Auxiliary Exam Questions

Which of the following is a relative contraindication for using a foam roller?

Tenderness from recent bruising
• Rationale: Foam rolling over areas with recent bruising can worsen the injury and
increase pain. It's best to avoid direct pressure on bruised areas until they have had time
to heal

What is a relative contraindication for passive stretching?

Post-surgical joint with limited mobility
• Rationale: Passive stretching may be too aggressive on a joint that has recently
undergone surgery. Controlled, gentle movements are preferred during early recovery
stages.

In which situation is active stretching relatively contraindicated?

Acute muscle tear with significant pain
• Rationale: Active stretching could further damage an acutely torn muscle. Gentle
stretching may be considered only after initial healing

Which of the following scenarios represents a relative contraindication for using a massage
stick?

Varicose veins in the lower leg
• Rationale: Using a massage stick over varicose veins may aggravate the condition and
cause discomfort or damage to the veins

When might trigger point release therapy be relatively contraindicated?

Active trigger points in a muscle with a recent injury
• Rationale: Trigger point release on recently injured muscles could worsen the injury. It's
safer to allow partial healing before applying direct pressure

Which condition would be considered a relative contraindication for myofascial release?

Edema from a recent soft tissue injury
• Rationale: Applying pressure in myofascial release can increase swelling and worsen
edema. This technique should be used cautiously in such case

What is a relative contraindication for using functional release techniques on a patient?

Acute tendonitis with significant inflammation
• Rationale: Functional release techniques may further irritate inflamed tissues. It is best
used after the acute inflammatory phase has subsided

Which of the following is a relative contraindication for using Post-Isometric Relaxation (PIR)
technique?

Muscle tightness after a recent muscle strain
• Rationale: Using PIR on a recently strained muscle may exacerbate the injury if the
tissue is not fully healed. PIR can still be used but with caution and modified intensity.

The patient stands with hips pushed forward relative to the
line of gravity, resulting in an extended lumbar spine but with a slight posterior pelvic tilt. The
thoracic spine shows mild kyphosis, and the head is positioned forward. The patient complains
of occasional hip and lower back tightness.

Sway back posture

Flat back posture

The patient displays a posterior pelvic tilt with a flattened
lumbar spine, reduced thoracic kyphosis, and a forward head posture. The patient describes
occasional discomfort in the upper back and neck region.

The patient has a lateral shift of the torso to the right, with an
elevated right shoulder and a slight curvature of the spine visible from a posterior view. The
pelvis is tilted with a higher right iliac crest. The patient complains of mid-back discomfort,
particularly after standing for long periods.

Scoliosis

The patient exhibits a forward head posture with rounded
shoulders, protracted scapulae, and an increased thoracic kyphosis. The pelvis is neutral, and
there is no significant lumbar curve deviation. The patient reports neck stiffness and occasional
headaches.

Upper Cross Syndrome

The patient presents with an anterior pelvic tilt, increased
lumbar lordosis and the shoulders are slightly retracted. The patient reports occasional low
back pain, especially after prolonged sitting.

Lower Cross Syndrome

Explain a relative contraindication when using myofascial release on a patient presenting with Osteoporosis

Pressure should be gentle and controlled,
focusing on soft tissue areas while avoiding
bony prominences and fragile regions.
Continuous patient feedback should guide
the treatment to ensure comfort and safety

Explain a relative contraindication when using MET on a acute muscle strain

MET can be used cautiously with gentle
contractions, avoiding excessive force and/
or overstretching the muscle. The
technique should only be applied when the
acute phase of the injury has passed, and
healing is underway

What is a relative adaption to treatment for Varicose Veins

Myofascial release may be used
whilst avoiding any direct pressure
on or near the varicose veins to
prevent potential irritation or clot Formation

What is a relative adaption to treatment for Osteoperosis

Soft tissue work may be applied but
with gentle techniques. Pressure
should be reduced to avoid the risk
of bone fracture and
communication with the patient
should be clear to gauge the
pressure applied.

The right side scalenes
are notably tight. please present a myofascial intervention

Functional release for tight right
scalenes: laterally flex the neck
to the right tight side and apply
firm, precise pressure to the
target muscle while guiding the
patient through lateral neck flexion to the left. Move the
"lock" along the length of the
muscle/s and repeat up to 2-3
times.

The patient presents
with forward head
posture. Please provide a progression and regression

Progression:
Increasing isometric
hold time for deep
neck flexor
endurance exercise
or increasing
resistance band tension for Finnish
chin tuck exercise.
An increase in
stretching time (10 -
30 sec.) to a point of
mild discomfort. An
increase in stretching
rounds (sets)
between 2-4.
Regression:
Decreasing the
isometric hold time
for deep neck flexor
endurance exercise
or decreasing
resistance band
tension for Finnish
chin tuck exercise. A
decrease in
stretching time (10 -
30 sec.) to ease
discomfort. A
decrease in
stretching rounds
(sets) between 2-4.

Patient presents with forward head posture please provide sets/reps and duration

Sets or duration:
Exercises: 1-2 sets.
Stretches: 10-30
seconds for 2 - 4
rounds (sets)
Reps:
Progression:
Increasing isometric
hold time for deep
neck flexor
endurance exercise
or increasing
resistance band
Exercises: 5 - 20 reps
with a 10-second
hold.

Patient presents with forward head posture functional rehabilitation

Deep neck flexor
endurance exercise,
Finnish neck strength
exercise (with band
and chin tuck) or
upper trapezius
release.

Muscle tension is
observed in the right
upper trapezius. Please give a progression and regression

Progression:
Adding a band to the
low row, 4-point/
kneeling "W", "T" , "I"
or "Y" exercise. An
increase in stretching
time (10 - 30 sec.) to
a point of mild
discomfort. An
increase in stretching
rounds (sets)
between 2-4.
Regression:
Brugger/4-point hold
with reduced
isometric hold time,
low row without
band, "W", "T" , Y" or
"I" without a band in
the prone position. A
decrease in
stretching time (10 -
30 sec.) to a point of
mild discomfort. A
decrease in
stretching rounds
(sets) between 2-4.

Muscle tension is
observed in the right
upper trapezius provide sets/ rep durations

Sets or duration:
Exercises: 1-2 sets.
Stretches: 10-30
seconds for 2 - 4
rounds (sets).
Reps:
Exercises: 5 - 20
reps.

Muscle tension is
observed in the right
upper trapezius Please perform a functional rehabilitation

Brugger's relief
exercise/ technique,
4-point postural
correction exercise,
banded low row, 4-
point kneeling "W",
"T" , "I" or "Y" exercise
(unilateral); or a
stretch that targets
the right upper
trapezius.