phone, you can click here to send us an email.

Video Transcription (please excuse grammatical errors and the conversational nature of the transcription):

“When a patient has a headache when they come in to the clinic, there are two different potential variations you can apply of the Mulligan Techniques. One is called the “Headache SNAGS” and the other one “Reverse Headache SNAGS”.

The first thing you need to do is come in with your pinky finger and find C2 and you place it gently right on the back side of the spinous process of C2. Then, you come in with the lateral border of the thenar eminence and you’re giving it a straight PA glide.

It’s very gentle when cupping her head with barely any movement. What you’re doing is to see if it resolves her headache at all. You hold it for at least 10 seconds before you decide if it’s making a change in the headache.

If you need to, you give it a little bit of left or right rotational pull or push to see if it that does something better. If it does not help the headache, you just hold it until the headache is gone. If it doesn’t after 10 seconds or so, maybe you should try to couple some variations of right or left pressure to see if any of those work.

You tilt the person a little bit more forward with your pinky finger right at the occiput and with a lumbrical grip, you try to get around to the lateral T-processes/transprocess of the d2. You grip the backside of the neck primarily trying to hold C2 and now the PA is through the occiput.

You tilt the person just a little bit forward because they say it’s important not to have them move into extension and you can do this in a very gentle a very small amount of movement. So you just hold the C2, PA on the occiput not letting her go into extension at the sub-occipital joints, and then again asking “Is this helping the headache at all?” If so, great; and you’re just going to hold it till it gets as good as it can be. Sometimes this will totally abolish a headache.

So that is something you can try when a patient has a current headache in the clinic:, a SNAG and reverse SNAG.


What to do About Your Back Pain – Part 3

On November 10th, 2016, posted in: General by 0 Comment

In the Part 2 of this series, we discussed how between 60-70% of people will have an episode of low back pain in their life. [1] The real problem becomes what do you do about it. Do you take it easy for a few days and hope it gets better? This is strategy that works for some people. But what do you do if isn’t better in a week.

Back pain that isn’t improving within a week of the original injury needs to be looked at by a professional. The reality is though if you go to your doctor they will likely hand you pain meds or muscle relaxers. And while those can be a good option at times we have an epidemic of pain medication abuse in this country [2].

If you are lucky your doctor will give you prescription for physical therapy. But what if he/she owns the physical therapy clinic that is next door? How do you know you will get the best care possible? Early intervention with physical therapy leads to better outcomes. And the sooner you get better the sooner you can get back to living your life.

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What to do About Your Back Pain – Part 2

On November 10th, 2016, posted in: General by 0 Comment

In Part one of this series, we talked about how back pain is the most common reason people visit their doctor. This time, I’d like to start by asking you a question:

Have you ever worked in the yard or picked up something the wrong way, and before you know you are on the ground writhing in pain? I know I have. And studies show that most people will have an episode of significant back pain at some point in their life. [1]

I can recall one very distinct story when my back went out. I was 24 years old helping my brother move to Dallas and unfortunately he was moving to the 3rd story of an apartment. We had driven several hours to get there and arrived late in the evening.

Everything was going well until I moved this one small lamp. As I set it down I had this very distinct feeling that I was about to be in a lot of pain,and sure enough I was right. This was pain like I had not experienced before. I was incapacitated.

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What to do About Your Back Pain – Part 1

On November 10th, 2016, posted in: General by 0 Comment

Low back pain is the third most common reason why people visit their doctor! [1] Think about that. The number one reason people visit their doctor is for cold and flu symptoms.

Back pain is an epidemic in this country and is THE LEADING CAUSE of activity limitation and work absence throughout much of the world. [2]

You have all heard the stories about someone lifting too heavy of a weight or working in the yard and someone’s back going out. That experience can be very painful and debilitating. You find yourself in bed with a heating pad unable to move. You call in sick the next day hope that it will go away soon.

The reality is that most of us will have a low back episode at one point in our lives. [2] And if you are lucky enough it will go away quickly. If you aren’t lucky, it will become more of an issue. The great thing about low back pain (if there is such a thing) is that if you treat if quickly it typically gets better much faster.

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Difference Between “Physical Therapy” and “Physiotherapy”

On November 3rd, 2016, posted in: General, Manual Therapy by 0 Comment

Many people ask me what is the difference between “Physical Therapy” and “Physiotherapy.” In my opinion, nothing … I use the terms synonymously.

Some people however, claim that Physiotherapy indicates more of a hands-on manual therapy approach to rehabilitation, while Physical Therapy indicates a more exercise-based approach to rehabilitation.

This probably stems from the fact that outside of the United States, at least until the last 5 or so years, treatment of musculoskeletal conditions by physiotherapists was much more hands-on manual-therapy-based than in the United States.

Manual therapy training and its popularity has exploded in the United States lately and many more of our therapists are becoming certified and highly advanced in manual therapies. Since the term “physiotherapy” is used outside of the United States and “physical therapy” is used inside of the United States, some think there is an actual difference in what is provided when either of these terms is used.

The next thing I’m often asked is:

‘‘Why did you choose the name ‘Carter Physiotherapy’ for your practice rather than ‘Carter Physical Therapy’?”

The answer to that question is two-fold:

  1. Carter Physical Therapy was a name already taken by a PT practice in California.
  2. I have Australian citizenship and therefore, do feel somewhat of a tie to the term ‘physiotherapy’ as well.

So whether, a practice in the United States uses the term physical therapy or physiotherapy, they basically mean the same thing in my opinion.

The important thing for consumers to seek out has nothing to do with the term used for the clinic, but rather the training and treatment approach of the practice itself. I’m a huge proponent of making sure that wherever you decide to get treatment, that treatment involves hands-on manual therapy techniques along with the rehabilitation exercises common to most physical therapy clinics in the United States.

In most cases, you will get much more complete and much faster results by employing hands-on treatment along with exercises versus doing exercises and stretches alone.

For more information on our treatment philosophies and methods, click here.



Part 3 – Why do I keep getting injured when I run?

On July 8th, 2016, posted in: General by 0 Comment

In part 2 of this article series we discussed the ways the foot can have a big impact on all the joints above and cause various forms of running injuries.

In part 3 below, we will discuss the critical role of the hips and pelvis, and their importance to running without pain and injury.

The hip, or coxofemoral joint, is a classic ball-and-socket joint that attaches to your pelvis. It is inherently a very stable joint due to the depth that it possesses, but hip muscle weakness is incredibly common problem among runners.

One of the distinct signs we look for as bio-mechanical experts is a hip drop or, “Trendelenburg sign,” during stance phase (when the foot is on the ground).

What that means is that when you are on one leg while running we are looking if that opposite hip drops (see image below). If it drops significantly compared to the other side we know that hip weakness is present. Hip weakness can be attributed to back, hip, knee, and foot pain. That’s how important it is!

Running injury in Austin Texas

So how can you tell if you have this type of hip weakness and what can you do about it?

See the Video below to find out if you’re at risk for injury due to hip weakness, and learn 3 quick exercises you can do fix the problem.

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Part 2 – Why Do I Keep Getting the Same Injuries When I Run?

On July 8th, 2016, posted in: Ankle, Running by 0 Comment

In the last blog post we discussed how your knee is usually not to blame when it hurts during runs. And we specifically addressed how often overpronation issues can really impact the knee.

There is an old saying that is ‘as the foot goes so does the knee.’ This is very true. 

Pronation is not inherently a bad thing. In fact we need to pronate through our feet. It is how we properly transfer forces through our body.

Pronation is the foot movement in which  your foot rolls in causing your arch is getting to get lower. But when we overpronate we put our other joints as risk for injury … including our feet.

[RELATED REPORT] The Top 10 Causes of Running Injuries and How You Can Recover Faster if You’re Injured

But how do you know if you pronate too much? Do you know if your shoes are enough to provide the support you need? 

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Part 1- Why do I keep getting the same injuries when I run?

On July 8th, 2016, posted in: Ankle, Hip, Injury Prevention, Running by 0 Comment

Are you frustrated with constantly dealing with same running injuries over and over again? Are you tired of thinking you have recovered only to have the same injury come back several months later? Read on to find out why you are dealing with repetitive injuries.

A wise man once said “running reveals weakness and if you run enough, injury is not too far away.” When you run, you experience 2-3 times the force of your own body-weight! .. with every step! Over the course of a run you experience an extreme amount of force through your joints which can lead to injury.

What if you could get to the underlying cause of your injuries that keep plaguing you and keep you from doing what you love? What if you knew exactly what to do to prepare for your upcoming 5K,10K, or even half marathon?

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What are the most common issues in your patients with back pain?

During a presentation for a group of personal trainers, I discussed the most common back pain issues I treat in my clinic.

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Weight Bearing Hip Rotation with Theraband

During a presentation for a group of personal trainers, I taught them how to use a Theraband to perform weight bearing hip rotation.

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