Salter-Harris Fracture of the Proximal Humerus in an Adolescent Gymnast.

A 13-year-old male gymnast presented via direct access to physical therapy with a chief complaint of insidious-onset right anterolateral shoulder pain that occurred only when performing on the rings and high bar. Following physical examination, the patient was advised to avoid any gymnastic activities that might cause pain while completing stretching and neuromuscular training over the following 2 weeks. Due to continued symptoms, the patient was then referred to an orthopaedist.

How should we teach lumbar manipulation? A consensus study.

Background: Spinal manipulation is an effective intervention for low back pain, yet there is little consistency in how this skill is taught.

Objectives: The purpose of this study was to identify what educators and clinicians believe are important characteristics of the patient and operator position prior to side-lying lumbar manipulation and the patient position and operator motion during the manipulative thrust.

Design: A multi-disciplinary correspondence-based Delphi method.