Myofascial release (kania )

Question 1

what is stress

Answer 1

force normalized over the area on which it acts.

Normal stress is perpendicular to the cross-section

sheer stress is parallel.

Question 2

what is stiffness

Answer 2

the ratio of load to the deformation/strain it causes the “tight” concept

Question 3

what is creep

Answer 3

the continued deformation (increasing strain) of a viscoelastic material under constant load over time

release of stored kinetic energy

solid material moving slowlly and deforming permanately under the stress placed upon it.

ice flowing despite being frozen

Question 4

what is compliance

Answer 4

the inverse of stiffness “the loose concept”

Question 5

what is hysteresis

Answer 5

a time lag in the occurrence of two associated phenomena, as between cause and effect; change in energy content

it is the energy lost when the energy returned is not equal to the energy stored and represents residual strain

so when you stretch down to touch your toes you can get farther each time and the longer you hold it

Question 6

what is strain

Answer 6

change in shape due to stress

Question 7

what is fascia

Answer 7

fibrous CT masses that bind together the structures of the body

Question 8

what are GAG’s and their function

Answer 8

glycosaminoglycans

generated from fibrocytes in response to motion

HYDROPHILIC (water loving) and determine the relative fluid content of connective tissue

more GAGs = more H20 binds to them so this makes the tissues less stiff

Question 9

what is the function of fascia?

Answer 9

packaging
protection- stabilize structures and establish limits of motion
posturing - contain proprioceptors that sense movement
passageways - for arteries, vv’s, nn’s, lymphatics

Question 10

where does 75 percent of proprioception occur? and the remaining 25 percent?

Answer 10

in fascial sheaths - so this is why we might treat fascia to improve proprioception

remaining 25 percent occurs in ligaments, tendons, joint capsules and muscle spindle activity

Question 11

what does joint immobilization or long periods of decreased motion enable the formation of?

Answer 11

increased collagen crosslinks causing myofascial connective tissue stiffness

**myofascial adaptations accompany the articular and periarticular motion restrictions and muscle imbalance

Question 12

in what orientation is normal stress?

Answer 12

perpendicular to the cross section

Question 13

in what orientation is sheer stress?

Answer 13

parallel to the cross-section

Question 14

what is wolff’s law

Answer 14

bones (and soft tissue) tend to deform along the lines of force placed on them.

Question 15

what is hooke’s law?

Answer 15

any strain/deformation placed on an elastic body is in proportion to the stress placed on it

Question 16

what is newton’s third law>

Answer 16

when 2 bodies interact, the force exerted by the first on the second is equal in magnitude and opposite in direction to the force exerted by the second body on the first body.

Question 17

what is pascal’s law

Answer 17

pressure applied to a liquid at rest from any point is transmitted equally in all directions.

Question 18

external forces applied to fascia facilitate …

Answer 18

restoration of normal structure and function

Question 19

what is elastic material

Answer 19

The amount of deformation is the same for a given amount of stress
Material returns to its original length or conformation when the stress is removed

Question 20

what is viscoelastic material?

Answer 20

Nonlinear properties due to the viscous nature
Magnitude of stress applied is dependent on the rate of loading
Stored mechanical energy not completely returned once stress removed (hysteresis)

Question 21

both elastic and viscoelastic materials can be….

Answer 21

stiff, compliant, and brittle

Question 22

what is the area under the curve of a stress vs. strain graph

Answer 22

stored mechanical or kinetic energy

think of jumping on a trampoline
the difference of that position compared to the unstrained position represents stored mechanical energy

Question 23

stress- strain curve of a viscoelastic material. what does the slope of the curve mean?

Answer 23

slope represents the stiffness of a substance

Applying force to the substance prior to reaching the yield point allows elastic strain = the material can return to its original position without deformation.

Surpassing the yield point leads to plastic deformation = molecular components are permanently displaced.

example would be taking a credit card and bending it too far

Question 24

what is residual strain in a stress vs. strain graph

Answer 24

the residual strain occurs due to reorganization at a molecular level after stress has been applied

removed stress and it doesn’t come back along the same line b/c it has been deformed

Question 25

if elastic and plastic zones are exceeded the imparted energy is released as a

Answer 25

FRACTURE oh shit Bone needs strength to be weight-bearing and flexibility to absorb high-impact forces by changing shape without failing and then return to its normal length.

Question 26

bone is ...

Answer 26

a viscoelastic substance weight bearing and flexible

Question 27

what is the mechanical plastic model (viscous model)

Answer 27

apply tensile force | now have changed post load (deformed)

Question 28

what is an elastic mechanical model

Answer 28

pre load and post load look the same! nothing changed, went back to normal

Question 29

viscoelastic model mechanical model?

Answer 29

preload is loaded with tensile force some goes back to how it was (the spring) and some is deformed so some elongation is lost and some is retained after the application of tensile force this is an example of creep

Question 30

what is the tight/loose concept

Answer 30

Pain is typically at loose sites as muscles are usually weak and inhibited Tight areas are frequently tethered Looseness suggests joint or soft tissue laxity so if your left knee gets tight your left ankle would be loose

Question 31

big bandage of fascial continuum model

Answer 31

Emphasizes the fascia Uses the integrity of the fascial continuum to treat proximal to distal fulcrum with leverage torsion and traction respiratory assistance reflexive neurologic reset

Question 32

DEEP fascial lines

Answer 32

deep fascia in the thigh that becomes contiguous with the deep fascia of the pelvis to the torso/abdomen/thorax the entry point at the ankle allows one to pick up the IOM and continue deeply into the pelvis and thorax

Question 33

Bioenergetic model

Answer 33

O'connell Piezoelectric model What accounts for the change in energy content? (hysteresis) Collagen is a Piezoelectric substance in bone and has been shown to affect growth/remodeling of bone Negative charge stimulates osteoblasts Positive charge stimulates osteoclasts Mechanical tension creates bioelectric current changes that guide the orientation of fibrin and collagen.

Question 34

what is piezoelectricity>

Answer 34

Piezoelectricity is current that is produce by the transformation of mechanical stress to electrical energy. Piezoelectric substances act as transducers and are able to discharge electrical current when physically stressed.

Question 35

what is palpatory diagnosis

Answer 35

high-level haptic skill (motor and sensory aspects of hand activities)

Question 36

what are the MFR indications ?

Answer 36

Somatic dysfunctions involving myofascial or other connective tissues

Question 37

what are the goals of myofasical release?

Answer 37

relaxation of contracted muscles release tightness or tethering Decrease oxygen demand Decrease pain Normalize ROM across a joint Restore 3-D functional symmetry DON"T AGGRAVATE HYPERMOBILITY don't make things looser Increased circulation to area of ischemia Increase venous drainage and lymphatic drainage

Question 38

complications of MFR

Answer 38

Exceeding the limits of dysfunctional and injured tissue creates iatrogenic trauma layered on top of the somatic dysfunction and complicates the treatment and healing. Temporary worsening of symptoms may occur the first day or two typical of post-exercise muscle soreness. Older aged or debilitated patients, inflammatory conditions (auto-immune diseases, rheumatic conditions, fibromyalgia) are likely to experience post-OMT flare-ups. Drinking more water, resting, soaking in a hot bath can help.

Question 39

what are the absolute contraindications of MFR

Answer 39

Absence of somatic dysfunction | Lack of patient consent and/or cooperation

Question 40

what are the relative MFR contraindications

Answer 40

``` Fractures open wounds, acute thermal injury soft tissue or bony infections deep venous thrombosis (threat of embolism) disseminated or focal neoplasm recent post-operative states over the site of proposed treatment (wound dehiscence) aortic aneurysm ```

Question 41

how do you do MFR

Answer 41

Technique is a procedure that utilizes a position, method and an activating force. Static and dynamic movement barriers are released as they are encountered by sequentially loading areas of tightness using compression, traction and twisting

Question 42

what is direct MFR

Answer 42

a myofascial tissue RESTRICTIVE BARRIER IS ENGAGED for the myofascial tissues and the tissue is loaded with a constant force until tissue release occurs. Identifies the restrictive barrier in all planes. Brings the body to the restrictive barrier and applies a corrective force (traction, compression, twist, may also utilize: Respiratory cooperation in the phase which encourages tissue tension Tissue inhibition Oscillation Eye, tongue, jaw, head or limb movements

Question 43

what is indirect MFR

Answer 43

the dysfunctional tissues are guided along the path of least resistance until free movement is achieved. Identifies the position of free motion in all planes = neutral. Brings the body to the neutral place and waits for the body to initiate the corrective action. may also use: Regional compression, distraction, or torsion Tissue inhibition or traction Respiratory cooperation in the phase which encourages tissue relaxation Eye, tongue, jaw, head or limb movements

Question 44

objectives

Answer 44

2. Describe the difference between elastic and visco-elastic material. 3. Know the different models of myofascial systems. 4. Describe the different force effects on fascia. 5. Describe the myofascial mechanisms of action. 6. Describe the effects of mechanical deformation on fascia. 7. Discuss the tight-loose concept.

Question 45

objectives

Answer 45

2. Describe the difference between elastic and visco-elastic material. 3. Know the different models of myofascial systems. 4. Describe the different force effects on fascia. 5. Describe the myofascial mechanisms of action. 6. Describe the effects of mechanical deformation on fascia. 7. Discuss the tight-loose concept.

Question 46

what are the absolute contraindications for doing myofascial release

Answer 46

``` absence of SD lack of patient consent acute fractures open wounds dermatitis (inflammatory or infectious) acute thermal injury ```

Question 47

how long do you hold the patient in the position of ease or restriction

Answer 47

until you feel a release