Introduction: ME and HVLA Flashcards
muscle energy basics
direct technique active technique using pt. mm energy as activating force dr counteracts pts force isometric = no movement in active phase mm remain the same length achieve relaxation after contraction of mm
muscle energy
direct technique
active technique
goals of mm energy
Mobilize restricted joints and tissues Stretch tight muscles and fascia Decrease hypertonicity Lengthen fibers Improve local circulation Balance neuromuscular relationships Strengthen weaker side of asymmetry Make Patient feel better
advantages of mm energy
“Safer” than HVLA gentle technique Geriatirc pt Osteoporosis or risks other conditions which may not allow the use of thrust techniques
contraindications of mm energy
Open wounds Broken bones Uncooperative patients Unresponsive patients Severe pain in muscle group utilized
indications of mm energy
Somatic Dysfunction
Use alone or to prepare patient for HVLA or other modality
after ME, may find HVLA not needed
Segmental or regional somatic dys
Useful in torticollis
also good for chronic pain conditions, tight hamstrings, tension HA…..
techniques of mm energy
diagnos engage restrictive barrier and pt. provides a force against it dr provides equal counterforce to achieve isometric contraction hold for 3-5 seconds pt and dr relaxes together engage new barrier repeat until no further restrictions reassess
golgi tendon reflex
afferent neuron (1b) carry information to spinal cord
synapse w/ inhibitory interneurons
synapse with alpha motor neuron in anterior gray horn
send inhibitory message to mm to cause reflex relaxation of mm
post isometric relaxation
neuromuscular bundle is in a refractory state immediately after contraction, allowing passive
stretching to occur without reflex opposition
muscle contraction stretches Golgi tendon organ ultimately causing reflex relaxation
HVLA basics
This is a direct technique
Passive technique
Moving the joint in the direction of the restrictive barrier
Applying a precise thrust
Immediate restoration in range of motion
Consider relaxing surrounding soft tissues first
HVLA basics
This is a direct technique
Passive technique
Moving the joint in the direction of the restrictive barrier
Applying a precise thrust
Immediate restoration in range of motion
Consider relaxing surrounding soft tissues first
indications for HVLA
Primary = Somatic Dysfunction
Must understand somatic dysfunction and barrier concepts
Secondary benefits – restoration of motion, removal of restrictions…
Improve motion and biomechanical function
Pain reduction
Decrease inappropriate somato-visceral reflexes
thrust force
applied after the setup is locked against the restrictive barrier
short quick thrust
DO NOT back off the barrier just before the thrust
DO NOT carry the thrust over a great distance
DO NOT be over tentative and apply a low velocity force
neruophysiology of HVLA
asymmetric tension in tissues around a joint leads to pressure and thus asymmetric afferent inputs
thrusting gaps the joint causing a sudden stretch
sudden stretch activates the golgi tendon organ
HVLA precautions/contraindications
risk-benefit ration neurological complications joints can be sprained osseous or ligamentous damage pathologic fractures psychological contraindications
