52: Manual Medical Approach to the Lower Extremity - Klock Flashcards
principles of osteopathic medicine
- The human being is a dynamic unit of function.
- The body possesses self-regulatory mechanisms that are self-healing in nature.
- Structure and function are interrelated at all levels.**
- – [Normal body structure promotes normal body function/Improving the functionality of the body will promote good health/Truing up the frame of the body will allow it to function more efficiently] - Rational treatment is based on these principles.
what does “truing up” the frame of the body do?
- Promotes normal arterial circulation.
- Promotes normal venous and lymphatic return.
- Improves the health of the tissues.
- Decreases the wear-and-tear on the joints from normal use.
- Decreases the wear-and-tear on the joints from extraordinary use.
define somatic dysfunction
- impaired or altered function of related components of the somatic system or body framework
key indicators that somatic dysfunction is present ***
TART
tenderness
asymmetry of motion and position
restriction of motion
texture changes of the tissues
We describe/document SD by position and motion characteristics
The position of a body part as determined by …
– palpation (described in relation to other body structures or landmarks).
– The directions into which the body part moves freely.
acute v. chronic SD
Acute: Redness, Swelling, Tenderness, Pain
Chronic: Tenderness, Itching, Ropiness, Paresthesias (altered sensation)
Both: tissue contraction/increased tension
what is a restrictive barrier? how do you identify it?
- Asymmetry of joint motion caused by restrictive barriers indicates a problem exists.
- Often times it is somatic dysfunction.
- These barriers are often caused by muscular strains.
- Strained muscles are often tighter than normal and restrict joint motion.
jones tender point
- The injury is often due to over-stretching resulting in a strain.
- A strained muscle will typically have a tender point in a specific location along its’ length
the limit of passive motion =
the limit of active motion =
anatomic barrier
physiologic barrier
elastic barrier = The range between the physiologic and anatomic barrier in which passive ligamentous stretching occurs
the hallmark of SD
restrictive barrier
- Functional limit within the anatomic range of motion that abnormally diminishes the normal physiologic range of motion.
if the following m are tight .., psoas hamstrings popliteus gastrocnemius soleus
Reduced hip extension Reduced knee extension Reduced knee extension Reduced ankle dorsiflexion Reduced ankle dorsiflexion
what do you do for muscle strain?
- Can’t be made normal by just stretching.
- To establish a lasting lengthening of strained muscles:
- —Resolve the strain.
- —Allow the muscle to reach a normal length by normal use.
- —Stretch the muscle
what is OMM?
- The intent is to restore symmetry of position and motion, to improve body function and restore health.
- OMM is to be integrated into management of the whole patient
describe indirect OMM
The body part is moved away from the restrictive motion barrier.
It is placed in a position where tissue tension is decreased and equal in one or all planes and directions.
The physician holds and directs the body part until a tissue release is noted
describe counterstrain
- Dysfunction is considered to be a continuing, inappropriate strain reflex.
- The reflex is inhibited by putting slack in the area of strain in the muscle:
- – Find a tender point in the strained muscle.
- – Position the muscle so that the tenderness is 75-100 % relieved.
- – Hold the position for 90 seconds.
- The circuit is broken and the strain is “erased.”
