Treatment 11 — Global Review of Key Concepts

Session Goal: Reinforce foundational education, consolidate patient understanding, and prepare for transition to independent self-management.

1. Review the Anatomy & Pain Science Foundation

   • Sub-acute LBP (1–3 months) involves lingering inflammation + muscle guarding + altered neuromuscular control.

   • Many structures contribute to pain: discs, facet joints, paraspinals, hip muscles, fascia.

   • Pain ≠ damage — nervous system sensitivity plays a key role.

   • Education reduces fear and increases confidence in movement.

     • Suggested Therapist Script

       “Your back is healing — movement and understanding help your nervous system calm down.”
       

2. Review Posture & Body Mechanics

   • Posture = alignment; body mechanics = how you move.

   • Neutral spine + hip hinge protect lumbar spine during lift/carry tasks.

   • Small corrections during daily tasks reduce cumulative strain.

   • Military environments add load, heat, fatigue → correction more important.

     • Suggested Therapist Script
       “Posture isn’t rigid — it’s adaptable. Awareness prevents unnecessary stress.”
       

3. Review Self-Massage & Breathing Techniques

   • Self-massage reduces muscle tension between sessions and enhances blood flow.

   • Breathing activates (parasympathetic) nervous system → reduces pain, stress, and guarding.
     

     Techniques

     • Tennis ball / foam roller

     • Diaphragmatic breathing

     • 4-7-8 breathing

     • PMR (Progressive Muscle Relaxation)
       

     • Suggested Therapist Script
       “These tools extend your gains between treatments and support better sleep and recovery.”
       

4. Review Hydration as a Recovery Tool

   • Massage increases circulation → hydration clears metabolites and reduces soreness.

   • Discs are water-dependent — hydration improves cushioning and mobility.

   • Heat, gear, sweat, field exposure raise dehydration risk.

   • Daily hydration + electrolytes in hot environments support performance and pain reduction.

     • Suggested Therapist Script
       “If your tissues are hydrated, they function better — recovery depends on it.”
       

5. Patient Homework / Reinforcement

   • Reflect on which strategies have made the biggest difference.

   • Continue applying learned techniques daily.