Soft Tissue

Question 1

trigger point technique

Answer 1

finger applies force

Question 2

tender point technique

Answer 2

palpating hand and a force hand (strain-counterstrain)

Question 3

trigger point=

Answer 3

a myofascial trigger point (TrP) is a hyperirritable locus within a taut band of skeletal muscle, located in the muscular tissue or its associated fascia
-myofascial pain is referred from TrP’s in specific patterns characteristic of each muscle

classified as ACTIVE or LATENT

can be a primary problem- occurring in the absence of another condition
OR
a co-morbid condition (OA, whiplash)

autonomic changes may be seen in the presence of TrP’s: diaphoresis, vasoconstriction…
may also see changes in proprioception

Question 4

active trigger point

Answer 4

causes the patient pain

vary in irritability from hour to hour and day to day

develop habits of guarding that limit movement of the affected muscle

Question 5

latent trigger point

Answer 5

clinically silen with regards to pain, but can cause restriction of movement and weakness of the affect muscle. it predisposes muscle to acute attacks of pain years after “healing” of original healing occurs

Question 6

trigger points are activated by:

Answer 6

• acute overload (specific event or movement)
• overwork fatique (repetitive or sustained contractions)
• direct trauma and chilling?
• indirectly by other TrP’s (synergistic muscles that are chronically overloaded by the first affected muscle)
• visceral disease
• arthritic joints
• emotional distress

Question 7

factors for latent to active TrP:

Answer 7

• leaving a muscle shortened for prolonged periods (such as sleeping)
• chilling the muscle, during or after viral infection

Question 8

myofascial trigger points

Answer 8

a history of sudden onset during or shortly following acute overload stress, or history of gradual onset w/ chronic overload of the affected muscle
-characteristic patterns of pain that are specific to individual muscles

Question 9

TrP signs

Answer 9

• weakness and restriction in stretch of the affected muscle
• a taut palpable band in the affected muscle
• exquisite, focal tenderness to digital pressure
• a local twitch response elicited through snapping palpation or dry needling of the TrP
• reproduction of the patient’s pain by pressure on the tender spot
• elimination of symptoms through therapy directed specifically to the affected muscles

single or multiple
may occur in any skeletal muscle
may cause a specific referred pain pattern
more focal

Question 10

treatment of TrPs

Answer 10

goal is to inactivate the TrP, therefore decreasing or eliminating the local and referred pain associated w/ the TrP

manual techniques

needling w/ or w/out injection of medication
dry needling= needling w/out injection

Question 11

tender points

Answer 11

local tenderness
multiple

occur in specific locations that are symmetrically located

do not cause referred pain, but often cause a total body increase in pain sensitivity

Question 12

gamma motor neuron

Answer 12

sends info to CNS; gives/gets feedback that influences length of muscle

*a patient with tender/trigger points/spasm– we want to reduce the gamma MNs to diminish the amount of input from the spindle by putting the muscle on slack (reflexive relaxation)–>stops spasm–> increases flexibility

Question 13

alpha motor neuron

Answer 13

extra-fusal fibers

sends info from CNS to muscle (movement)

Question 14

RPP

Answer 14

referred pain pattern

Question 15

MFS

Answer 15

myofascial stretch

Question 16

PSS

Answer 16

positive stress sign