Myofascial Techniques Flashcards
What is the goal of myofascial techniques?
Maintain or restore the functional capacity of the integrated myofascial network
What are some indications for myofascial work?
Restricted ROM c or w/o specific injury
Decreased power or strength
Visible scars in the area of complaint
Painful movement (passive/active) w/ or w/o specific injury
Tenderness in muscles or fascial zones w/o specific injury
Palpable thick, adhered, and/or fibrous fascia
What are the absolute contraindications for myofascial techniques?
Malignancy Cellulites Fever Systemic infections Aneurysm Lymphedema Acute RA Advanced osteoporosis Advanced diabetes Hemophilia or anticoagulant therapy Hyperesthesia/hypersensitive of skin
What are some regional contraindications for mysofascial techniques?
Sever hematoma local infection traumatic edema open wounds or fractures degenerative joint disease
What are some assessment techniques for myofascial restrictions?
Postural assessment and visual inspection
Palpation
ROM and movement assessment (muscle length tests)
Contract relax neuromuscular techniques
What are some techniques for palpation assessment?
Tissue excursion
Skin rolling
When do you use tissue excursion?
Assesses broad areas
Use both hands
Stretch tissue to it’s limit in each directions
Where do you mostly do the skin rolling technique?
Lumbosacral
Abdominal
IT band
Erector spinae
How can you tell if it’s a fascial restriction and not a neuromuscular dysfunction after a contract-relax treatment for muscle tightness?
ROM stays the same or has little improvement after stretching
What are some site-specific techniques for myofascial?
Deep Transverse Friction - applied to connective tissue (helps normalize lines of stress during tissue repair, releases histamine)
Scar Release
What is the difference between indirect and direct myofascial techniques?
Direct - applied over the area of complaint
Indirect - applied in an area outside the area of complaint
What are the guidelines for Deep Transverse Friction (DTF)?
Pain and tissue resistance
Which direction do you want to stretch the tissue in DTF?
Perpendicular to fiber alignment (breaks up cross-links and disorganized repair fibers)
How can you make DTF more effective?
No emollient
Broad strokes that stretches and separates fibers
Muscle/tendon is in relaxed position
Start perpendicular to fibers
Frequency is enough to cause permanent change (can’t do it just once)
What does DTF do and when don’t you want to do it?
Facilitates proper alignment of the repair fibers
- Shouldn’t cause sharp pain greater than 5/10
- Never use directly over edematous tissue
Do you use lubrication with a scar massage?
Small amount
What are some broad plane myofascial techniques?
Pin-and-stretch
Linear Shifts/Cross hand
Traction releases
What are linear shifts/Cross Hand Release?
Shifts and stretches in superficial fascia will be transmitted to deeper layers of tissue
How long can the linear shift/cross hand technique take?
Can take several minutes. Hold until you feel the letting go or release of the fascia
How do you perform the traction release?
- PT maintains good body mechanics
- hold extremity w/ your arms fully relaxed and extended
- Hold the patient distally (hand/foot)
- Provide traction to the extremity
- Slowly move the extremity until a barrier is felt in each plane of motion
- Hold the position until the barrier is released
- Repeat technique through the whole arc of available motion
What are macrophages?
Acts as a phagocyte
What do plasma cells do?
Produce antibodies
What are Mast Cells?
Most abundant around blood vessels. Produce these 2 chemicals
- Histamine: vasodilation and increased capillary permeability
- Heparin: Anticoagulant
What are fibroblast key for?
tissue regeneration and repair
