P6 - Pain Management of the Shoulder Flashcards
What are the two types of movements in a joint?
1) Physiological movements (osteokinematic) from muscle contractions, and
2) Accessory movements between articulating joint surfaces.
What are examples of physiological movements?
Flexion, Extension, Abduction, Adduction, Internal Rotation, External Rotation.
What are examples of accessory movements in a joint?
Spin, Roll, Glide, Distraction, Compression.
What is the importance of accessory movements in joint function?
They are essential for full-range physiological movement. Without normal accessory motion, normal physiologic movements will not occur.
What can cause loss of movement following joint injury?
Loss of movement may result from contracture of inert connective tissue (e.g., ligaments, joint capsule) or resistance of contractile tissues (e.g., muscles, tendons, fascia).
Can accessory movements occur independently from physiological movements?
No, accessory movements accompany physiological movements and cannot occur independently.
Why is it important for the joint to move freely during rehabilitation?
A muscle cannot be fully rehabilitated if the joint is not free to move, and vice versa.
What is the purpose of Maitland Grades?
Maitland Grades are used to classify the intensity of mobilization techniques in manual therapy for joint pain and stiffness.
Describe Maitland Grade I mobilization.
Small amplitude rhythmic oscillation in the early range of movement, typically used for pain modulation.
Describe Maitland Grade II mobilization.
Large amplitude rhythmic oscillation in the mid-range of movement, used for pain relief.
Describe Maitland Grade III mobilization.
Large amplitude rhythmic oscillation to the point of limitation in the range of movement, aimed at increasing mobility.
Describe Maitland Grade IV mobilization.
Small amplitude rhythmic oscillation at the end of the available range of movement, typically used to improve joint stiffness.
Describe Maitland Grade V mobilization (Thrust Manipulation).
A small amplitude, quick thrust at the end of the available range of movement, often used for stiff joints.
What are some contraindications to manual therapy?
Osteoporosis, fractures, inflammatory conditions (RA/AS), DVT, neurological instability, hypermobility, pregnancy, clotting disorders, malignancy, lack of consent.
List some precautions when applying manual therapy.
Fragile skin, incompletely healed scars, calcified soft tissue, skin grafts, inflamed tissue, osteoporosis, joint instability, pregnancy.
What is the goal of manual therapy in rehabilitation?
To increase ROM, reduce pain, prevent contractures, maintain soft tissue integrity, increase venous circulation, improve synovial fluid production, and enhance kinaesthetic awareness.
How does manual therapy help reduce pain?
Manual therapy initiates neurophysiological responses in the peripheral and central nervous systems, modulating pain through the Pain Gate mechanism.
How can you explain manual therapy’s pain modulation to a patient?
It is like taking ibuprofen for temporary pain relief; manual therapy provides short-term relief, allowing the patient to incorporate exercise for long-term benefits.
