Barral Institute Case Studies

VM/NM - Mid-back & Neck Pain Barbara LeVan, P.T.

Patient Age / Gender

Kate D., age 16. Last date of treatment 12-15-08

Patient Symptoms

Self referred for mid-back and neck pain, headaches of gradual onset 2-3 weeks following MVA Sept 08 when she lost control of her car as she was driving around a corner and ran her right front bumper into a ditch flipping the car onto its side. Functional restrictions: must change postions frequently due to pain. C-T junction pain radiates to shoulders bilaterally. Unable to run for exercise as done usually. PMHx: orthodonics age 13-15, Concussion age 14 with loss of consciousness for less than 1 min., closed head injury at age 2 when hit in forehead by swing.

Evaluation / Treatment

Significant postural asymetry in shoulder heights (R lower by 1"), head slightly SB to R. Left shoulder positioned forward, marked Forward head posture. Trunk AROM: Normal and painfree in flexion and Right Rotation, restricted in extension to 1/2 normal ROM in Thoracic spine and she deviates to left. Sidebending normal to Left, 75% to right with increase pain lower parathoracic area. Left Rot is 2/3 normal with c/o Left SI pain. Neck AROM: normal and painfree in extension, flexion 75% normal and rotation R 65, Left 50' with c/o midline C-T junction pain. Left SB 30', R SB 40' with c/o mid c-spine pain. Strength - Normal throughout U.E.s without pain. Joint mobility: restricted right SB at C6/7 - T2/3, restricted R 1st rib depression, restricted A/A rotation to right 45', Left 55' Palpation: Dural restrictions right lower C spine, significant cranio-fascial restrictions on Left affecting sphenobasilar junction. Cranial restrictions in coronal suture, post falx cerebri, osseous restriction left post parietal area. General List: left post cranium. 3 visits including Initial evaluation 12-1-08 Treatment consisted of cranial techniques to address intracranial pressure, craniofascial sutural membrane restrictions, osseous restrictions L post parietal,sutural release Left temporal/parietal, Right tentorium, spinal dura manipulaton, Visceral fascial release of VSON, Pharyngeal basilar fascia, Right pleural dome.


Gain in left SB to 40' and Rotation right 70', Left Rotation 70' without pain. No headaches, no midback or C-T junction pain and able to return to running. Discontinued all meds after first visit.

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