Soft Tissue Techniques Final - Sheet1

Question 1

Scapular Lift Position

Answer 1

Patient is in the lateral recumbent position. Operator stands facing the patient, level with their shoulder. Internally rotate the arm by placing the forearm behind their back. This is achieved by asking the patient to “place their hand on the small of their back.” The operator’s caudad hand grasps the medial border of the scapula, and stabilizes the anterior shoulder with the other hand.

Question 2

SCapular Lift Action

Answer 2

The operator lifts the scapula laterally and away from the thoracic cage. Respiratory cooperation can be used to
assist the operator in enhancing the lift by asking the patient to take a breath and cough. This technique will stretch the rhomboids, and either a kneading motion or sustained inhibitory pressure on the rhomboids can be added to help relax these muscles.
Recheck
Reassess scapular motion and TART around scapula.

Question 3

Pectoral Traction Position

Answer 3

The  patient  lies 
supine  with  knees 
flexed and feet flat on 
the  table.   The 
operator  is  seated  or 
standing  at  the  head 
of the table. Grasp the 
patient's  anterior 
axillary fold with both 
hands  to  engage  the 
pectoralis  major  and 
minor muscles.

Question 4

Pectoral Traction Action

Answer 4

With both hands, apply a superior traction to stretch the muscles
and deep fascia of the axillary space. Then instruct the patient to
take a deep breath and cough while taking up any slack. This may be
repeated several times.
Recheck
Reassess respiration motion and pectoralis hypertonicity

Question 5

Lymphatic Drainage of Posterior Axillary Fold Position

Answer 5

Patient is supine. The operator is seated. Stabilize forearm with one
hand, and grasp the axillary fold with thumb and index finger
(defined by the teres major and latissimus dorsi)

Question 6

Lymphatic Drainage of Posterior Axillary Fold Action

Answer 6

Apply slow and gentle pressure to squeeze and release the tissues.
This moves fluids from the area causing a “sensation of warmth” in
the arm. It encourages lympathic drainage.
Recheck
Reassess tissue bogginess in the posterior axillary fold.
Note:
This technique can be adapted to treat the anterior axillary fold.

Question 7

Elow Wobble Technique Position

Answer 7

The patient is supine with their elbow abducted to 45 and the hand positioned midway between supination and pronation. The operator stands facing the patient. Grasp the elbow with both
hands, and stabilize their wrist against operator’s side.

Question 8

Elbow Wobble Action

Answer 8

The operator wobbles the patient’s elbow in a medial-lateral
direction to produce the articulation of each elbow joint.
Recheck
Reassess motion at the elbow.

Question 9

Rib raising method 1 Purpose and Position

Answer 9

Enhance dynamic function of rib cage in respiration. Method One: Lateral
recumbent
Position
Patient is in a lateral recumbent position with their upper hand placed on their
posterior head. The operator stands facing the patient.
The operator holds the patient’s upper elbow with one hand and
places her other hand on the posterior rib cage.

Question 10

Rib raising method 1 Action

Answer 10

The elbow is steadied while the rib cage is lifted and released with a
gentle rhythmic “make or break” motion. The operator can treat
different levels by moving the hand along the posterior rib cage.

Question 11

Rib raising method 2

Answer 11

Method Two: Supine
Position
Patient is supine. The operator sits or stands at the side of the
patient. The operator places both hands under the rib cage, with the
fingers contacting the angles of the ribs.
Action
By flexing the fingers in a rhythmic manner, the patient’s rib cage is
pulled laterally and raised, then released. Two operators can work
together, one on each side of the patient.

Question 12

Suboccipital tension release

Answer 12

Suboccipital Tension Release
This technique may be used to assist in treatment of tension
headaches, prepare the cervical tissues for other techniques, or to
relax cervical tissues at the end of a treatment.
Position
Patient is supine. The operator is seated at the head of the table.
The operator lifts the patient’s head so that the
weight of the head is primarily supported on the
pads of the operator’s fingers (not resting in the palm of
the operators hands). The fingers may be
positioned anywhere between the occipito-atlantal
junction and just inferior to the superior nuchal line
depending on the location of the hypertonicity.
Action
The physician directs traction anteriorly and superiorly with a force comparable to the weight of the head. The treatment is continued until the tissues release. After the tissues release, traction is gently withdrawn.
Recheck
Reassess suboccipital tissue hypertonicity.

Question 13

Stretching techniques for the cervical area

Answer 13

Stretching Techniques for the Cervical Area
This technique stretches the myofascial elements of the cervical and
upper thoracic areas. It also promotes venous and lymphatic
drainage.
Position
Patient is supine. The operator sits or stands at the
head of the table.The operator crosses her
forearms and places them behind the patient’s head
with hands on the patient’s shoulders.
Action
The operator exerts a slow forward bending stretch
until a restrictive barrier is engaged. Gently and slowly
increase the stretch, and release just as slowly.
When the head is returned to a more neutral position,
this stretch can be repeated to the left or the right, using
the shoulder opposite the stretch as counterforce.

Question 14

Posterior cervical soft tissue technique

Answer 14

Position
Patient is supine. Operator stands at the
patient’s side.Operator places one
hand on the patient’s forehead. The other
hand is positioned with the fingertips on the soft
tissue between the spinous processes and
articular pillars.
Action
The operator rhythmically stretches and compresses
the soft tissues, while side bending, rotating,
and extending the cervical spine. The hand that is positioned on the
forehead acts as a counterforce.
This technique is applied bilaterally from the occipito-atlantal area
to the 1st thoracic vertebra.

Question 15

Anterior neck - soft tissue

Answer 15

Position
Patient lies supine with physician at head of table. Patients head is
grasped by placing the basiocciput in physician’s palms. This allows
the physician to use their fingers to palpate superficial and deep
tensions.
Action
The physician then motion tests the cervical spine by moving
through sidebending, rotation, flexion and extension both with and
without gentle traction. From these motions, the physician should
assess for restrictions and hypertonicity within the myofascia of the
cervical region.
Treatment
Similar to the diagnosis, the physician should move gently and
directly into the restriction. This may require a combination of
multiple movements.
Recheck
Cervical motion