Soft Tissue & MFR Techniques Lecture Flashcards
What does soft tissue entail?
Fascia, muscles, organs, nerves, vasculature, lymphatic tissue
What is Fascia? What is NOT fascia?
It is a complete system with blood supply, fluid drainage, and innervations which is composed of irregularly arranged fibrous elements of varying density which is all involved in tissue protection and healing of surrounding systems.
It is NOT tendons, ligaments, or aponeuroses
What are the 4 fascial layers?
Pannicular fascia, axial and appendicular fascia, meningeal fascia, and visceral fascia
What is pannicular fascia?
The outermost layer of fascia derived from somatic mesenchymal and surrounds entire body with exception of the orifices
the outer layer is adipose tissue and the inner layer is membranous and is generally adherent to the outer portion
What is Axial and appendicular fascia?
It is internal to the pannicular layer and is fused to the panniculus
It surrounds all of the muscles, periosteum of bone, and peritendon of tendons
What is meningeal fascia?
It surrounds the nervous system, including the dura
What is visceral fascia?
Surrounds the body cavities (i.e. pleural, pericardial, and peritoneum)
What is viscoelastic material?
Any material that deforms according to rate of loading and deformity
What is stress vs. strain?
Stress is the force that attempts to deform a connective tissue structure
Strain is the percentage of deformation of a connective tissue
(during cyclic loading of tendon, the stress-strain curve gradually shifts to the right)
What is hysteresis?
The energy lost in the connective tissue system between loading and unloading the tendon
What is creep?
Connective tissue under a sustained, constant load (below failure threshold) which will elongate (deform) in response to the load
What is ease?
The direction in which the connective tissue may be moved most easily during deformational stretching
What is bind?
A palpable restriction of connective tissue mobility
What is the concept of a “fascial sweater” or fascial continuity?
Fascial restrictions in one area of the body, will create connective tissue restrictions (pulls) at a distance away from the site of the initial restriction
If you pull at one corner, it can affect different regions, like pulling on a sweater
What is Newton’s Third Law?
When 2 bodies interact, the force exerted by one is equal in magnitude and opposite in direction to the forces exerted by the other
What is Hooke’s Law?
The strain (deformation) placed on an elastic body is in proportion to the stress (force) placed upon it.
What is Wolff’s Law?
Bone will develop according to the stresses placed upon it
[applies to fascia too]
What is Sherrington’s Law?
When a muscle receives a nerve impulse to contract, its antagonists receive, simultaneously, an impulse to relax
What is a common compensatory pattern?
80% of healthy people have it
L/R/L/R
Head and neck compensates toward the left, shoulder and arm compensates to the right, chest and waist compensate to the left, and hip and leg compensate to the right
What is an uncommon compensatory pattern?
20% of healthy people have it
R/L/R/L
Head and neck compensate to the right, shoulder and arm compensate to the left, chest and waist compensate to the right, and hip and leg compensate to the left
What is an uncompensated pattern?
It is usually symptomatic and had a trauma involved
Anything that is not part of the RLRL or LRLR schema
What are the 4 transition zones of the spine?
OA, C1, C2
C7, T1
T12, L1
L5 and sacrum
What are the transverse restrictors?
Tentorium Cerebelli, Thoracic Inlet, Thoracolumbar diaphragm, and the pelvic diaphragm
What are ST Relative contraindications?
Severe osteoporosis cannot have prone pressure techniques in the thoracocostal region, but lateral recumbent techniques are fine.
Acute injuries cannot have direct techniques that stretch acutely injury muscles, tendons, ligaments, or joint capsules
What are ST Absolute contraindications?
Fracture/dislocation, neurologic entrapment syndromes, serious vascular compromise, local malignancy, local infection, or bleeding disorders
What kind of traction is stretching vs kneading?
Parallel vs perpendicular, respectively
What is Myofascial Release (MFR)?
A system of diagnosis and treatment first described by A.T. Still and his early students, which engages continual palpatory feedback to achieve release of myofascial tissues.
What is Integrated Neuromusculoskeletal Release (INR)?
A treatment system in which combined procedures are designed to stretch and reflexively released patterned soft tissue and joint related restrictions
What are some examples of REMs?
Breath holding, prone and supine simulated swimming, prone and supine pendulum arm swing maneuvers, R/L cervical rotation, Isometric limb and neck movements against the table/chair, and patient evoked movement from cranial nerves (eye, tongue, jaw, oropharynx)
What are some indications for MFR?
Somatic dysfunction, when you can’t use HVLA or muscle energy, and when counterstrain may be difficult secondary to pt’s inability to relax
What are relative contraindications of MFR?
Infection of soft tissue or bone, fracture/avulsion/dislocation, metastatic disease, soft tissue injuries (thermal, hematoma, or open wounds), post-op patient with wound dehiscence, rheumatologic condition involving instability of C-spine, or DVT/anti-coag therapy
What are Absolute contraindications of MFR?
Lack of patient consent and absence of somatic dysfunction
