L6/7 Soft Tissue Flashcards
Massage therapy includes
kneading
wringing
skin rolling
rhythmic percussion
cupping
Manual therapy includes
joint mob
manual traction
soft tissue mob
compression bandaging
Goal of STM
break down adhesions
increase circulation
improve ROM
reduce swelling
decease pain
restore function
Contraindications of STM
acute/emergency conditions
fever
open wounds
malignancy
blood disorders
RA flares
Precautions of STM
recent surgery
burns
fractures
decreased sensation or oversensation
osteoporosis
varicose veins
Effleurage
gliding strokes, slow
can be a flush, movement of fluids (acute). Stretching (deep)
Petrissage
kneading, lifting
improve mobility
circulation
decompression
Tapotement
rapid percussive movements
stimulating effect
Scar mobilization
circles, perpendicular and parallel to scar
can work on post op scars
5-10 min
expect 4-8 weeks of work
Cross Friction Massage
repetitive non gliding movement of finger tips
helps to increase blood flow, break up adhesions
focusing on tendon stretches tissue
Short term effects w/STM
LBP
Patellofemoral pain
not effective for headaches
Why do we do STM?
pt expectations
revenue generating
b/c predecessors did it
confirmation bias
press and guess
5 Rs of Rehab
Reset
Reeducate
reinforce
reload
return
purpose of taping
stability to unstable segments
swelling
neuromuscular facilitation
postural corrections
Taping variables
rigidity
breathability
length of time worn
skin irritation
dependence
Athletic taping
rigid cotton tape
can be done with pre wrap under
short <1 day duration of application
most supportive
least breathable
McConnell Taping
breathable, less irritable Coverall tape
Leuko-tape to pull or stabilize
strong evidence helps with pain and functional ability
possibly causes skin irritation, dependence
Kinesio-tape
reduce pain/swelling, increase circulation, minimize bruising, support. drains lymph
up to 5 days of wear time
water resistant
latex free
Depth and kinesiotape
Ultra light = epidermis
Super light = dermis
Paper off = superficial fascia
Moderate = deep fascia
Severe = tendon
Full = ligament
Using broad slow manual strokes with your hands to reduce edema is which type of soft tissue mobilization?
effluerage
Important principles of soft tissue mobilization to maximize the therapeutic effect include
pt expectations
PT body mechanics
consent
education
What is positional release therapy?
Mild pressure at the trigger point for 90 seconds
Active Release Technique protocol involves a particular order. If the initial treatment was well tolerated what could you do to potentially get more benefit?
increase number of AROM reps
Increase pressure on the trigger point
Increase the amount of stretch by adding PROM at the end of the available AROM
Active Release Technique benefits
restore free motion of all soft tissues
release entrapped nerves, vasculature, lymph
re-establish optimal texture
Steps of ART
find tender spot
position pt
put pressure
PROM or AROM
pressure should be close to parallel
Positional Release Therapy
applying pressure to manipulate the nervous system to interrupt pain/spasm
usually when muscle is in a shortened position, relaxing the nerve can help the muscle stretch/contract/heal
Effects of positional release therapy
reduce muscle hypertonicity
increase local circulation
increase ROM
improve lymphatic flow
decrease pain
increase strength
IASTM
easier on PT hands, lose real-time feedback
quicker than traditional
enhance fibroblast activity
tools applied at 30-60° for 40-120s
increase pressure/angle based on response
STM effects
break up adhesions
decrease tone
increase ROM, decrease pain, increase circulation
