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UM - Soft Tissue Techniques > Exam 2 - Sports massage, tapotement, triggerpoint release, and PNF > Flashcards

Exam 2 - Sports massage, tapotement, triggerpoint release, and PNF Flashcards

1
Q

What is a trigger point

A

A hyperirritable point w/taught band of skeletal muscle or associated fascia that is painful on compression and evokes a characteristic referred pain pattern

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2
Q

What are the 3 criteria for identification of a trigger point

A
  • Hyperirritable point/spot
  • palpable taught band w/subject recognition of pain
  • Referred pain/numbness on compression
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3
Q

What is an active trigger point

A

There is pain at rest and symptoms increase w/palpation

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4
Q

What is a latent trigger point

A

No pain at rest (clinically silent) and pain and referred symptoms occur w/palpation

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5
Q

What is a satellite trigger point

A

It is a secondary trigger point that develops in the same mm or a nearby mm as the primary active trigger point

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6
Q

List some causes of trigger points

A
  • MM ischemia and hypoxia resulting from mm overuse
  • MM spindle dysfunction due to underlying neural hypersensitivity
  • Emotional stress, visceral disease, arthritic joints
  • Ischemia and hypoxia !
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7
Q

What is a trigger point release

A

Release of primary trigger point that not only eliminates that trigger point, but also eliminates the secondary and satellite ones

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8
Q

List the trigger point release techniques

A
  • Ischemic compression
  • Ischemic Compression w/elongation
  • Strain-counterstrain
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9
Q

Steps of Ischemic Compression (IC)

A
  1. Find trigger point
  2. Maintain pressure until pain/discomfort decreased by 50 %
  3. Increase pressure again and holdup to 90 seconds
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10
Q

Steps of Ischemic Compression w/elongation

A

1) Find the trigger point
2. Maintain pressure until pain/discomfort decreased by 50 %
3) Keep same Pressure & passively elongate the mm slowly until pain increases
4) Wait until the pain/discomfort is decreased by 50%

  • Repeat this process until there is no more change in pain level or no more change in length
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11
Q

Steps of Strain-Counterstain

A

1) Find the trigger point
2) Passively position the body part/mm into a position of ease or comfort while monitoring the trigger point (SHORTEN IN 3 PLANES)
3) Maintain the shortened position for 90-120 seconds
4) During the time, reduce P but keep finger in the same spot
5) slowly return pt to original position and reassess

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12
Q

What are the expected responses of TPR

A

Good pain during, less tenderness after, and improvements in perceived stiffness afterwards

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13
Q

What are the Dos and Don’ts of trigger points

A

Do:

  • Know TP vs something else
  • Know when to back off/give up

Don’t

  • get too caught up at the expense of other impairments
  • flare a pt up
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14
Q

What is dry needling

A

A monofilament needle ussed to penetrate the skin subcutaneous tissue, and mm w/intent to mechanically disrupt tissue w/o use of medication

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15
Q

What does dry needling lead to

A
  • reduced local and central sensitization to pain

- Increased pain pressure threshold, ROM, and reduced pain and mm tone

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16
Q

T or F: MPTA has lots of data on dry needling

A

FALSE - they have none

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17
Q

What is the intention of a deep friction massage?

A
  • mobilize scar tissue
  • normalize alignment of collagen
  • produce acute inflammation in the presence of chronic inflammation
  • facilitate healing
  • stimulate the mechanoreceptors to modulate pain
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18
Q

What is deep friction massage (GOAL)

A

To stimulate optimal fibroblast proliferation and recruitment of inflammatory cells as well as to allow response, recommended on alt. days

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19
Q

What are contraindications to deep friction massage?

A
  • open wounds
  • infection
  • cancer
  • edema
  • arterial or venous pathology
  • acute injury
  • areas of hyperesthesia
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20
Q

What are the 2 types of deep friction massage?

A

Transverse - short deep strokes perpendicular across the fibers of the target tissue

Circular friction - deep circular movements performed on the same spot, gradually getting deeper into the tissue

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21
Q

What is the frequency and duration for deep friction massage

A

2-10 minutes, 2-3 x a week

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22
Q

Protocol for transverse friction massage

A

Apply @ right angle to long axis of the fibers w/structures placed on full stretch

Delivered via index finger reinforced by middle finger

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23
Q

Protocol for circular Frictions

A

Tips of index, middle & ring finger to form tripod, w/pressure applied obliquely into the tissues before beginning the movement and then very small circles
P released gradually and fingers lifted and moved to an adjacent area

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24
Q

Where is circular friction massage commonly performed

A

Along the paraspinal mm or areas around bony landmarks and joints

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25
What is tapotement
Percussive manipulations consisting of various parts of the hand striking the tissues at a fairly rapid rate
26
List the types of tapotement
Clapping/cupping Beating Hacking Pounding
27
What are the primary effects of tapotement
- Stimulation of mechanoreceptors - Stimulation of the circulation of blood and lymph - Loosening of mucus in the lungs - Pian relief as a result of pain gating
28
What are the contraindications of tapotement
A: - Large open areas - Cancer - Infection - Presence of rib fx if in chest area - Over thorax if Pt has acute heart failure, severe HTN, or pulmonary embolism - Arterial or venous pathology - Acute mmm tears U: - varicosities in the areas to be treated - LE chronic swelling due to congestive heart failure
29
Clapping
Tapotement w/cupped hands strike the skin surface rapidly, catching air and compressing it causing a vibration weave to penetrate into the tissue
30
What happens when clapping is performed over the ribs
It will loosen the secretions of the lungs
31
What is the position of the hand for clapping
Flexion of MCPs and extension of PIPS and DIPs - closed but relaxed
32
Beating
Tapotement w/a closed hand w/loosely flexed fingers and striking made with the heel of the hand and dorsal aspect of the Middle and Distal phalanges
33
What is hacking
A type of tapotement that uses the lateral edges of the hand to strike at right angles to the long axis of the mm being treated
34
What is pounding
a type of tapotement that uses the ulnar borders of loosely clenched and extended fists that penetrates deeper than hacking or clapping
35
What are some other types of tapotement (not the main 4)
Vibration Shaking Rocking
36
What are the positive effects of sports massage
- Improve circulation - Decrease edema/inflammation - Promoted relaxation and decreased arousal - Decreased stress and competitive anxiety - Enhanced mental recovery - Decreased/managed pain - Decreased DOMs - Increased ROM - Decreased adhesions - Increased tissue extensibility
37
Sports massage before competition
More seasoned athletes will use it w/timing critical to goal of treatment
38
Sports massage between competitions
(First should hygiene and consume carbohydrates and liquids) Used as a recovery for subsequent performances and promotes lactate mobilization from the bloodstream, giving a quick flush
39
Sports massage after competitions
Used for recovery to - decrease cramping - move fluids - maintain flexibility - promotes blood flow to the mm to remove lactic acid and waste
40
Define PNF
A method of promoting or hastening the response of neuromuscular mechanism by stimulation of the proprioceptors
41
Define proprioceptive
Receiving stimulation w/in the tissues of the body
42
Define facilitation
To promote or hasten a process to make it easier
43
What 3 people are responsible for the development of PNF and approx when was this
Dr. Herman Kabat Margaret Knott, PT Dorothy Voss 1940s
44
What is the philosophy of pnf
- humans respond to demand - existing potential can be developed more fully - mvmt must be specific, functional, and goal oriented - activity is needed - stronger body parts strengthen weaker body parts
45
What grip should be used for PNF
Lumbrical grip w/stable, pain free contract b/t Pt and PT that facilitates the appropriate contraction
46
What is the PT body position
At either end of the desired movement, in line with the direction of the movement w/resistance coming from whole body
47
What is optimal resistance
The amount of resistance that allows a smooth, coordinated movement through the entire ROM
48
What is an isometric contraction
Static contraction i which minimal or no joint motion occurs
49
When is a good time to utilize isometric contractions vs isotonic?
In acute phases
50
What is an isotonic contractoin
Contraction w/intention of movement - concentric or eccentric
51
What is irridation
The predictable spreading of mm contraction to weaker mm groups in the trunk or extremity when a demand is placed on stronger groups
52
What is approximation
The compression of a segment to increase muscular response and promote stability
53
What is approximation used for
To promote stabilization, WB and contraction of antigravity mm, facilitate upright mm, resist some component of movement
54
What is traction
Elongation of a segment to increase muscular response and promote movement or enhance stabilization
55
What is traction used for
1 . facilitate motion (esp antigravity) 2. Aids in elongation of mm tissue when using the stretch reflex 3) Resist some part of the motin 4) Traction of an affected part if helpful when treating pt w/jt pain
56
What is the general rule w/approximation and traction?
Use traction w/anti-gravity movement and facilitate movement approximation w/gravity assisted movement
57
What is quick stretch good for?
To help initiate a movement to allow quicker and stronger mm responses
58
What should your commands be like for PNF?
Short and precise w/appropriate volume for Pt situation
59
How do adults typically move?
Distal to proximal
60
How can vision be used w/PNF
1) learn activities 2) ID the position in space and direction of motion 3) Increasing ROM
61
What are the components of UE D2 flexion
``` Scapular: Posterior elevation Shoulder: Flex, ABD, ER Forearm: supination Wrist: radial extension Fingers: Ext, abd ```
62
What are the components of UE D2 extension
``` Scapular: Anterior depressoin Shoulder: Ext, ADD, IR Forearm: pronation Wrist: ulnar flexion Fingers: Flex, add ```
63
What are the components of UE D1 flexion
``` Scapular: Anterior elevation Shoulder: Flexion, ADD, ER Forearm: supination Wrist: radial flexion Fingers: flex, add ```
64
What are the components of UE D1 extension
``` Scapular: Posterior depression Shoulder: EXT, ABD, IR Forearm: pronation Wrist: ulnar extension Fingers: Ext, abd ```
65
What are the components of LE D1 flexion
Hip: Flex, ADD, ER Ankle: DF, Inv Toes: Ext
66
What are the components of LE D1 extension
Hip: EXT, ABD, IR Ankle: PF, ev Toes: flexion
67
Technique: Rhythmic Initiation
Rhythmic motion of limb or body through desired range, starting w/passive motion and progressing to active resisted motion
68
Technique: | Combination of isotonics
Combined concentric, eccentric, and stabilizing contractions of one group of mm w/o relaxation
69
Technique: | Isotonic Reversal / Slow Reversal
Active motion changing from one direction to the opposite w/o pause or relaxation
70
Technique: | Rhythmic Stabilization
Alternating isometric contractions opposed by enough resistance to prevent motion
71
Technique: | Contract Relax
Resisted isotonic contraction of the restricting mm (antagonists) followed by relaxation and movement into the increased range
72
Technique: | Hold Relax
Resisted isometric contractions of the antagonistic mm (shortened) followed by relaxation
73
Technique: | Quick Stretch
Stretch reflex elicited from mm under the tension of elongation
74
Purpose: | Rhythmic Initiation
Improve Pt awareness of mvmt and assist them in initiation of movement
75
Purpose: | Combination of Isotonics
Teach new pattern, improve ecc contraction, improve coordination during changing of contractions
76
Purpose: | Isotonic/Slow Reversal
Teach reversal of direction, improve strength and ROM, improve coordination
77
Purpose: | Rhythmic Stabilization
Develop co-contraction and increase stability, decrease pain, increase strength and endurance
78
Purpose: | Contract Relax
Increase PROM when no pain is present
79
Purpose: | Hold Relax
Relax of spasm accompanied by pain, decrease pain
80
Purpose: | Quick stretch
Aid in learning, speed up mvmt, delay fatigue
81
Application: | Rhythmic Initation
Passive, Active, then resistive movement w/Pt only performing desired movement
82
Application: | Combination of Isotonics
Start where you want Pt to end and have Pt hold, eccentrically move them back into pattern, then concentrically pull into starting position
83
Application: | Isotonic/Slow Reversal
Start in direction of mvmt, have Pt pull up, then push across w/resistance slowly increasing
84
Application: | Rhythmic Stabilization
Command is hold/stay there Resistance slowly builds Can apply approx or traction
85
Application: | Contract Relax
Passively move to point of tightness, have Pt hold for 5-8 seconds to ANTAGONIS w/some movementT, relax and move to new point of tightness
86
Application: | Hold Relax
Passively move to point of tightness, have Pt hold for ANTAGONIST, then move to new point of tightness
87
Application: | Quick Stretch
Start in full lengthened position, short and quick stretch given to al movements, then have "and pull/push" w/resistance to elicit contraction

UM - Soft Tissue Techniques (3 decks)

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