MFR Techniques Flashcards
Cervical Traction
1) Cradle occiput and chin
2) Apply axial cephalad traction slowly and rhythmically, with gradual increasing amplitudes
3) Continue until desired soft tissue or disc response
4) recheck
C-Spine: Bilateral Forearm Fulcrum Forward Bending
Arms are crossed under patient’s head and hands placed palm down on patient’s shoulders
Repetitively flex patients neck, giving a longitudinal stretch of the paravertebral muscles
Repeat for 203 minutes or until desired effect is achieved
Re-evaluate for TART
C-Spine: Unilateral Forearm Fulcrum Forward Bending
Contract patient shoulder with one hand and use the same arm to cradle patients occiput
Repetitively flex the patients c-spine, stretching the desired muscle by moving the forearm anteriorly for 1-2 seconds
Repeat for 2-3 minutes or until desire defect is achieved
Re-evaluate for TART improvement
C-Spine: Contralateral Traction, Supine
Caudad hand reached across with finger pads medial to the cervical paravertebral muscles on side opposite of where you are standing
Superior hand rests on patient’s forehead to stabilize head preventing rotation
Engage tissue with anterolateral force thru you finger pads creating a perpendicular stretch to the cervical paraspinal muscles
C-Spine: Cradling with Traction, Supine
Fingers placed under patient’s neck bilaterally on paraspinal muscles, just lateral to the spinous process
Engage soft tissue with anterior and lateral force
Longitudinal traction exerted by moving cephalad along the soft tissues
Head and C-Spine: Suboccipital Release
Finger pads are placed in the suboccipital region
Apply anterosuperior pressure
- kneading: pressure may be slowly and rhythmically applied until tissue texture changes occur of for 2 min
- Inhibition: apply a constant inhibitory pressure for 30 sec-1 min
Thoracic: Prone Pressure
Place thumb pads medial to the side opposite to the one you are standing
Keeping you elbows straight-ish and using you own body weight, engage soft tissues with a ventrolateral force creating a perpendicular stretch
Thoracic: Prone Pressure with Counterpressure
Place thenar eminence and thumb of caudad hand over the thoracic paravertebral muscles opposite the side you are standing
Place hypothenar eminence of cephalad hand on paravertebral muscles on the same side you are standing
Engage tissue with a ventral force and then move your hands in direction in which they are facing
Thoracic: Subscapular Stretch
Take patient’s arm, on the side being treated, and placed it behind their back
Place fingers around medial border of scapula
Engage the tissue ventrally then give gentle and upward traction, pulling scapula away from rib cage
Upper Thoracic w/Shoulder Block
Standing at side of table facing patient
Inferior hand passes under patients arm and contacts paravertebral muscles
Superior hand contacts anterior portion of shoulder to give counterforce. Drape patient’s arm over your arm
Thoracic and Lumbar MFR
Finger pads placed on paravertebral muscles, lateral to the spinous processes
Engage muscle with ventrolateral force to induce a perpendicular stretch
Lumbar: Prone Pressure
Place thenar and hypothenar eminence on paravertebral muscles opposite the side you are standing
Place other hand on top of hand contacting the muscles
Keeping your elbows straight and using own body weight, engaging soft tissues with a ventral force and move out laterally creating a perpendicular stretch
Lumbar: Prone Pressure with Counterleverage
Using Inferior hand, grasp ASIS on other side of patient
Place thenar and hypothenar eminence of superior hand on the paraspinal muscles
Pull posteriorly on the ASIS and apply anterlateral pressure on lumbar paraspinal muscles in a repetitive rhythmic fashion holding the stretch for 1-2 seconds
Treat the tighter portions of the muscles and move after the muscle release
Lumbar: Paraspinal Perpendicular Stretch
At side of table facing patient, reach over patient’s back and place finger pads on the paravertebral muscles
Engage tissues with a ventral force and mover out laterally to create a perpendicular stretch
Hip Myofascial Release
Flex hip and the knee to 90 degrees, and test internal rotation and external rotation to determine direction or laxity and restriction
Indirect: Move the hip to its position of laxity, apply compression or traction along the femur to facilitate laity and follow any tissue release until tissue release is perceived
Direct: Move the hip into its restrictive barrier and apply compression or traction until tissue release is perceived
Superior Popliteal Space/Hamstring MFR
Use your finger pad on either side of the superior aspect of the popliteal space and introduce a spreading force to load the fascia
Test directions
Engage the barriers stacking either indirectly or directly
Use REMs to induce a release
Follow the release until there is no more creep of the tissue
Direct/Indirect Thoracolumbar MFR
Hands on either side of T/L junction
Introduce myofacial stress, clockwise rotation of right hand and counterclockwise rotation of left hand
Engage Barriers
Perform REM
Prone Regional Thoracic Direct or Indirect MFR
Hands on bilateral sides of thoracic spine
Put area under myofascial stress, clockwise rotation of right hand and counterclockwise rotation of left hand
Engage barriers
Lower Thoracic Under the Shoulder (Lateral Recumbent)
Forearms contacting the axilla and the iliac crest, fingers contact medial aspect of the erector spinae
Elbows spread apart, elongating distance between the shoulder and the hip
Traction the paraspinal muscles laterally
The patient breaths deeply as the activating force
Seated Paraspinal Lumbar Soft Tissue
Palm on medial aspect of erector spinae muscles, other hand grasps ipsilateral shoulder
In repetitive, fluid motion, apply force anteriorly and laterally while depressing and translating the erector spinae laterally until tissue response
MFR: Lumbosacral Region
Place one hand over the inferior lumbar segment and the other hand over the superior lumbar segment
Monitor inferior and superior glide, left and right motion and clockwise and counterclockwise motion. noting the direction of ease of motion or restriction of motion
Direct /Indirect Lumbosacral MFR
One hand at the L/S junction
Other hand over the superior lumbar vertebrae
Engage the barriers
Fascial Release Technique: Prone-sacral release
Hand placed on top each other covering the sacrum
Engage Barriers
Activating Force
Hamstring Hypertonicity SD and MFR
Patient supine. Stabilize at contralateral ASIS with one hand. Other hand grasps leg above ankle and flexes at hip until a fascial barrier is reached
Patient is instructed to push leg downward toward floor against resistance
ITB Syndrome (Prone)
Use caudad hand to grab foot or ankle, flex knee to 90n
Cephalad hand will contact lateral thigh
Push the foot and lower leg out laterally while simultaneously engaging the IT band by compressing cephalad hand into patients IT band and pulling posteromedially
ITB Syndrome (Lateral Recumbent)
Stand facing the front of the patient
stabilize patient by placing cephalad hand on the posterolateral aspect of iliac crest
Engage tissue giving a slight downward pressure into IT band and slide fist proximally towards the greater trochanter region. Then move proximal to distal
Knee MFR/INR
With your move superior hand, grasp distal femur and stabilize it
With your more inferior hand grasp the proximal tibia/fibula and use it as a lever to examine the knee for 3D tightness and looseness
Passively twist th edistal LE in Ir/ER to treat with direct/indirect MFR
Knee Myofascial Release
Grasp the proximal leg with your thumbs on the tibial plateau an dhold th efoot between you rknees
Move the tibia into anterior-posterior glide, medial-lateral glide, and internal-external rotation to determine directions of laxity and restriction;
Indirect: slowly move the tibia to its positions of laxity and follow any tissue release until completed
Direct: Slowly move the tibia into its restrictions and maintain constant force until tissue give is completed
Retest tibial or knee motion is successful and tolerated, consider prescribing hamstring position of ease or hamstring stretch
Indirect Myofascial Release of the Sprained Ankle
Use your finger pads of your most superior hand to monitor fascial milieu of either individual ligaments or any kind of combination that you can palpate
Use your inferior/distal hand on the forefoot to introduce
the engage as many indirect barriers as possible and use inherent mechanisms to release the fascia
Follow the release until there is no more creep of the tissue
Plantar Fascia, Longitudinal Stretch
Stabilize foot by placing hand over dorsum of foot
Make a closed fist with your other hand and contact sole of Patients foot just proximal to metatarsal heads
Exert moderate pressure and move fist distal to proximal rolling the fist as you move the fist
Plantar Fascia MFR
The patient lies supine, and the physician sits at the foot of the table
The physician’s thumbs are crossed, making an X, with the thumb pads over the area of concern (Tarsal to distal metatarsal) at the plantar fascia
The thumbs impart an inward force that is vectored distal and lateral. This pressure is continued until the restrictive barrier is met
The pressure is held until a release is palpated
This is repeated with the foot alternately attempting plantar flexion and dosiflextion
Upper Limb and Shoulder MFR
Grasp the humeral head of the prone patient whose arm is dangling from the table
Monitor the tissues for tissue texture response to the following motions introduced thru the humeral head
Choose to engage either for direct or indirect MFR-REMS used
Follow the release until there is no more creep of the tissue
Thoracics: Lateral Stretch, Rhomboid Region
Inferior hand loops beneath axilla and grasps inferior portion of medial scapular border
Superior hand grasps superior border of medial scapula
Apply lateral traction to scapula for 1-2 sec. in repetitive rhythmic manner
Elbow MFR
Hold the patients hand with one hand and the proximal radius and ulna with you other hand
Test elbow flexion-extension and forearm supination-pronation to determine directions of laxity and restriction
Indirect: gently and slowly move the elbow to its position laxity, apply compression or traction between your hand to facilitate laxity, and follow tissue release until it is complete
Direct: Slowly move the elbow into its restriction and apply steady force until tissue give is compeleted
Still’s Wrist MFR
Grasp carpal bones with thenar eminences
Test the following motions: Flexion/extension, ulnar/radial deviation
Stack restrictive barriers
Instruct patient to make a fist and/or spread fingers widely for 5 sec and then relax hand
Engage next restrictive barrier and repeat steps 2-4 until no new restrictive barriers are encountered
