MFR 2 Flashcards
Concept of fascia
It is everywhere! It connects the entire body
Forward head posture - possible myofascial restrictions
Anterior chest wall Thoracic Abdominal Post C spine Ant C spine Diaphragm Hip flexor REMINDER - pt with neck pain, do not just treat their neck!
Basic principles - Tx with MFR will affect
the treated area and distal body areas
Basic principles - Release of tightness and restrictions can affect
other body organs through a reflexive relaxation of tension transmitted through fascial system
Basic principles - MFR can change _____ if ____ does not have ___
Can change posture if posture does not have joint changes
Basic principles - Progress measured through
the normal stuff - ROM, function, impairments
Basic principles - comfort with MFR
MFR is more comfortable than other stretching techniques
Historical assumptions - how does it work
MFR will work even though we don’t know why it works
Historical assumptions - Finding and stretching tightness
Utilizing feedback from the pt, the therapist can find and stretch tightness and restrictions that can’t be detected by other techniques
Historical assumptions - Asymmetrical soft tissue tightness can cause
pain proximal to, or distal to the area of dysfunction
Historical assumptions - In the conflict of what the therapist sees and feels - what wins
Feel!!! Always go by what you feel
Historical assumptions - As long as the therapist can locate the tightness and restriction,
the actual structure of the restriction does NOT have to be known
Treatment techniques - efficacy
Lack of research - the tx is dependent on what therapist feels
Balance clinic intuition with scientific scrutiny
Treatment techniques - Sequencing - where to perform
Perform myofascial tx in involved and regional areas of involvement - pain area might not be the problem area
Treatment techniques - Sequencing - myofascial before or after joint mobs
Treating myofascial tissues before joint mobs allows joint mobs to be applied with less force
Treatment techniques - Sequencing - direct vs indirect
Direct before indirect techniques
Treatment techniques - Sequencing - Superficial vs deep
Superficial to deep
Treatment techniques - Sequencing - what is the sequence
Myofascial techniques Joint mobility Stretching after joint and myofascial Neuromuscular re-ed Postural instructions
What is a release - descriptors
Melting
fluttering
resulting autonomic response - heat or cold
What is a release - end feel
Soft rubbery quality
Calm sensation of relaxation
Inherent tissue motion stops guiding the therapists hand when no further tightness or restrictions are present
What is a release - Sensation that
no unnecessary tension is present in the tissue
What is a release - might see
Psychological release of emotion
Where do you release
Anywhere that has decreased myofascial mobility
How do you do a release?
Take up slack POET3 Stretch or hold until release occurs Take up new slack and hold - repeat Need quiet and be attentive to sensory feedback Your hands guide you
What directions do you release
Traction
Twist
Compressive
What directions do you release - Traction
CT loaded along the long axis of myofascial elements
PT hands go in opp directions
Inc tension in tissues
What directions do you release - Twist
Rotational loading into the tissues in a radial or ulnar direction
Twist will localize the traction, not only at point of contact, but also at points of distance
What directions do you release - depth of release can be seen by position of the hands - describe
The more perpendicular to the body, the deeper the release
What directions do you release - compressive
Localizes tension from superficial to deep in the fascial system
Gross releases - what is it
Releases an entire body area or mm group and is used to locate and release restrictions
Gross release - how to
One hand stabilizes, other stretches
Stretch in line with mm fibers and then move diagonally
Once released, can pick up tissue and do a vertical lift
Focused release - what is it
release of small segment within a mm using several fingers
Treatment effects usually last
24 hours, then the tx’s build on each other with repetition
Treatment - begin with
gross superficial releases and progresses deeper
Treatment - as one area releases, may not
improvement in other areas OR further restrictions in other areas
Post tx
New posturing of the body so pt may have pain
Important to follow up with strengthening, ARON in new posture
Drunk lots of water
Indications
1 Traditional PT has not helped
2 Complex, global, or specific pain that does not follow dermatomal, myotomal or visceral referral patterns
3 Underlying chronic conditions that cause tightness and restriction in soft tissue (postural asymmetries, COPD, CNS dys)
4 frequent HA stimulated by mm or joint
5 Nonlabyrinthe vertigo and dizziness secondary to active myofascial trigger points
6 Competitive athletes who need subtle stretching to inc speed/accuracy
Contraindications
1 unstable med condition 2 skin inflammation - dermatitis 3 contagious skin disease 4 wounds, fracture, infections, tumors, CA 5 psych impairments
Contraindications - psych impairments includes
Lack of boundaries Does not tolerate physical contact Does not trust PT Cog impaired PT not comfortable with pt
Precautions
May lower BP - let rest supine or prone post tx and stand close when they sit up or change position
May lower blood sugar
Cautious in those with impaired circulation
Cautious with those who are on blood thinners
Two dx that we often treat with MRF
Fibromyalgia
Myofascial pain syndrome
Two dx that we often treat with MRF - Fibromyalgia - describe
Altered nociception Sleep disturbances Depression Ex seems to worsen condition Tender points Multisystem dysfunction
Two dx that we often treat with MRF - Myofascial pain syndrome - describe
Priamry issue or secondary to systemic disease
Mechanical dysfunction with multp. trigger points
Activation of trigger points can cause autonomic response
Trigger points may cause diminished ROM and strength
