E4: HVLA Flashcards
What is another name for HVLA?
Mobilization with impulse
How fast is the impulse in HVLA?
0.04 to 0.06 seconds
High velocity makes the technique ______; low amplitude makes the technique ______.
Efficient; safe
What are the absolute contraindications for HVLA?
There are none
When is HVLA contraindicated?
If the risk of harming the patient exceeds the potential benefit.
For what type of somatic dysfunction is HVLA most effective?
Articular dysfunctions
What is thin layer adherence?
A process where two congruent surfaces are “glued” together by a typically lubricating substance when said substance is spread thinly enough
What is the most likely articular popping theory?
Breaking of joint seal or thin layer adherence
What can excessively frequent articular mobilization lead to?
Hypermobility and ligamentous / capsular hypertrophy.
This is much more common in women than men.
What is the most effective way to mobilize a small joint?
A combination of gapping force and gliding force
What are the relative contraindications for HVLA?
Same as for soft tissue
What are contraindications dependent upon?
Physician skill and experience
T/F: Pain is an indication for HVLA.
False. Pain is not an indication for any technique.
When is HVLA indicated?
Somatic dysfunction with articular restriction
What can cause articular restriction?
Acute trauma Sustained muscle hypertonicity Repetitive microtrauma Fascial/ligamentous contracture Poor postural alignment
What is an example of congruent joints?
Spinal facet joints
What is an example of non-congruent joints?
Femoral condyles on tibial plateau
In a normal joint, the surfaces become _____ slipperier than ice on ice.
10x
Where does the synovial fluid go in an acute condition?
It is squeezed out into the joint capsule with subsequent capsular distention and pain
Where does the synovial fluid go in a chronic condition?
It is absorbed into the surface of the cartilage and joint capsule, then removed from the surrounding tissues via the lymphatics.
What is an articular clunk?
Similar to a loud thud.
Present normally from SI joint, hip joint.
May emanate from any osteoarthritic joint.
What is an articular pop?
“Popping” noise expressed as a single modal curve on a sound frequency scale.
Usually occurs with small, spinal joints.
What is an articular crack?
A “breaking” noise. Bimodal or multimodal peak on sound scale.
Occurs with tearing adhesions. Sounds similar to ripping velcro.
Where does crepitus usually occur?
When the wrist is placed in lateral extension.
Crackling sound akin to rubbing hair between one’s fingers.
What is a ligamentous or tendinous strum?
A sound that results from a tense ligament or fascial structure rolling over a bone or other solid prominence.
Snapping ankle, snapping psoas tendon
Torn adhesion sound usually occurs with what condition?
Frozen shoulder. Sounds like Velcro.
What is the refractory period for spinal articulations?
One to several hours
