ST/MFR/INR

Question 1

Indirect technique

Answer 1

technique that takes tissues away from the restrictive barrier

Question 2

Direct technique

Answer 2

technique that takes tissues toward the restrictive barrier

Question 3

Soft Tissue definition

Answer 3

a direct technique that usually involves lateral stretching, linear stretching, deep pressure, or traction

Question 4

Soft Tissue proposed mech. of action

Answer 4

• relaxes hypertonic muscles and reduces spasm by decreasing alpha motor neuron activity
• stretch and increase elasticity of shortened fascial structures
• improve local tissue nutrition, oxygenation, and removal of metabolic wastes
• identify areas of restricted motion, tissue texture abnormalities, and sensitivity
• improves local systemic immune system
• provides a general state of relaxation
• provides state of tonic stimulation by stimulating the stretch reflex in hypotonic muscles

Question 5

Soft Tissue indications

Answer 5

• TART findings (somatic dysfunction)
• clinical conditions that would benefit from ST (hypertonic muscles, excessive tension in fascial structures, abnormal somato-somatic or somato-visceral reflex)
• Adjunct to other OMT

Question 6

Soft tissue contraindications - Absolute

Answer 6

• lack of consent
• skin or soft tissue not intact (traumatized, friable)
• absence of somatic dysfunction

Question 7

Soft tissue contraindications - Relative

Answer 7

• Skin (contagious skin diseases, acute burns, painful rashes, abscess or cellulitis, skin cancers)
• Fascia (Acute fasciitis, acute fascial tears)
• Muscle (acute muscular strains, myositis, muscle neoplasms)
• Ligament (acute ligamentous strain, acute ligamentous inflammatory disorders)
• Bone (acute fracture, osteomyelitis, primary or secondary bone tumors, osteoporosis)
• Vascular (hematoma, deep venous thrombosis, coagulopathy)
• Viscera (infection, neoplasm, organomegaly, gastric or bowel obstruction or distention, acute or undiagnosed abd pain, pelvic pain)
• Joint (septic joint, instability/collagen disorders)

Question 8

Soft Tissue: principles of treatment

Answer 8

• Traction/stretching: origin and insertion of the myofascial structures being treated are longtitudinally separated
• Kneading: rhythmic, lateral stretching of the myofascial structure, origin and insertion are held stationary, the central portion is stretched like a bowstring
• Inhibition: sustained deep pressure over a hypertonic myofascial structure

Question 9

Myofascial release (MFR) definition

Answer 9

System of diagnosis and treatment which engages continual palpatory feedback to achieve release of myofascial tissues.

• can be applied as direct, indirect, or combined
• myofascial is the combination of muscles and fascia

Question 10

what is fascia

Answer 10

• thin sheath of fibrous tissue enclosing a muscle or other organ
• surrounds, protects, provides structure to organs, blood vessels, bone, nerve fiber, muscles (to the tiniest myofibril)
• has nerve cells to sense stress or injury and has the ability to contract in reaction
• MFR interacts with fascia and the tissues it surrounds to improve homeostasis and innate healing

Question 11

Stress

Answer 11

the effect of a force normalized over an area

Question 12

Viscosity

Answer 12

capability of a solid to continually yield under stress with a measurable rate of deformation

Question 13

Plastic deformation vs. Elastic deformation

Answer 13

• A stressed, formed, or molded tissue PRESERVES its new shape = plastic
• when the stress, formed, or molded tissue RECOVERS its original shape = elastic

Question 14

Strain

Answer 14

a change in shape as a result of stress

Question 15

Creep

Answer 15

the continued deformation of a viscoelastic material under constant load over time

Question 16

Hysteresis or stress-strain

Answer 16

a connective tissue response to loading and unloading where the restoration of the final length of the tissue occurs at a rate and to an extent less than during deformation (loading) representing energy loss in the connective tissue

Question 17

MFR indications

Answer 17

addresses somatic dysfunction by:
normalizing motion, relieving edema, re-establishing symmetry, relieving pain, aiding in circulatory and lymphatic function, normalizing neuroreflexive activity, supporting visceral function, restoring bioenergetic balance, supporting homeostatic function

Question 18

MFR contraindications

Answer 18

Absolute: lack of consent and absence of somatic dysfunction
Relative: open wounds, soft tissue or bony infections, abscesses, DVT (threat of embolism), anticoagulation (especially if they are over-coagulated), disseminated or focal neoplasm, recent postop conditions over the site of proposed treatment (wound dehiscense), aortic aneurysm. Use extreme caution in patients with fractures