Manual Theapy

Question 1

Contraindications of Manual therapy

Answer 1

● Systemic or localized infection
● Acute circulatory conditions (DVT, etc) 
● Malignancy in the area
● Open wound at site
● Recent fracture at site
● Hematoma in area
● Hypersensitive skin in area
● Advanced diabetes
● Rheumatoid arthritis (if in a flare)
● Cellulitis

Question 2

Precautions for Manual Therapy

Answer 2

● Joint effusion or inflammation
● Rheumatoid arthritis (if not in a flare)
● Osteoporosis
● Steroid or anticoagulant therapy

Question 3

What are indications of musculoskeletal pain

Answer 3

○ Pain reported with activity and that is relieved by rest
○ Pain that is relieved or provoked by particular motions or positions
○ Pain altered by changes related to sitting or standing posture

Question 4

With transverse friction massage, what direction is your pressure moving

Answer 4

Perpendicular to normal orientation of fibers

Question 5

Effects of transverse friction massage

Answer 5

Traumatic hypermedia (increasing blood flow to the area)
Pain relief ( gate control theory )
Assist with collagen orientation

Question 6

What manual therapy should you preform with tendinitis

Answer 6

Transverse friction massage

Question 7

Transverse friction massage indications

Answer 7

acute, subacute, or chronic ligament, tendon, or muscle injuries

Question 8

Contraindications for transverse friction massage

Answer 8

hematomas, open skin, frail skin

Question 9

Purpose of scar massage

Answer 9

to stimulate collagen to lay down scar tissue appropriately (avoid hypertrophic and keloid scars), maintain scar mobility, and desensitize scars as needed

Question 10

Before preforming a scar massage, ensure incision is….

Answer 10

ensure incision is clean, dry, intact prior to performing

Question 11

Theory behind myofascial release

Answer 11

Based on principle that trauma or structural abnormalities creates inappropriate fascial strain, because of an inability of the deep fascia to absorb or distribute forces
● Strains to deep fascia results in slow tightening of the fascia; these fascial restrictions eventually lead to postural impairments

Question 12

Myofascial Release Purpose:

Answer 12

Apply gentle sustained pressure to deep fascia to release restrictions and restore normal pain-free function

Question 13

What is ischemic compression

Answer 13

Pressure applied to center of trigger point

Question 14

Theory behind ischemic compression

Answer 14

sustained pressure deprives trigger point of oxygen; temporary blockage of circulation! —->reactive hyperemia that in turn reduces overall energy crisis and breaks pain cycle

Question 15

Effect of soft tissue mobilization

Answer 15

increases circulation and skin temperature of the massaged area via vasodilation

Question 16

Types of massage/STM

Answer 16

○ Effleurage
○ Petrissage
○ Strumming

Question 17

What type of soft tissue massage is used to reduce edema

Answer 17

Retrograde massage

Question 18

Describe the technique for retrograde massage

Answer 18

With sustained pressure go distally to proximally (move only in one direction)

Question 19

What is the intention of retrograde massage?

Answer 19

Reduce edema : Intention is to push the fluid back towards the lymphatic system and assist with edema control

Question 20

Relative contraindications of soft tissue mobilization

Answer 20

● Cancer
● Kidney dysfunction
● Pregnancy
● Rheumatoid arthritis
● Varicose veins
● Osteoporosis
● Lymphedema
● Fracture
● Chronic regional pain syndrome
● Use of certain medications (e.g., anticoagulants, steroids, or nonsteroidal anti-inflammatory drugs)

Question 21

Absolute contraindications of soft tissue mobilization

Answer 21

● Open wound
● Unhealed suture sites
● Thrombophlebitis
● Uncontrolled hypertension 
● Skin infection
● Hematoma
● Myositis ossificans
● Unstable fractures

Question 22

What is Nociceptive pain

Answer 22

Increased sensitivity of peripheral afferent nerves