Still Technique

Question 1

Who redeveloped the still technique?

Answer 1

Richard van buskirk

- got techniques from Charles hazard

Question 2

Charles hazard description of steps associated with the still technique from dr. Still

Answer 2

1) make the diagnosis
2) focus compression on the level of dysfunction
3) place the patient in the indirect position first
4) while maintains compression and force, move the patient towards the direct barrier

Question 3

Indications for still technique

Answer 3

Somatic dysfunction and joint articulation techniques indicated

Tendonitis

Soft tissue somatic dysfunctions

Sprained ligaments

Question 4

Primary MSK goals for still technique

Answer 4

Reset joint surface apposition

Reset muscle length and tone

Reset autonomic balance

Improved peripheral nervous function

Improved fluid flow

Question 5

How is still technique similar to other OMT models?

Answer 5

Starts in the Counterstrain position every time
- direction of ease

Ends in the ME position every time
- direction of restriction

Question 6

Keys to success with still technique

Answer 6

More precise the localization to dysfunction the more successful the treatment

Use as little force as possible

Motion is low velocity, moderate/high amplitude through a smooth arc of motion

Question 7

Force vector with still technique

Answer 7

Is always done with the operating hand And is directed to the facet joint at the vertebral level of your monitoring finger

Degree of compression should only be done to the monitoring finger

Question 8

Note about using head and neck as long lever

Answer 8

Can be done with young people for upper thoracic

- should be avoided in elderly and use shoulders/trunk instead

Question 9

Long muscles vs short muscles in thoracolumbar somatic dysfunctions

Answer 9

Long muscles = type 1

• Longissimus
• semispinalis capitis
• illiocostalis
• erector spinae
• etc.

Short muscles = type 2

• Rotatores cervicis
• Rotatores thoracis
• semispinalis thoracis
• Multifidus thoracis and lumborum

Question 10

Normal Rating of pulses, nerves and reflexes

Answer 10

Motor strength
- normal = 5/5

Pulses
- normal = 3/4

Reflexes
- normal = 2/4

Question 11

Why is lumbar side bending greater than thoracic sidebending?

Answer 11

Ribs

Question 12

Why is rotation greater in thoracic rather than lumbar?

Answer 12

Orientation of the facet joints

- (1-2) degrees of lumbar rotation per segment

Question 13

What side does the physician always stand on when doing still technique on a supine patient?

Answer 13

The side of sidebending somatic dysfunction

Question 14

why was still technique lost to history for a good time?

Answer 14

Still did not insist his exact instructions be followed, only that they get the same results

therefore everyone had different techniques to get the same thing

Question 15

what is the steps in determining position of ease in still technique?

Answer 15

First rotate patient towards posterior transverse process

Then sidebend patient towards and away
- if sidebending is the same side, then flex or extend the patient

*doing this way requires less flexion/extension in the sagittal plane

Question 16

how does the physician position themselves in seated lumbar/thoracic still?

Answer 16

Opposite side of rotation

Question 17

Lower extremity reflex and their nerve root/muscles innervated

Answer 17

Patellar tendon reflex = L4
- quadriceps femoris

Tibialis Posterior reflex = L5
- dorsal flexor muscles

Calcaneal (Achilles) tendon reflex = S1
- plantar flexor muscles