Second Year Fall Flashcards
What is Dr. Jones’ theory about Counterstrain?
Gamma system was responsible for inappropritate procprioceptive reflex leading to hypertonic myofascial tissue and restricted motion (Tender point)
What are the contraindications for counterstrain
Inability to relax and/or maintain positiion
What are the steps to performing counterstrain?
- Find tender point
- Position for tx that reduces pain by 70%
- Hold for 90 seconds
- Return to neutral
- Retest
How can you differentiate trigger points from tender points?
- Trigger points radiate, tender points dont
- Trigger points are only found in muscle
- Tender points dont cause a twitch response
Discuss Posterior Thorax and Lumbar tenderpoints
Tx: E SARA
On spinous or transverse processes
Where are the Anterior Thorax tenderpoints? Treatment?
AT1= Apex of Sternal notch
AT2= Angle of Louis
AT3-6= On sternum at corresponding costal level
Tx: Flex and IR arm
Where are the Anterior Lumbar Points?
AL1 = Medial to ASIS AL2= Medial to AIIS AL3= Lateral to AIIS AL4 = Inferior to AIIS AL5 = Anterior pubic ramus
Where are the Anterior Cervical tenderpoints?
AC1= Posterior surface of ascending ramus of jaw AC2-6= Transverse process AC7= Sternal SCM attachment AC8= Clavicular SCM attachment
Where are the Posterior Cervical tenderpoints?
PC1= 2 cm below inion PC2 = Semispinalis PC3-8 = Inferior aspect of spinous process
Where are the Anterior Rib tenderpoints?
AR1=Just below medial end of Clavicle
AR2 = Superior aspect of second rib at midclavicular line
AR3-7 = Superior aspect of rib along anterior axillary line
Where are the two Hip tender points? Treatment?
- Tensor Fascia Lata = Inferior to the iliac crest in the body of the TFL (FAB)
- IT band = Below trochanter on lateral side of femur (FABE/IR)
Treatments for tender points on the knee
Md Meniscus: FADIR (tibia)
Lt Meniscus: FABE/IR
ACL: Push tibia postieriorly on femur
PCL: Push femur posteriorly on tibia
Where are the tender points for the ACL and PCL?
ACL: Superior aspect of popliteal fossa on hamstring tendon
PCL: Center or slightly inferior aspect of popliteal fossa
Where are the tender points on the ankle?
- Md ankle: 2 cm inferior to md malleolus along deltoid ligament (Inv, IR, dorsiflex)
- Lt ankle: Inferior 3 cm, anterior to lt malleolus (Ev,ER,plantar flex)
- Flexed ankle: Anterior aspect of the calcaneus at the attachment of the plantar fascia (Flex)
- Extended ankle: Proximal aspect of calf, inf to popliteal fossa (Plantar flex)
How do you treat SC joint abduction using MET?
Lying supine, pt extends arm off the table, Lift arm towards ceiling against resistance.
Discuss elbow tx
Restricted extension = Post isometric relaxation of biceps contraction
Restricted flexion = Concentric isotonic triceps contractions
Supination = external rotation
Pronation = Internal rotation
If you put a patients legs into adduction, which muscles are tested?
Abductors: Glut medius, minimus, TFL
If you put a pts legs in internal rotation with hips in neutral, which muscles are tested?
external rotators: obturators, gemellus, quadratus, piriformis
If you put a pts legs in external rotation with hips in neutral, which muscles are tested?
internal rotators: Glut medius, minimus
If straight leg raised (hip flexion), muscles tested?
Hip extensors: Hamstrings, glut max, adductor magnus
If hip extension, muscles tested?
Hip flexors: Iliopsoas, rectus femoris, Thomas position
If knee flexion, muscles tested?
quads
MET for anterior fibula
Inv the foot, ER the foot have patient plantar flex
MET for posterior fibula
Inv the foot, IR the foot, have patient dorsiflex
