Manual Therapy

Question 1

How does MT reduce Pain

Answer 1

• Neurophysiological mechanisms
• Relieve muscle spasm/ improve muscle relaxation
• Facilitate tissue healing??

Question 2

How does MT reduce stiffness

Answer 2

• Increase joint ROM
• Reduce reflex muscle facilitations
• Increase tissue extensibility??
• Facilitate movement (due to pain relief/muscle relaxation)

Question 3

Biomechanical Mechanisms of MT

Answer 3

normal joint movement and muscle recruitment patterns BY ↓ peripheral nociceptive signal

Question 4

Neuromuscular Mechanisms of MT

Answer 4

↓ Motor neuron excitability, muscle spasm, ischaemia BY ↓ peripheral nociceptive signal

Question 5

Neurophysiological Mechanisms of MT

Answer 5

Activate descending inhibition from brain (release inhibitory neurotransmitters)

Question 6

Joint movement severely limited by pain (P1). Highly irritable. (PAM)

Answer 6

<P1 or in opposite direction (Gr 1-3)

Question 7

Joint movement limited by pain (P1 or P2) (PAM)

Answer 7

Early to mid-range techniques (GRI-III) depending on irritability and response to treatment

Question 8

Restricted mobility but pain at EOR (R2). non-irritable.

Answer 8

EOR techniques (Gr III - IV)

Question 9

Restricted mobility but no pain at EOR (R2)

Answer 9

EOR techniques (Gr III - IV)

Question 10

Contraindications to PAMs and PPM

Answer 10

Local malignancy, Local bony infection (e.g. osteomyelitis) , Fracture / Risk of fracture (i.e. low bone density), Spinal cord compression, Cauda Equina syndrome and Active inflammatory arthritis

Question 11

Effleurage

Answer 11

The hands are passed rhythmically and continuously over a client’s skin, in one direction only, with the aim of increasing blood flow in that direction, stretching tissues, relaxing the client and aiding the dispersal of waste products

Question 12

Petrissage

Answer 12

Alternate squeezing and relaxation of the tissues stimulate the local circulation and may have a pain-relieving effect with some muscular disorders.

Potential effects:
* Stimulate the flow of venous and lymphatic fluid
* Increase tissue mobility

Question 13

Myofascial Release

Answer 13

Position: target tissue is in a position of stretch or involvement a stretching movement (active or passive) in your technique.

Technique: Apply a tensile force with the thumb, fingers, knuckles, forearm in the direction of tissue restriction.

Possible mechanisms: Potentially rupture the abnormal cross-linkages between collagen fibres, stimulate fibroblast synthesis of collagen and increase inter-fibre distance.

Question 14

Myofascial Trigger Points

Answer 14

A hyperirritable spot which is painful on compression and can give rise to characteristic referred pain, motor dysfunction, and autonomic phenomena

Mechanism: equalising sarcomere length by pressure, needle, stretch or contraction.