Hands to the occupational therapists and feet to the podiatrists.

How many patients have you referred out because of that belief?
I guess one of the reasons is that as physiotherapist students, we're always taught to look at the joints which are more 'important'/ commonly suffering from dysfunctions. Ironically, its common to see dysfunctions in the smallest joints and somehow, the contents gets more and more dry as it goes more distal in the peripherals. So it ends up as hands to the occupational therapists and feet to the podiatrists as they're experts in those fields.
Not to say that its wrong to refer patients out but never underestimate what we can do as physiotherapists.
I mean, how much difference can there be between PTs, OTs and Podiatrists?
Shouldn't we as physiotherapists be well versed in the biomechanics of all joints and the anatomy of the human body?
Surely the podiatrist have more knowledge in terms of feet pathology, prescribing orthotics, etc.
But end of the day, principles remain the same regardless of body parts.
Muscles, tendons, ligaments, nerves and blood vessels all work more or less the same way throughout our body. As long as we take the time to appreciate the biomechanics and anatomy of the hands and the feet, even PTs can provide rehabilitation for patients with hands/feet dysfunction.
Well, the human body is indeed a complicated structure to comprehend and different people might have their own interest in a particular part of the body.
But at the end of the day, I believe that all of us are all genuine to our patients and we should be able to answer the question that lies after we see the patient - "Have we done all we can for them?"
Well, there's always more knowledge to be attained and more secrets of the human body to be uncovered.
Kudos to all healthcare professionals and may your passion in your career remain burning as strong as it will be till the end of time.

Cervical + Clavicle Pain from increased CervicoPleural Ligament tension and poor breathing mechanics

Subjective

Mr S, 23 years old, Male, L hand dominant

Pa - deep ache over lateral neck, onsets once it reaches afternoon and pain lingers till sleep time

Pb - discomfort over lateral supraclavicular space upon shoulder elevation & protraction

MOI - nil trauma, insidious onset 3 months ago, neck pain initially on both sides, L more than R but subsequently shifted to R side only. Significant history to be noted is that patient changed his mattress around the same time, unable to determine if it was before or after onset. Prefers to sleep side lying.

Patient also reported sometimes shoulders felt like they were gonna drop off and post exercise DOMS of upper trapezius persists longer than usual ever since as well as increased sensation over R thumb and index finger occasionally.

Objective findings:
Observation - typical swayed back posture, well developed abdominals
Palpation:

• Upper Trapezius L more tone than R
• R Subclavius & Diaphargm tender on palpation
• 1st Rib depressed on R
• R CervicoPleural Ligament tight

ROM - Extension/Right Rotation/Right Lateral flexion near full, limited by pain at end range, Lower Cx and Upper Tx reduced ROM, improved with postural correction.

PAIVM - C5-T2 hypomobile (C7-T2 hypomobile++), R worse than L
SCJ - reduced depression(clavicle head didn't go down) on R with shoulder protraction, symptoms improved with manual AP glide.
No biomechanical issues with scapula elevation, no change of symptoms with AP and inferior glide during scapula elevation
ACJ - slight hypomobile on the R, no reproduction of symptoms
ScapuloThoracic Joint - no hypomobility and symptoms in all directions

Breathing - reduced upper ribs mobility
Ribs accessory:
Sternocostal Joint - 1 & 2 hypomobile
Costotransverse Joint- 1 & 2 hypomobile

Muscle Length Test
Upper Trapezius NAD
Scalenes - R worse than L, especially posterior scalenes

Treatment
MET to facilitate SCJ AP glide
//Pb ->0/10 on shoulder protraction, Pb still persist on scapula elevation
R CervicoPleural Ligament release
//Pb ->0/10 on scapula elevation
R C7/T1 manipulation
//Pa decreased and onset in extreme end range, Range increased
T1/T2 mobilisation in manip position + MWM with R Cx quadrant
//Pa -> 0/10, range increased.
Linea Albea release
//R diaphragm reduced pain on palpation.