soft tissue mobilization

Question 1

what are some manual therapy techniques we could use?

Answer 1

Soft Tissue Mobilization
Neurodynamic mobilization techniques
Manually resisted exercise
Proprioceptive neuromuscular facilitation (PNF)
Joint mobilization
High-velocity thrust (manipulation) techniques.

Question 2

what are some soft tissue mobilization techniques we could use?

Answer 2

Massage
Instrument-Assisted Techniques
Cupping
Transverse Friction Massage
Myofascial release
Trigger point release
Strain-Counterstrain
Acupressure
Lymphatic drainage
Rolfing
Mechanical Percussion Devices
Active Release Techniques
Muscle Energy Technique

Question 3

what is massage?

Answer 3

a mechanical stimulation of the tissues by means of rhythmically applied pressure and stretching

Question 4

what is effleurage?

Answer 4

using light strokes toward the heart, contact maintained to promote relaxation

Question 5

what is Petrissage?

Answer 5

kneading manipulations that press and roll the muscles under the fingers or hands

Question 6

what is Tapotement (Percussion)?

Answer 6

rapid, alternating, brisk blows, administered with relaxed hands.

Question 7

what is vibration?

Answer 7

fine, shaking technique

Question 8

what are some indications for therapeutic massage?

Answer 8

increase coordination, decrease pain, decrease neuromuscular, excitability, stimulate circulation, facilitate healing, restore joint mobility, remove lactic acid, alleviate muscle cramps, increase blood flow, increase venous return, retard muscle atrophy, increase ROM, edema, myofascial trigger points, stretching scar tissue, adhesions, muscle spasm, myositis, bursitis, fibrositis, tendinitis, revascularization, raynaud’s disease, intermittent claudification, dysmenorrhea, headaches, migraines

Question 9

what are some contraindications for therapeutic massge?

Answer 9

arteriosclerosis, thrombosis, embolism, severe varicose veins, acute phlebitis, cellulitis, synovitis, abscesses, skin infections, cancers, acute inflammatory conditions

Question 10

what are absolute contraindications to manual therapy?

Answer 10

heres just a few (ones that were in green)
Hypersensitivity of the skin
Constant, severe pain, including pain at rest or that disturbs sleep, indicating that the condition is likely to be very irritable
Any condition that has not been fully evaluated

Question 11

what are relative contraindications to manual therapy?

Answer 11

heres just a few (ones that were in green)
Osteoporosis
pregnancy if applied to spine
steroid or antocoagulant therapy

Question 12

what are the effects of massage?

Answer 12

physiological (mechanical, reflexive) and psychological

Question 13

what are the mechanical effects on muscle of therapeutic massage?

Answer 13

increase blood flow to skeletal muscle, and thus to increase venous return
slow muscle atrophy following injury
increase the range of motion

Question 14

what are the mechanical effects on skin of therapeutic massage?

Answer 14

increase skin temperature
indirect vasomotor action
soften scar tissue

Question 15

what are the reflexive effects of therapeutic massage?

Answer 15

Pain (Gate Control Theory)
Circulation (Blood and lymph)
Metabolism (Chemical balance)

Question 16

what are the psychological effects of therapeutic massage?

Answer 16

Hands-on techniques can encourage a feeling of “being helped”
Can reduce tension/anxiety
Placebo effect (response resulting from the suggestion that something is beneficial) may complicate the measurement of outcomes of manual therapies.

Question 17

why is reassessment important for massage?

Answer 17

Reassessment is an integral part of any intervention.
The clinician must be able to gauge how effective a technique has been so that necessary modifications can be made.
The measurement selected should be related to the functional limitation that the clinician is expecting to change with the intervention.

Question 18

what is a trigger point?

Answer 18

Hyperirritable foci lying within taut bands of muscle
Often found in postural support muscles

Question 19

what is an active trigger point?

Answer 19

painful at rest, refers familiar pain

Question 20

what is a latent trigger point?

Answer 20

asymptomatic

Question 21

how is a trigger point massage perfomed?

Answer 21

he skin is moved on the trigger point
pain will diminish or subside during the treatment

Question 22

how is a transverse friction massage performed?

Answer 22

the tendon/ligament is placed on slight stretch
thumb or index finger to exert intense pressure in a direction perpendicular to the direction of the fibers being massaged
may apply ice prior to treatment for analgesic effects

Question 23

how long is the treatment time for transverse friction massage?

Answer 23

up to 10 minutes

Question 24

what are some therapeutic effects of transverse friction massage?

Answer 24

Traumatic hyperemia
Pain relief
decreasing scar tissue

Question 25

describe the therapeutic effects of traumatic hyperemia of transverse friction massage

Answer 25

Friction increases blood/lymph flow
Removes chemical irritant by-products of inflammation
Increased blood flow reduces venous congestion, decreasing edema/hydrostatic pressure on pain-sensitive structures

Question 26

describe the therapeutic effects of pain relief of transverse friction massage

Answer 26

stimulates type I and II mechanoreceptors, producing presynaptic anesthesia. (Gate Control Theory of Pain)
if the treatment is too vigorous in the acute stage, the stimulation of nociceptors will override the effect of the mechanoreceptors, causing the pain to increase.

Question 27

what are the indications for TFM?

Answer 27

acute or subacute ligament, tendon, or muscle injuries
chronically inflamed bursae
adhesions in ligament or muscle, or between tissues.
TFM also can be applied before performing a manipulation or a strong stretch to desensitize and soften the tissues.

Question 28

what are the contraindications of TFM?

Answer 28

hematomas
debilitated or open skin
peripheral nerves
patients who have diminished sensation in the area

Question 29

what is instrument assisted soft tissue mobilization (IASTM)?

Answer 29

Derived from Cyriax cross-friction massage
Use of hard tools to manipulate soft tissue
Motions vary in direction, force and pattern
Facilitates healing through increased fibroblast proliferation, increased collagen synthesis, maturation and alignment

Question 30

what are some instrument examples for IASTM?

Answer 30

Graston Technique
ASTYM
HawkGrips
Edge Mobility Tool
Rockblades

Question 31

what is the treatment graston technique for IASTM?

Answer 31

Lubricant is applied to the skin prior to using an instrument, allowing the instrument to glide over the skin without causing irritation.
Using a cross-friction massage in multiple directions, which involves using the instruments to stroke or rub against the grain of the scar tissue, the clinician creates small amounts of trauma to the affected area.
This temporarily causes inflammation, which increases the rate and amount of blood flow in and around the area. The theory is that this process helps initiate and promote the healing process of the affected soft tissues.
It is common for the patient to experience some discomfort during the procedure and possibly some bruising. Ice application following the treatment may ease the discomfort.

Question 32

what is dry cupping?

Answer 32

medical grade cups made of glass, silicone, or rubber
creates suction of the skin to lower the air pressure inside the cup and create a vacuum, thus drawing the skin upward
causes reddening as the blood vessels expand inside the cup increasing blood flow
a single cup can be used for treatment but most often, multiple cups are used

Question 33

what is the recommended treatment time for dry cupping?

Answer 33

5-15 minutes

Question 34

what are some general contraindications for cupping?

Answer 34

open wounds
bone fractures
sites of deep vein thrombosis

Question 35

what are some absolute contraindications for cupping?

Answer 35

Patients with cancer
Patients with organ failure
Pacemaker
Hemophilia or similar conditions

Question 36

what are some relative contraindications for cupping?

Answer 36

acute infections
Patients using anticoagulants
Severe chronic disease
pregnancy
puerperium (6 weeks after childbirth)
menstruation
anemia
recent wet cupping session
recent blood donation

Question 37

what are mechanical percussion devices?

Answer 37

TheraGun®, Hyperice®
Combines manual tapotement/percussion massage with vibration therapies
Believed to increase blood flow, modulate pain, improve myofascial mobility
May cause mechanical and neurophysiological changes by targeting afferent receptors through myofascial vibration
Future research needed to guide clinical application

Question 38

why is patient education important with percussion devices?

Answer 38

It is not recommended to use these devices above the neck
Risk of injury may be higher in individuals with underlying health conditions