5. BLT FPR ST Flashcards
engage the restrictive barrier directly
direct techniques
positioning away from the restrictive barrier to perform tx
indirect treatment
founder of this indirect technique: cranial tehcnique (BMT)
Dr. William Sutherland, DO
founder of this indirect technique: dynamic neutral point of joint motion
Dr. Harold Hoover, DO
founder of this indirect technique: first used the term “BLT”
Dr. Anne Wales, DO
founder of this indirect technique: strain-counterstrain
Dr. Lawrence H. Jones, DO (1955)
founder(s) of this indirect technique: facilitate positional release
Dr. Stanley Schiowitz, DO & Dr. Eileen DiGiovanna, DO (1977)
Are (1) Still’s, (2) BLT, and (3) FPR indirect or direct?
- combinaton
- indirect
- indirect
place patient in indirect position
utilize activating force
hold until “air hunger”
BLT: balanced ligamentous tension
3 principles of BLT
- disengangement of the dysfunctional area
- exaggeration of dysfunctional pattern
- balanced tension of the ligaments
What is the activating force of BLT?
inherent respiration (respiratory assist) & holding until air hunger
[breathing/respiratory phase associated w/ greatest ease]
flattens the spine in the anterior-posterior direction
inhalation
increases AP spinal curves
exhalation
indications of BLT
- ligamentous articular strain
- lymphatic congestion or local edema
contraindications of BLT
- fx, dislocation, instability
- open wounds
- soft tissue/bony infxn
- abscess
- DVT
- malignancy
What is the goal of BLT?
balance the articular surfaces’ directions of physiologic motion common to that articulation
Which tenet of osteopathy is emphasized with BLT?
2nd tenet
flatten or neutralize the curve
add compression (<1 lb)
indirect positioning
hold 3-5 seconds and return to neutral
FPR: facilitated positional release
What is the mechanism of FPR?
interaction b/w 1-alpha-afferent and gamma-efferent activity
intrafusal fibers allowed to return to normal length (1 alpha-afferent signals decrease)
muscles achieve normal length and tone
Name secondary effects of FPR.
improved lymphatic drianage
venous drainage
improved fluid dynamics
indications of FPR
- muscle hypertonciity
- all SD
- time crunch
contraindications of FPR
- unstable fx
- manifestation of neurologic symptoms
- life-threatening symptoms
- wounds <6 weeks
- joint instability
move to position of ease (indirect position)
apply force vector (localizing force <5 lb)
apply articulatory movement (move through RB & maintain force)
release force vector (AB is attained)
return to neutral
Still’s technique
Who coined the name “Still’s Technique”?
Dr. Richard von Buskirk, DO, PhD (2000)
