Intro To Spinal Traction Flashcards
Traction is
An attempt to “open up” compressed bony surfaces… attempts to release pressure from compressed tissues
= Distraction
Medical Traction
Continuous & Static
- used to promote reduction & immobilization following trauma
How can spinal traction be applied?
Either manually or mechanically
What does Manual Traction - Joint play consist of?
Grade I - applied by slowing distracting joint surfaces — unweight
Grade II - Slow moderate amplitude movement — taking up the slack
Grade III - larger amplitude — deform the tissue
Manual Traction Characteristics
1) Oscillaatory
2) Progressive
3) Positional – think of kaltenborn (describing traction that has been positioned with respect to cardinal planes of motion)
What can spinal traction do?
- Stretch soft tissues
- Relax muscles
- Mobilize joints
What percentage of body weight is enough to increase the length of the lumbar spine?
25% of patients body weight (or closer to 50% of body weight)
What percentage of body weight is enough to distract the cervical vertebrae?
about 7% of patients body weight
Pathologies treated with traction
1) Nerve Impingement
2) Disc Herniation/ Prolapse
3) Joint Hypomobility
4) Arthritic conditions of facet joints
5) Muscle Spasm
6) Generalized Joint pain
Tissues affected by spinal traction
1) Ligaments
2) Intervertebral Discs - allows the disc to hopefully go back into space
3) Facet Joints
4) Muscles
5) Nerves
Physiology of Traction _ Ligaments
1) Ligament deformation – allows spinal vertebrae to temporarily move apart
2) Traction encourages adaptive changes in length & strength
- Traction should be AVOIDED in the ACUTE STAGE
Physiology of Traction _ Invertebral Discs
1) Decreases central pressure of the nucleus
2) Return of nucleus to central position
3) Help push disc material more centrally
4) Movement of structures relieves pain if pressure is on vascular of nervous tissues
5) Improves fluid exchanges within the disc & spinal canal
6) Possible reduction of disc herniation
Physiology of Traction _ Facet Joints
1) Seperates joint surfaces up to 1 - 2 mm
2) Decompresses articular cartilage, increasing synovial fluid exchange to the cartialge
3) Stimulates proprioceptive nerves (at the facet joints capsules “gate effect”)
Physiology of Traction _ Muscles
1- 10 minutes of continuous spinal traction can decrease muscle tension
Physiology of Traction _ Nerves
1) Decrease pressure on the nerve from structures such as: Bone spurs, Narrowed intervertebral foramen, buldging disc material
2) Increase Blood flow to the nerve, decresing edema
- positive effects depends on degernative changes & fibrosis that occurs during repair
Indications
- Nerve root impingement
- Disc Herniation
- Spondylolisthesis
- Osteophyte formation
- Degenerative joint disease
- Sub acute sprain
- Joint Hypomobility
- Discogenic Pain
- Muscle spams or guarding
- Muscle Strain
- Ligament or Connective tissue contractures
Contraidnications
- Acute sprains or strains
- Acute inflammation
- Fractures
- Joint instability
- Tumors
- Bone disease
- Osteoporosis
- Infections in bones/joints
- Vascular conditions
- Pregnancy
- Cardiac or Pulmonary problems
- Compressing chest
Types of Traction
1) Continous Traction - constant force
2) Intermittent Traction- applies force then releases force
3) Manual Traction- applied by the therapist
4) Positional Traction - a way to effect bony tissue & alleviate pressure
5) Gravity-assisted traction- inversion
