Introduction to ST & MFR

Question 1

Direct Techniques

Answer 1

• restrictive/pathologic barrier
• move tissues to where they don’t want to go
• Bind: tissues will tighten up

Question 2

Indirect Techniques

Answer 2

• shifted midline/neutral
• moe tissue to where they want to go
• Ease: tissues will soften/relax

Question 3

Soft Tissue Technique Definition

Answer 3

• “targeted massage”
• direct technique
• lengthen fascia or muscle (tightens) by lateral stretching (pushing away from midline), linear stretching (pushing neds of muscles away from each other), deep pressure, or kneading

Question 4

Soft Tissue Technique Proposed Mechanism of Action

Answer 4

• decreased muscular pain by: increasing elasticity in the shortened fascial structures, releases hypertonic muscles by decreasing alpha motor neuron activity, improves local tissue circulation by removing metabolic wastes

Question 5

Benefits of Soft Tissue Techniques

Answer 5

• decreases muscle spasm and pain
• simultaneous monitoring and treating

Question 6

Risks of Soft Tissue Techniques

Answer 6

• ecchymosis
• acute muscle spasm
• post-procedure muscle soreness

Question 7

Absolute Contraindications to Soft Tissue Technique

Answer 7

• no SD
• lack of consent
• open traumatized/friable tissues

Question 8

Relative Contraindications to Soft Tissue Technique

Answer 8

• other therapies are indicated
• acute muscle strain
• ligamentous sprain
• nearby skin infection or burns
• nearby fractures or dislocations

Question 9

Activating Forces of Soft Tissue Technique

Answer 9

• Hold & Wait until tissues soften: can do this via Traction (separate ends of muscle and wait) or Inhibition (sustained deep pressure and wait)
• Kneading until tissues release: rhythmic lateral stretching

Question 10

Myofascial Release Technique (MFR) Definition

Answer 10

• can be direct or indirect (direct = moves fascia to restrictive/pathologic barrier; indirect = moves fascia to shifted midline/neutral)
• apply an activating force – continuous palpation to dynamically localize to new restrictive barriers or shifted neutrals (fascia will change quickly); can also add inherit forces (follow until fascia normalizes, passive) or Release Enhancing Technique (respiratory force, active)

Question 11

Fascia

Answer 11

• protects and provides structure
• allows tissue gliding
• innervated by sensory nerves
• transfers motion/force – forms tendons and ligaments, dynamically contracts and relaxes

Question 12

MFR Mechanism of Action

Answer 12

• provides dynamic input
• changes tension of associated muscles
• decreases tension within fascia
• improves local tissue circulation and removal of metabolic wastes/edema

Question 13

Benefits of MFR

Answer 13

• normalize ROM
• decrease MSK pain
• improve circulation to decrease edema
• simultaneous monitoring and treating

Question 14

Risks of MFR

Answer 14

• post-OMT muscle soreness

Question 15

MFR Indications

Answer 15

• edema (swelling) by improving circulation
• MSK pain

Question 16

MFR Contraindications

Answer 16

• Absolute: no SD, no consent
• Relative: other therapies are indicated, acute muscle strain or ligamentous sprain, nearby skin infection or burns or fractures or dislocations

Question 17

MFR: associated motion if physician moves both hands inferior

Answer 17

Extension

Question 18

MFR: associated motion if physician moves both hands superior

Answer 18

Flexion

Question 19

MFR: associated motion if physician shifts both hands left

Answer 19

Rotate Right

Question 20

MFR: associated motion if physician shifts both hands right

Answer 20

Rotate Left

Question 21

MFR: associated motion if physician moves R hand superior and L hand inferior (counterclockwise)

Answer 21

Sidebend Left

Question 22

MFR: associated motion if physician moves R hand inferior and L hand superior (clockwise)

Answer 22

Sidebend Right