5 ST & MFR Lecture Flashcards by Austin Collison

Soft Tissue Techniques directly applied where?

Soft tissue preparation facilitates what?

Applied to muscular and fascial structures of body

Facilitates improvement of articular motion

How well did you know this?

Not at all

Perfectly

What is soft tissue?

What is included?

Living tissues of the body other than bone

Fascia, Muscles, Organs, Nerves, Vasculature, Lymphatic

How well did you know this?

Not at all

Perfectly

Fascia

What is it?

Composed of?

Function?

What is it not?

Complete system with blood supply, fluid drainage, & innervations (largest organ system in body)

Composed of irregularly arranged fibrous elements of varying density

Involved in tissue protection and healing of surrounding systems

It is not Tendons, Ligaments, Aponeuroses

How well did you know this?

Not at all

Perfectly

Fascia is Omnipresent

There is a myofascialarthroidal continuity throughout the body

How well did you know this?

Not at all

Perfectly

Describe continuity of Fascia

Perimysium (Fascia) –> Peritendium –> Periosteum

How well did you know this?

Not at all

Perfectly

Pannicular Fascia

Outermost layer derived from Somatic mesenchyme and surrounds entire body with exception of orifices

Outer layer is adipose & Inner layer is membranous and adherent to outer portion

How well did you know this?

Not at all

Perfectly

Axial & Appendicular Fascia

Internal to Pannicular layer; fused to Panniculus and surrounds all muscles, periosteum of bone, and peritendon of tendons

How well did you know this?

Not at all

Perfectly

Meningeal Fascia

Surrounds nervous system including the Dura

How well did you know this?

Not at all

Perfectly

Visceral Fascia

Surrounds body cavities (pleural, pericardial, & peritoneum)

How well did you know this?

Not at all

Perfectly

Fascia is Omnipotent

Contractile components

Healing components

Provides for mobility and stability of MSK system

Myofibroblasts

Macrophages, Mast Cells

How well did you know this?

Not at all

Perfectly

Fascia is Omniscient

20% of cutaneous mechanoreceptors supplying skin have receptive fields in subcutaneous tissue (loose fascia)

75% of stretch receptor free endings for muscles and proprioception in fascia

How well did you know this?

Not at all

Perfectly

Viscoelastic Material

Any material that deforms according to rate of loading and deformity

How well did you know this?

Not at all

Perfectly

Stress-Strain Relationship

Stress is force that attempts to deform CT structure

Strain is percentage of deformation of CT

How well did you know this?

Not at all

Perfectly

Hysteresis

Difference between loading and unloading characteristics represents energy that is lost in CT system; energy loss is Hysteresis

How well did you know this?

Not at all

Perfectly

Creep

CT under sustained, constant load (below failure threshold), will elongate (deform) in response to load

How well did you know this?

Not at all

Perfectly

Ease

Direction in which CT may be moved most easily during deformational stretching

Palpated as sense of tissue “looseness”, or laxity/greater degree of mobility

Bind

Palpable restriction of CT mobility

Hooke’s Law

Strain (deformation) placed on an elastic body is in proportion to the stress (force) placed upon it

Wolff’s Law

Bone will develop according to stresses placed upon it

Sherrington’s Law

When muscle receives nerve impulse to contract, its antagonists, receive, simultaneously, an impulse to relax

Common Compensatory Patterns

Uncommon Compensatory Patterns

Uncompensated Pattern

80% of Healthy People (L/R/L/R)

20% of Healthy People (R/L/R/R)

Usually symptomatic and a trauma usually involved

Transition Zones of Spine

OA, C1, C2

C7, T1

T12, L1

L5, Sacrum

Transverse Restrictors

Tentorium Cerebelli

Thoracic Inlet

Thoracolumbar Diaphragm

Pelvic Diaphragm

Soft Tissue (ST) Technique

System of Dx and Tx directed toward tissues other than skeletal or arthrodial elements

Tx Goals for TTA

Stretch and increase elasticity of myofascial structures to return symmetry Improve local tissue nutrition, oxygenation, and removal of metabolic wastes to normalize tissue texture

Tx Goals of Asymmetry of Myofascia

Restore symmetry Normalize tone

Tx Goal for Restriction of Motion

Set fascia free to normalize ROM

Tx Goal for Tenderness

Normalize neurologic activity Improve abnormal somato-somatic & somato-visceral reflexes

ST Indications

**Diagnostically**: identify restricted motion, sensitivity, TTA **Feedback** about tissue response to OMT Improve local & systemic **immune response** Provide general state of **relaxation** **Enhance circulation** to local myofascial structures Provide general state of **tonic stimulation**

ST Relative Contraindications

Severe Osteoporosis Acute injuries

ST Absolute Contraindications

Fracture/Dislocation Neurologic entrapment syndromes Serious vascular compromise Local malignancy Local infection Bleeding disorders

Stretch (Parallel Traction) Knead (Perpendicular Traction) Inhibition

Increase distance between origin and insertion (parallel with muscle fibers) Repetitive pushing of tissue perpendicular to muscle fibers Push and hold perpendicular to fibers at musculotendinous part of hypertonic muscle

MFR INR

System of diagnosis and Tx which engages continual palpatory feedback to achieve release of myofascial tissues Tx system in which combined procedures are designed to stretch and reflexively release patterned ST and joint related restrictions

What are REMs (Release Enhancing Maneuvers)

Breath holding Prone/Supine simulated swimming & pendulul arm swing R/L cervical traction Isometric limb and neck movements against table Patient evoked movement from cranial nerves

Indications for MFR

SD When HVLA or MET contraindicated When counterstrain may be difficult secondary to patient's inability to relax

**Contraindications of MFR** Absolute Relative

* Lack of consent or Absence of SD * Infection of ST or Bone * Fx, Avulsion, or Dislocation * Metastatic disease * ST injuries: Thermal, Hematoma, Open wounds * Post Op Patients with wound dehiscience * Rheumatologic condition involving instability of CS * DVT or Anticoagulation therapy

**Activating Forces** Inherent Forces Respiratory Cooperation Patient Cooperation

Using body's PRM (primary respiratory mechanism) Refers to physician directed, patient performed, inhalation/exhalation/holding breath to assist with manipulative intervention Patient asked to move in specific directions to aid in mobilizing specific areas of restriction

**MFR Treatment Endpoint** 3-D release often palpated as:

Warmth, Softening, Increased ROM