Mechanisms of Activating Forces- Luke Flashcards
What are some key diagnostic findings that indicate a SD?
short story- TART
long story- Viscerosomatic SD typically has a rubbery tissue texture change
Arthrodial SD usually a bony end feel at the restrictive barrier
Muscular SD has a tight, tense end feel
SD associated with strain/counterstrain tender points have more tenderness
What are some predisposing factors to SD? Discuss because there is a lot.
Posture Habitual Occupational Active (sports related) Gravity Body habitus (obesity, pregnancy) Weight-bearing Anatomical anomalies Vertebra or facets Transitional areas OA, thoracic inlet, TL junction, LS junction Muscle hyperirritability Emotional stress Infection Somatic or visceral reflex Muscle stress (overuse, overstretch, underpreparation, accumulation of waste products) Physiologic locking of a joint Adaptation to stressors Trauma Compensation for other structural deficits short leg muscle imbalance
What are the two main theories of the etiology of SD?
Proprioceptive and Nociceptive or combo.
What is the proprioceptive theory?
Alteration in both the intrinsic and extrinsic reflexes. Inappropriate gamma activity creates inappropriate muscle length and tone, resulting in a functionally imbalanced joint
Spinal facilitation
facilitated segment”- plays a part in the etiology of SD because that area is hyperirritable and hyper-responsive – muscles in that region will be hypertonic
Give examples of these reflexes Somatosomatic Viscerovisceral Somatovisceral Viscerosomatic
Somatosomatic ex. Defensive reflex
Viscerovisceral ex. Distension of the gut causing increased contraction of the gut muscle
Somatovisceral ex. Stimulation of abdominal skin inhibits gut activity
Viscerosomatic ex. Upper back pain with an MI
What is the nociceptive theory?
Pain, lots of pictures in lecture.
Is HVLA a direct or indirect tech.
What is it best suited for?
Direct.
HVLA best suited to SD with restricted motion with a hard end feel
Discuss HVLA steps. DONT need to hear a pop.
What is the mechanism?
Edge of barrier, no backing of with a HVLA force
Sudden stretch or change of position of the joint alters the afferent output of the mechanoreceptors in the joint capsule, resulting in release of muscle hypertonicity
What are some HVLA indications.
SD with distinct, firm barrier mechanics, useful when there is limited time
HVLA contraindications. Absolute. Discuss
Rheumatoid arthritis Down syndrome Achondroplastic dwarfism Chiari malformation Fracture / dislocation / spinal or joint instability Ankylosis / Spondylosis with fusion Surgical fusion Klippel-Feil syndrome Vertebrobasilar insufficiency Inflammatory joint disease Joint infection Bony malignancy Patient refusal
Relative contraindications.
Acute herniated nucleus pulposus Acute radiculopathy Acute whiplash / severe muscle spasm / strain/sprain Osteopenia / Osteoporosis Spondylolisthesis Metabolic bone disease Hypermobility syndromes
Describe MET.
Direct, patient pushes upon request.
What is an important step to MET
Must pause 2-3 secoonds after contraction before going into the barrier again.
Isometric/Isotonic
Concentric/eccentric
No length change/ length change
shortening/lengthening
What is post isometric relaxation?
Immediately after an isometric contraction, the neuromuscular apparatus is in a refractory state during which passive stretching may be performed without encountering strong myotatic reflex opposition. All the physician needs to do is resist the contraction, and then take up the soft tissue slack during the refractory period.
What is respiratory assistance?
Force of respiration that the physician can use.
Oculocephalogyric Reflex
Functional muscle groups are contracted in response to voluntary eye motion on the part of the patient. These eye movements reflexively affect the cervical and truncal musculature as the body attempts to follow the lead provided by eye motion. It can be used to produce very gentle post-isometric relaxation or reciprocal inhibition.
What is reciprocal inhibition?
When a gentle contraction is initiated in the agonist muscle, there is a reflex relaxation of that muscle’s antagonistic group.
Crossed Extensor Reflex, discuss.
This form of muscle energy technique uses the learned cross pattern locomotion reflexes engrammed into the central nervous system.
Important- When the flexor muscle in one extremity is contracted voluntarily, the flexor muscle in the contralateral extremity relaxes and the extensor contracts.
MET indications?
SD
MET absolute contraindications
Absence of somatic dysfunction
Lack of patient consent and/or cooperation
Oculocephalogyric reflex technique in someone with recent eye surgery or trauma
Relative?
Infection, hematoma, or tear in involved muscle
Fracture or dislocation of involved joint
Rheumatologic conditions causing instability of the cervical spine
Undiagnosed joint swelling of involved joint
Positioning that compromises vasculature
Patient with low vitality who could be further compromised (acute post myocardial infarction for example)
What is MFR,
what are the types?
continual palpatory feedback to achieve release of myofascial tissues
Direct MFR-a myofascial tissue restrictive barrier is engaged for the myofascial tissues and the tissue is loaded with a constant force until tissue release occurs.
Indirect MFR-the dysfunctional tissues are guided along the path of least resistance until free movement is achieved
