Lab 4: Myofascial Release OSCE

Question 1

Cervical MFR/INR

Answer 1

Physician cups the subocciput with hands (no pressure with thumbs) and gently add traction to engage the hypertonic tissues

Activating Forces:

• MFR: Inherent and respiratory
• INR: REMs– eye, tongue & UE movement
• Timing= 20-60 seconds or until palpable release

Question 2

Knee MFR/INR

Answer 2

Physician uses superior hand to grasp thigh superior to the patella & other hand inferior to patella on tibia and fibula

Activating Forces:

• MFR: Inherent and respiratory
• INR: REMs– knee flexion/extension
• Timing= 20-60 seconds or until palpable release

Question 3

Hip Region MFR/INR

Answer 3

Physician places one hand on the proximal anterolateral aspect of the leg (over quadricep and greater trochanter) and the other posteromedially (over hamstrings and adductors)

Activating Forces:

• MFR: Inherent and respiratory
• INR: REMs– knee/hip flexion/extension, AB/AD, IR/ER •Timing= 20-60 seconds or until palpable release

Question 4

Glenohumeral and Scapular MFR/INR

Answer 4

Physician grasps the proximal humerus inferiorly near the axilla and superiorly placing thumb & 5th digit on humerus and digits 2-4 on scapula

Activating Forces:

• MFR: Inherent and respiratory
• INR: REMs– arm F/E, IR/ER, AD/ABduction
• Timing= 20-60 seconds or until palpable release

Question 5

Thoracolumbar MFR/INR (prone)

Answer 5

Physician right hand at the right TLJ with thumb pads medial to the longissimus thoracis and thenar eminence upon it; the left hand is placed similarly on the left side

Activating Force

• MFR: Inherent and respiratory
• INR: REMs– leg extension, IR/ER; arm motion
• Timing= 20-60 seconds or until palpable release

Question 6

Prone Sacrum Base MFR/INR

Answer 6

Physician places one hand with pinky just superior to the lumbosacral junction, thenar & hypothenar eminence lateral to one of the sacroiliac joints and the contralateral finger pad on the lateral aspect of the other sacroiliac joint

Activating Forces:

• MFR: Inherent and respiratory
• INR: REMs– leg flex/extend, IR/ER
• Timing= 20-60 seconds or until palpable release

Question 7

Prone Regional Thoracic MFR/INR

Answer 7

Physician right hand with thumb pads medial to the longissimus thoracis and thenar eminence upon it at T7-9; the left hand his placed similarly on the left side

Activating Forces:

• MFR: Inherent and respiratory
• INR: REMs– arm motion flex/extend, IR/ER, Ab/Ad
• Timing= 20-60 seconds or until palpable release

Question 8

Elbow MFR/INR

Answer 8

Physician grasps the radioulnar area near the radiohumeral joint with one hand positioned inferior to the joint and the other superior

Activating Forces:

• MFR: Inherent and respiratory
• INR: REMs– supination/pronation
• Timing= 20-60 seconds or until palpable release

Question 9

Ankle MFR/INR

Answer 9

Physician grasps the patient’s distal leg crossing the ankle joint (holding medial & lateral malleoli) with superior hand and with inferior hand grasp the forefoot

Activating Forces:

• MFR: Inherent and respiratory
• INR: REMs– dorsiflexion/plantarflexion
• Timing= 20-60 seconds or until palpable release

Question 10

Wrist MFR/INR

Answer 10

Physician a) Grasp the wrist just proximal to the wrist joint; b) Grasp distal to the wrist joint with the other hand

Activating Forces:

• MFR: Inherent and respiratory
• INR: REMs– wrist flexion/extension, radial/ulnar deviation & clenching/unclenching fists
• Timing= 20-60 seconds or until palpable release

Question 11

Still’s Wrist MFR/INR

Answer 11

Physician grasps the wrist anteriorly/posteriorly using your thenar and hypothenar eminences

Activating Forces:

• MFR: Inherent and respiratory
• INR: REMs– wrist flexion/extension, radial/ulnar deviation & clenching/unclenching fists
• Timing= 20-60 seconds or until palpable release

Question 12

Popliteal Space MFR/INR

Answer 12

Physician uses finger pads to grasp the medial & lateral aspects of the hamstrings (superior) or the gastrocs (inferior) as they create the superior/inferior popliteal space

Activating Forces:

• MFR: Inherent and respiratory
• INR: REMs– knee flexion/relaxation; IR/ER at the hip
• Timing= 20-60 seconds or until palpable release

Question 13

Plantar Fascia MFR/INR

Answer 13

Physician’s thumbs are crossed, making an X, with the thumb pads over the area of concern at the plantar fascia. •The thumbs provide a separating force to load tissues appropriate to dMFR.

Activating Forces:

• MFR: Inherent and respiratory
• INR: REMs– plantarflexion/dorsiflexion
• Timing= 20-60 seconds or until palpable release