MFR 2 Flashcards by Alex Stein

Concept of fascia

It is everywhere! It connects the entire body

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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!

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Basic principles - Tx with MFR will affect

the treated area and distal body areas

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Basic principles - Release of tightness and restrictions can affect

other body organs through a reflexive relaxation of tension transmitted through fascial system

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Basic principles - MFR can change _____ if ____ does not have ___

Can change posture if posture does not have joint changes

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Basic principles - Progress measured through

the normal stuff - ROM, function, impairments

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Basic principles - comfort with MFR

MFR is more comfortable than other stretching techniques

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Historical assumptions - how does it work

MFR will work even though we don’t know why it works

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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

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Historical assumptions - Asymmetrical soft tissue tightness can cause

pain proximal to, or distal to the area of dysfunction

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Historical assumptions - In the conflict of what the therapist sees and feels - what wins

Feel!!! Always go by what you feel

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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

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Treatment techniques - efficacy

Lack of research - the tx is dependent on what therapist feels
Balance clinic intuition with scientific scrutiny

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Treatment techniques - Sequencing - where to perform

Perform myofascial tx in involved and regional areas of involvement - pain area might not be the problem area

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Treatment techniques - Sequencing - myofascial before or after joint mobs

Treating myofascial tissues before joint mobs allows joint mobs to be applied with less force

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Treatment techniques - Sequencing - direct vs indirect

Direct before indirect techniques

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Treatment techniques - Sequencing - Superficial vs deep

Superficial to deep

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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