NMT Flashcards
Focus of NMT
Somatic Dysfunction
impaired or altered function of related components of the somatic (body framework) system
Manipulable Lesion
any impaired or altered aspect of the somatic, visceral, craniosacral or energetic system for which a known manual intervention is indicated to restore “normal” or homeostatic function
• associated with pathomechanical (structural) or pathophysiologic (functional) alterations of the neuromuscular system and its joints
What is the hallmark of a manipulable lesion is the somatic system?
Hallmark: the impaired or altered function has caused hypomobility (or less than optimal movement) of one or more of the components of the somatic system
Osseous Mobilization
- skilled, passive movement of bones/joints designed to restore physiologic motion
- performed by a practitioner directly moving one or both bony members of a joint in a low velocity, graded manner
- designed to stimulate mechanoreceptors, move synovial fluid and stretch the joint capsule
Joint Manipulation
• performed by using a high velocity, low amplitude thrust technique which can break adhesions in the joint capsule and release endorphins
Benefits of Manipulation
Restoration of normal physiologic motion
Nourishment of cartilage via movement of joint synovial fluid
Increased circulation of blood and lymph to surrounding tissues via reflex muscle relaxation and improved posture and breathing
Increased movement of soft tissues including increased muscle contraction
Mechanoreceptor and proprioceptor reeducation through joint movement
Breaking adhesions in the joint capsule and ligaments
Pain control through stimulation of joint movement
Release of endorphins
Strain/Counterstrain (Positional Release)
The most gentle effective technique; an Indirect Manual Therapy Technique
• an indirect method of treating joint dysfunction
by easing the residual strain in the neuromuscular mechanism
• indirect technique because it does not directly engage a barrier to motion and move against it
• the practitioner does not necessarily directly touch the joint
• the practitioner passively places the patient’s
body part in a position of ease while the patient relaxes
• the practitioner monitors the results of the treatment and then, after 90 seconds, slowly returns the body part to it’s neutral position
• this helps re-educate the neuromuscular system, relieve somatic dysfunctions and joint dysfunction
An Indirect Manual Therapy Techniques
• a form of positional release, performed passively by the practitioner
• involves relaxation of the paraspinal muscles
• example … gently rotate a vertebra from its spinous process to release tension in the intersegmental muscles
Direct Manual Therapy Techniques
Muscle Energy Technique (MET) …
moving bones by asking the patient to contract the correct muscle to cause correction in the joint; requires work from the patient
• a direct technique involving muscle contraction
and relaxation designed to move bone and restore alignment and/or joint motion
• a good alternative when contraindications to osseous manipulation exist … e.g., Rheumatoid Arthritis or Osteoporosis
• also assists in neuromuscular reeducation
• this form of treatment requires specific positioning of the patient often similar to that of manipulation
• the patient is instructed to contract their muscles (muscle energy) and resist the movements of the doctor
Type of Muscle Energy Technique (MET) Contractions
- eccentric … contraction while lengthening
- concentric … contractions while shortening
- isometric … contractions without movement
Myofascial Release (MFR)
• a direct technique that effects myofascial tissue and the neural and vascular structures running through it
• the doctor feels the patient’s inherent tissue motion and then provides sustained pressure into the myofascial restrictions to eliminate pain and restore motion
- MFR is also capable of freeing hypomobile joints by reducing tension of the myofascial structures associated with them
Myofascial Release Methods
• Direct method … finding a tissue tension barrier and gently moving the myofascial tissue against and through the barrier
• Indirect method … amplifying the inherent tissue motion,
thus “unwinding” the restrictions
