BLT, Stills FPR OMT Flashcards
_____ Techniques method of action engage the restrictive barrier directly.
Direct
Direct techniques (6)
MFR
INR
ST
MET
HVLA
Visceral
Comination techniques (direct and indirect)
MFR
Stills
Indirect techniques
- MFR
- INR
- BLT/LAS
- FPR
BLT definition
Load tissue of the affected ligaments in a position so where tension is equal in all planes, so the bodies inherent forces can fix the SD
BLT is described as a _____ _________ tx method
indirect passive
BLT says that since it is the ________ that are involved in maintaining a lesion, it is they, not muscles that are the main agency for reduction… point of balanced tension
ligaments
BLT indications (2)
SDs that involve
1. ligamentous articular strains
2. Lymphatic congestion/ edema
BLT relative contraindications
- fxs
- open wounds
- soft tissue or bony infections
- absesses
- DVT
- anticoagulation, disseminated or focal neoplasm
- post-op on site of tx
- aortic aneurisms
What does BLT/LAS say about direct techniques
if you articulate back and away from the lesion, it can strain the ligaments that are normal.
If force is used, you can seperate fibers from the ligaments and bony attachments
BLT says that the type of motion that occurs at any given articulation is determined by what?
- shape of joint surfaces
- position of ligaments
- forces of muscle on that joint
BLT says that the differences between ligaments and muscles
L do not stretch and contract like muscles do.
thus, tension in Ligaments has little varioation
BLT says that tension t/o the ligament of any joint is _____.
When moving, as you move your joint, the relationship between the ligament changes, but total tension in the ligamentous articular mechanism _________
BALANCED.
DOES NOT.
what biochemical changes occur before immobilization ,according to BLT
Fibrofatty infiltrates were found in capsular folds.
The longer the joint was immobilized, the more infiltration. Ground substance lost water and glycoaminoglycans.
Maintaing the interfiber distance for smooth movement requires collagen fiber lubrication. Whe not, microadhesions are form and collegen is deposited in a bad manner.
• Immobilization for >12 weeks resulted in an ___________
overall loss of collagen since rate of degradiation > rate of synthesis
Physiologic Changes Secondary to Immobilization, occording to BLT
moving an immobilized joint requires 10x more force. afteer several attempts, it is reduced to 3x more. OVertime, joint will regain normal mobility.
steps in BLT
in BLT, you dx a joint SD in all planes of motion
- Shift neutral (indirect positioning)- you want to move the distal structure of an extremity (superior segment) over the inferior segment to acheive BLT in all planes
- Activating force: breathing pahse assx with greatest east
- Reevaulate
Object of BLT is to do what?
Balance the articular surface or tissue in the directions of physiologic motion common to articulation.
Doc doesnt CAUSE the change, but helps the body help itself.
How much pressure should be put into BLT?
Not alot; you should not go to elastic limit and the doc should not make it so uncomfortable that the patient guards
Central principle of BLT
Make something you palpate hard–> soft.
When flow comes through dysfunctional area, your tx is complete.
FRP Def
Tx body with neutral positioning, activating force (torsion, compression or distraction) and put in position of ease
made by Stanley schiowitze
FPR is primary described as a _________ treatment method
indirect passive
w/ shifted neutral
adcantages of FPR
easy, effective, time effcient
patient satisfaction d/t immediate relied
thorough
FPR indications
myosfasial or articular SD
FPR absoluate contraindications
- Unstable fx
- Neurological sx
- Life- threatining symptomatology
FPR Relative Contraindications
- tx not tolerated
- osteoporosis/cancer
- moderate to severe joint instability
- spinal stenosis/nerve root impingment
FPR Proposed Mechanism
Gamma motor neurons cause somatic dysfunction/tension by stimulating muscle spindles.
Puting the muscles in neutral will inverse spindle output, reducing afferent excitatory input and resetting tension and hypertonisity and unloading the joint,
FPR steps
Diagnose SD in every plane
- setup by monitoring and put in neutral sagittal plane position (mechanically unloading)
- Add activating force: compression, torsion, distraction
- Indirect position, 3 plane positioning (neutral) and hold for 3-5 seconds
- return and reevaulate
Stills technique def
combined techique that uses both indirect and direct tx: first put in indirect position, add axial force (compression, traction, torsion) to carry through RB
-p
Still
Start at ________ then move to ___
shifted neutral–> anatomical barrier
same advantages as FPR
Still indications
- Any SD
- Efficacy is limited ONLY BY docs knowledge of anaomty
- safe 4 all agez
Still contraindications
dont use across wounds or fx < 6 weeks old
Why does Still technique go from indirect–> direct?
Still thinks that all dislocations should be loosened from other tissue–> bring back to original place
Steps in Still
- Indirect positioning (ease)
- Add localizing force (5 lbs of compression or traction)
- Move through barrier while maintaing cmopression (u may hear a click)
- go to final tx position at the anatomic barrier
- return to neutral
- Reassess
