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OS Test 1 > Lecture 5: soft tissue and myofascial release techniques > Flashcards

Lecture 5: soft tissue and myofascial release techniques Flashcards

1
Q

What does “soft tissue” entail?

A 
Living tissues of the body other than
bone.
– Fascia
– Muscles
– Organs
– Nerves
– Vasculature
– Lymphatic
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2
Q

what are connective tissue layers composed of?

A 
collagen fibers (and occasionally also
elastin fibers) in an amorphous matrix of hydrated
proteoglycans (PGs), which mechanically links the
collagen fiber networks in these structures.
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3
Q

what are the 2 components of fascia?

A
  • ECM (95%)

- cells (5%)

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4
Q

What is fascia?

A

• A complete system with blood supply,
fluid drainage & innervations
– Thus, fascia comprises the largest organ system in the body
• Composed of irregularly arranged fibrous
elements of varying density

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5
Q

what is the function of fascia?

A

Involved in tissue protection &

healing of surrounding systems

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6
Q

what is fascia NOT?

A
  • Tendons
  • Ligaments
  • Aponeuroses
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7
Q

Fasica- omnipresnet

A
  • is continuous throughout the body

- lacks a well defined border

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8
Q

Pannicular Fascia (aka Panniculus)

A

Outermost layer of fascia derived from somatic
mesenchyme & surrounds entire body with
exception of the orifices; outer layer is adipose
tissue & inner layer is membranous & adherent,
generally, to the outer portion

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9
Q

Axial & Appendicular Fascia (aka

investing layer)

A

Internal to the pannicular layer; fused to the
panniculus and surrounds all of the muscles, the
periosteum of bone & peritendon of tendons

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10
Q

endomysium

A

forms a continuous lattice connecting all the muscle fibers in the fascicle.

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11
Q

Meningeal Fascia

A

Surrounds the nervous system; includes

the dura

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12
Q

Visceral Fascia

A

Surrounds the body cavities (pleural,

pericardial & peritoneum

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13
Q

fascia-omnipotent

A

Provides for mobility and stability of the

musculoskeletal system

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14
Q

omnipotent contractile celss

A

-myofibroblasts

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15
Q

omnipotent healing cells

A
  • macrophages

- mast cells

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16
Q

fascia- omniscient

A
  • contains mechanoreceptors in loose fascia

- used for muscles and proprioception (balance) (relative positions of neighboring parts)

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17
Q

fascial layers (VAMP)

A
  • pannicular fascia
  • axial and appendicular fascia
  • meningeal fascia
  • visceral fascia
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18
Q

Viscoelastic Material

A

Any material that deforms according to rate of loading and deformity

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19
Q

Stress

A

is the force that
attempts to deform a connective
tissue structure.

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20
Q

Strain

A

the percentage of
deformation of a connective
tissue.

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21
Q

Hysteresis

A

energy loss in connective tissue system

-difference between loading and unloading characteristics

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22
Q

creep

A

Connective tissue under a sustained, constant load (below failure
threshold), will elongate (deform) in response to the load.

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23
Q

Ease

A

• The direction in which the connective tissue may be moved most
easily during deformational stretching.
• Palpated as a sense of tissue “looseness”, or laxity or greater degree
of mobility.

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24
Q

Bind

A

a palpable restriction of connective tissue

mobility.

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25
Q

Newton’s Third Law

A

‘When two bodies interact, the force exerted by
one is equal in magnitude and opposite in
direction to the forces exerted by the other.’`

26
Q

Hooke’s Law

A

“The strain (deformation) placed on an elastic
body is in proportion to the stress (force) placed
upon it.”

27
Q

Wolff’s Law

A 
• “Bone will develop according to
the under stresses placed upon
it.”
• This concept extends to fascia,
too.
28
Q

somatic dysfunction

A 
Impaired or altered function of:
– Skeletal,
– Arthroidal, and
– Myofascial structures, and their related
– Vascular,
– Lymphatic,
– Neural elements
29
Q

what does a somatic dysfunction produce?

A
  • a restrictive barrier with a decrease in AROM and PROM
30
Q

Direct techniques

A

Go towards & eventually
through the restrictive

barrier

31
Q

indirect techniques

A

Go away from the
restrictive barrier!
-shifted neutral

32
Q

Sherrington’s Law:

A

-when a muscle receives a nerve impulse to contracts, is antagonists receive simultaneously an impulse to relax

33
Q

Common Compensatory pattern

A
  • 80% of healthy people

* L/R/L/R

34
Q

Uncommon Compensatory pattern

A
  • 20% of healthy people

* R/L/R/L

35
Q

Uncompensated Pattern

A

-L/L/L/L
-R/L/L/R
• Usually symptomatic
• Usually a trauma is involved

36
Q

what are the transition zones of the spine

A

OA, C1, C2
C7, T1
T12, L1

L5, Sacrum

37
Q

transverse restrictors

A

Tentorium Cerebelli
Thoracic Inlet
Thoracolumbar Diaphragm

Pelvic diaphragm

38
Q

Soft Tissue Technique Defined

A

“A system of diagnosis and
treatment directed toward
tissues other than skeletal or
arthrodial elements.”

39
Q

what must be present for somatic dysfunction?

A

TART

40
Q

Tissue texture abnormality & Asymmetry of tissues treatment goals

A
  1. Stretch and increase the elasticity of
    shortened myofascial structures to return
    symmetry
  2. Improve local tissue nutrition, oxygenation,
    and removal of metabolic wastes to
    normalize tissue texture
41
Q

Asymmetry of muscles Treatment goals

A
  1. Restore symmetry

2. Normalize tone

42
Q

Restriction of

motion treatment goals

A

Set the fascia free to normalize ROM

43
Q

Tenderness treatment goals

A
  1. Normalize neurologic activity
  2. Improve abnormal somato-somatic &
    somato-visceral reflexes
44
Q

soft tissue relative contraindications

A

Severe osteoporosis

Acute Injuries

45
Q

soft tissue absolute contraindications

A
  • Fracture or dislocation
  • Neurologic entrapment syndromes
  • Serious vascular compromise
  • Local malignancy
  • Local infection (e.g., cellulitis, abscess, septic arthritis, osteomyelitis)
  • Bleeding disorders
46
Q

soft tissue technique

A

forces are very gentle and of low
amplitude. The force is applied rhythmically, typically 1 or 2
seconds of stretch followed by a similar time frame releasing that
stretch

47
Q

stretch (parallel traction)

A

Increase distance
between origin and
insertion (parallel
with muscle fibers

48
Q

The taffy pull Stretch

A

the forces being
applied are parallel to the myofascial structures
needing treatment. This may be done by
• Separating the proximal and distal attachments of
the muscle (both hands moving in opposite
directions like a taffy pull) or by
• Anchoring one end of the muscle and pulling on the
other (one hand or structure serving as a stationary
anchor, the other one mobile)

49
Q

Knead (perpendicular traction) (the bowstring)

A

Repetitive pushing of tissue

perpendicular to muscle fibers

50
Q

Inhibition

A

• Push and hold perpendicular to the
fibers at the musculotendinous part
of hypertonic muscle.
• Hold until relaxation of tissue

51
Q

MFR

A

A system of diagnosis & treatment first described
by A.T. Still and his early students, which
engages continual palpatory feedback to achieve
release of myofascial tissues

52
Q

INR (integrated neuromusculoskeletal release)

A

A treatment system in which combined
procedures are designed to stretch & reflexively
release patterned soft tissue & joint related
restrictions

53
Q

what technique helps speed the treatment process of INR

A

REMS

54
Q

Examples of INR

A

• Breath holding
– The goal is to alter both intrathoracic & intraabdominal pressure using
costodiaphragmatic, shoulder girdle & lumbopelvic interactions
• Prone & supine simulated swimming & pendulum arm swing
maneuvers as direct & indirect barriers are released.
• R/L cervical rotation
• Isometric limb & neck movements against the table, chair…
• Patient evoked movement from cranial nerves (eye, tongue, jaw,
oropharynx)

55
Q

indications for MFR

A

• Somatic dysfunction
– Almost all soft tissue or joint restrictions
• When HVLA or muscle energy is contraindicated
– Consider indirect MFR
• When counterstrain may be difficult secondary to a patient’s
inability to relax.

56
Q

absolute contraindications of MFR

A
  • Lack of Patient Consent

- Absence of Somatic Dysfunction

57
Q

relative contraindications MFR

A
  • Infection of soft tissue or bone
  • Fracture, Avulsion or dislocation
  • Metastatic disease
  • Soft tissue injuries: Thermal, Hematoma or Open wounds
  • Post-op patient with wound dehiscence
  • Rheumatologic condition involving instability of cervical spine
  • DVT or Anticoagulation therapy
58
Q

activating forces- inherent forces

A

using the body’s PRM (primary respiratory

mechanism)

59
Q

activating forces-Respiratory Cooperation

A

Refers to a physician directed,
patient performed, inhalation or exhalation or a holding of the
breath to assist with the manipulative intervention.

60
Q

activating forces-Patient Cooperation

A

the patient is asked to move in specific

directions to aid in mobilizing specific areas of restriction

61
Q

MFR treatment endpoint

A

• A three dimensional release is often palpated as:
– Warmth
– Softening
– Increased compliance/ROM
• The continuous application of activating forces no longer produce
change
• When finished, recheck of the tissue demonstrates symmetry

OS Test 1 (7 decks)

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