Soft Tissue Myofacial Release

Question 1

What does “soft tissue” entail?

Answer 1

fascia, muscles, organs, nerves, vasculature, lymphatic

Question 2

fascia

Answer 2

a complete system with blood supply, fluid drainage, and innervations composed of irregularly arranged fibrous elements of varying desity

Question 3

function of fascia

Answer 3

tissue protection and healing

Question 4

omnipresent

Answer 4

continuous throughout the body

Question 5

pannicular fascia

Answer 5

outermost layer of fascia derived from somatic mesenchyme and surrounds entire body with exception of orifices; outer layer is adipose tissue and inner layer is membranous and adherent to the outer portion

Question 6

axial and appendicular fascia

Answer 6

internal to the pannicular layer; fused to the panniculus and surrounds all of the muscles, the periosteum of bone, and peritendon of tendons

Question 7

meningeal fascia

Answer 7

surrounds the nervous system; includes the dura

Question 8

visceral fascia

Answer 8

surrounds the body cavities (pleural, pericardial, and peritoneum)

Question 9

omnipotent

Answer 9

provides mobility and stability of the musculoskeletal system

Question 10

omniscient

Answer 10

mechanoreceptors, stretch receptors, liquid crystal like properties

Question 11

viscoelastic material

Answer 11

material that deforms according to rate of loading and deformity

Question 12

stress

Answer 12

force that attempts to deform a connective tissue structure

Question 13

strain

Answer 13

percentage of deformation of a connective tissue

Question 14

hysteresis

Answer 14

energy lost between the loading and unloading characteristic in the connective tissue system

Question 15

creep

Answer 15

connective tissue under a sustained, constant load (below failure threshold) will elongate in response to the load

Question 16

ease

Answer 16

the direction in which the connective tissue may be moved most easily during deformational stretching
palpated as a sense of tissue “looseness” or laxity or greater degree of mobility

Question 17

bind

Answer 17

a palpable restriction of connective tissue mobility

Question 18

newton’s third law

Answer 18

when two bodies interact, the force exerted by one is equal in magnitude and opposite in direction to the forces exerted by the other

Question 19

Hooke’s law

Answer 19

the strain (deformation) placed on an elastic body is in proportion to the stress (force) placed upon it

Question 20

Wolff’s law

Answer 20

bone will develop according to the under stresses placed on it – extends to fascia

Question 21

direct technique

Answer 21

towards and through the restrictive barrier

Question 22

indirect technique

Answer 22

away from the restrictive barrier

Question 23

Sherrington’s law

Answer 23

when a muscle receives a nerve impulse to contract, its atagonists receive, simultaneously, an impulse to relax

Question 24

common compensatory

Answer 24

left, right, left, right

80% healthy people

Question 25

uncommon compensatory

Answer 25

right, left, right, left | 20% healthy people

Question 26

uncompensated pattern

Answer 26

usually symptomatic, trauma caused

Question 27

transverse restrictors

Answer 27

tentorium cerebelli, thoracic inlet, thoracolumbar diaphragm, pelvic diaphragm

Question 28

soft tissue technique

Answer 28

a system of diagnosis and treatment directed toward tissues other than skeletal or arthroidal elements

Question 29

treatment goal of ST techniques related to tissue texture abnormality

Answer 29

stretch and increase the elasticity of shortened myofascial structures to return symmetry improve local tissue nutrition, oxygenation, and removal of metabolic wastes to normalize tissue texture

Question 30

treatment goal of ST techniques related to asymmetry of muscles

Answer 30

return to symmetry and normalize tone

Question 31

treatment goal of ST techniques related to restricted motion of soft tissue

Answer 31

set the fascia free

Question 32

treatment goal of ST techniques related to tenderness

Answer 32

normalize neurologic activity and improve abnormal somato-somatic and somato-visceral reflexes

Question 33

ST indications

Answer 33

diagnostically to identify areas of restricted motion, tissue texture changes, and sensitivity feedback about tissue response to OMT improve local and systemic immune response provide a general state of relaxation enhance circulation to local myofascial structures provide a general state of tonic stimulation

Question 34

ST relative contraindications

Answer 34

severe osteoporosis - prone techniques | acute injury - direct techniques

Question 35

ST absolute contraindications

Answer 35

``` fracture or dislocation neurologic entrapment syndromes serious vascular compromise local malignancy local infection bleeding disorders ```

Question 36

principles of ST technique

Answer 36

patient comfort physician comfort: minimize energy expenditure initially apply forces gently with low amplitude apply forces rhythmically for 1-2 seconds of stretch followed by a similar time frame releasing the stretch increase amplitude, not rate comfortable for pt carry skin and subcutaneous tissues until tissue creep

Question 37

parallel

Answer 37

increase distance between origin and insertion with muscle fibers

Question 38

knead

Answer 38

repetitive pushing of tissue perpendicular to muscle fibers

Question 39

inhibition

Answer 39

push and hold perpendicular to the fibers at the musculotendinous part of hypertonic muscle

Question 40

MFR

Answer 40

a system of diagnosis and treatment first described by AT Still and his early students which engages continual palpatory feedback to achieve release of myofascial tissues

Question 41

INR (integrated neuromusculoskeletal release)

Answer 41

a treatment system in which combined procedures are designed to stretch and reflexively release patterned soft tissue and joint related restrictions

Question 42

REMs

Answer 42

speed up treatment process

Question 43

example of REMs

Answer 43

breath holding prone and supine simulated swimming and pendulum arm swing maneuvers as direct and indirect barriers are release R/L cervical rotation isometric limb and neck movements patient evoked movement from cranial nerves

Question 44

indications of MFR

Answer 44

somatic dysfunction HVLA or muscle energy contraindication counterstrain difficulty secondary to a patient's inability to relax

Question 45

absolute contraindications of MFR

Answer 45

lack of patient consent | absence of somatic dysfunction

Question 46

relative contraindications of MFR

Answer 46

``` infection of soft tissue or bone fracture, avulsion, dislocation metastatic disease soft tissue injury post-op pt with wound dehiscence rheumatologic condition involving instability of c-spine DVT or anticoagulation therapy ```

Question 47

inherent forces

Answer 47

using the body's PRM

Question 48

respiratory cooperation

Answer 48

physician directed patient performed inhalation or exhalation or holding of the breath to assist with manipulative intervention

Question 49

patient cooperation

Answer 49

patient asked to move in specific directions to aid in mobilizing specific areas of restriction

Question 50

activating forces

Answer 50

inherent forces, respiratory cooperation, patient cooperation

Question 51

MFR treatment endpoint

Answer 51

3D release palpated as warmth, softening, increased compliance/ROM continuous application of activating forces no longer produce change symmetrical