technique overview Flashcards
articulatory technique is a direct or indirect technique?
direct technique
articulatory technique indications
useful for treating SD which lie in the joint and/or periarticular tissues by increasing joint ROM and decreasing hypertonic mm restriction
articulatory technique contraindications
- relative:
1. repetitive rotation and extension due to risk of arterial or neurological compromise
2. malignancy - absolute:
1. lack of patient consent
2. absence of SD
3. fracture or dislocation
4. neurologic entrapment syndromes
5. serious vascular compromise
6. local infection
ligamentous articular strain
when dysfunction is introduced into the system, the ligaments are no longer balanced in relation to each other and one ligament may be more tight or loose than another ligament of the same joint
crimping
refers to the configuration of fibers that make up a ligament and allow it to work as a spring, checking and balancing the pressures applied to the joint.
what happens to crimping when a SD is introduced into a joint?
the ligament is straightened, destroying the crimp
principle treatment of BLT
- disengagement/decompression of the area until motion can be felt
- exaggeration of the dysfunctional pattern
- balancing of the ligaments in a position of equal tension among the joint’s ligaments until release
BLT indications
can be applied to any dysfunction or strained ligament to
- relax contracted musculature
- release teethered structures
- restore symmetry
- increase arterial circulation and venous/lymphatic drainage
BLT is direct or indirect technique?
both
BLT contraindications
- relative:
1. acute fractures
2. open wounds
3. acute thermal injury
4. soft tissue or bony infections
5. DVT
6. disseminated or focal neoplasm
7. recent surgery in area of proposed treatment
8. aortic aneurysm - absolute:
1. lack of patient consent
2. absence of SD
principle of counterstrain
- lower gamma gain activity is achieved by moving mm origin and insertion closer together around a tenderpoint, thereby reducing afferent activity from the mm spindle receptor and reducing nociception
- slow, intentional, post-treatment return to neutral position prevents increased firing from proprioceptive input via passive stretching of the CT
TP normally found where?
origin, insertion, or belly in tendons, ligaments, or fascia
CS indications
where tenderpoint can be identified
CS contraindications
- relative:
1. patient who cannot voluntarily relax
2. severely ill patient
3. vertebral artery disease
4. severe osteoporosis
5. patient with pathological limitations to certain body positions - absolute:
1. absence of SD
2. lack of patient consent
facilitated positional release (FPR) sequence of movements
- anatomical neutrality in dysfunctional tissues
- activating force directed into the tissues for 5-15 sec, which causes immediate release of restriction before the dysfunctional area is returned to a neutral position
if have both superficial and deep SD, which should be treated first when using FPR?
superficial SD
FPR principle of treatment
- applying activating force trigger the release of the dysfunction
- activating force is inactivating the mm spindle feedback to the spinal cord and eliminating the nervous stimuli maintaining the dysfunctional hypertonicity
FPR indications
SD that have caused mm hypertonicity and restricted ROM
FPR contraindications
- relative:
1. joint prosthetic
2. degenerative joint disease
3. radicular pain
4. osteoporosis
5. malignancy
6. stenosis
7. rheumatologic disorder
8. congenital malformation - absolute:
1. lack of patient consent
2. absence of SD
3. hip prosthetic
4. shoulder pathology
5. any acute or chronic joint dislocation or separation
6. recent trauma
7. acute fracture
HVLA indications
- treating SD with firm, distinct barriers
HVLA contraindications
- relative:
1. acute herniated nucleus pulposus
2. acute radiculopathy
3. acute whiplash/severe mm spasm/strain/sprain
4. osteopenia/osteoporosis/osteoarthritis
5. spondylolisthesis
6. metabolic bone disease
7. hypermobility syndromes - absolute:
1. lack of patient consent
2. absence of SD
3. rheumatoid arthritis
lymphatic technique principles of treatment
- removing barriers to the lymph flow
- enhancing mechanisms involves in respiratory-circulatory homestasis
- extrinsiclly augmenting lymph flow and other immune system elements
- mobilizing lymph fluid from other regions of the body to decrease congestion
lymphatic technique indications
treating patients with edema, tissue congestion, lymphatic stasis, infection, and inflammation, geriatric and hospitalized patients
lymphatic technique contraindcations
- relative:
1. cancer
2. osseous fracture or crushed tissue
3. bacterial infections with risk of dissemination
4. chronic infections
5. diseased organs
6. pregnancy
7. circulatory disorders
8. coagulopathies/patients on anticoagulatns
9. unstable cardiac conditions
10. CHF
11. COPD - absolute:
1. lack of patient consent
2. absence of SD
3. aneuresis if not on dialysis
4. necrotizing fasciitis
isometric MET
counterforces of patient and doctor equal each other and no length change is permitted by the mm
isotonic concentric MET
mm allowed to contract; physician force
isotonic eccentric MET
mm lengthens; physician force > patient force
isotonic isolytic MET
forced lengthening of shortened, fibrotic mm
isotonic isokinetic MET
may be concentric or eccentric, and occurs at a constant velocity
crossed extensor reflex
when flexor group of one region of the body is contracted, the contralateral flexor relaxes and the contralateral extensor tightens
reciprocal inhibition
agonist mm contraction produces antagonist relaxation because of CNS patterning
oculocephalogyric reflax
use of eye motion to stimulate contraction of cervical and truncal mm groups, such as occurs when mm groups reflexively contract in an attempt for the body to follow the direction of gaze
respiratory assistance
use of mm respiration to engage the mm directly or transmit motion to the rest of the body in order to provide the patient force against the physician’s fulcrum. enhancing respiration itself may be the goal of treatment
joint mobilization using mm force
the restoration of full and normal ROM results in gapping or rebalancing synovial pressures within a joint and its attachments causing relaxation to dysfunctional and hypertonic tissues
isokinetic strengthening
asymetry in ROM can cause an asymmetry of strength. restoring strength and balance to agonist/antagonist mm can be achieved by first lengthening the antagonist mm, then using isokinetic contraction to finish treatment
isolytic lengthening
may affect myotatic feedback and circulation to the treated area
post-isometric relaxation
refractory period after a controlled mm contraction during which proprioceptive and nociceptive feedback is absent, allowing the mm to be passively stretched without stimulating the myotatic reflex
using mm force of one region to move another region
moving one part of the body can affect another part of the body; a dysfunctional area may be effectively treated by using forces created while treating an adjacent body part
MET indications
presence of SD
MET contraindcations
- relative:
1. infection, hematoma, or tear in involved mm
2. fracture or dislocation of involved joint
3. rheumatologic conditions causing instability of the cervical spine
4. undiagnosed joint swelling of involved joint
5. positioning that compromises vasculature
6. patient with low vitality who could be further compromised - absolute:
1. absence of SD
2. lack of patient consent
3. young child that cannot comprehend treatment instructions
4. coma/unresponsive patient
myofascial release (MFR) indications
used to 1. relax contracted musculature 2/ release tethered structures 3. restore symmetry 4. increase circulation and venous/lymphatic drainage
MFR contraindications
- relative:
1. soft tissue or bony infections
2. DVT
3. disseminated or focal neoplasm
4. recent pos-operative states over the site of proposed treatment
5. aortic aneurysm - absolute:
1. absence of SD
2. lack of patient consent
3. acute fractures
4. open wounds
5. dermatitis
6. acute thermal injury
soft tissue: stretching (traction)
pulling or pressing tissues along a longitudinal axis within the area of treatment
soft tissue: kneading
pressing tissues along a latitudinal axis within area of treatment
soft tissue: inhibition
forces applied superficial to deep directly into a dysfunctional tissue to reset tension or tone
soft tissue: effleurage
superficial lymphatic treatment that applies pressure or light stroking to tissues from distal to proximal
soft tissue: petrissage and skin rolling
deep pressure and/or squeezing applied to break down adhesions between skin and mm
soft tissue: tapotement
repetitive striking of a mm belly with the hypothenar eminence
soft tissue indications
treating
- hypertonic mm
- excessive tension in fascial structures
- abnormal somato-somatic and somato-visceral reflexes
soft tissue contraindications
- relative: a lot (too many to write, please read the book)
- absolute:
1. absence of SD
2. lack of patient consent
still technique principle of treatment
- positioning the body into a place of ease allows neurological feedback to the mm or joint is neutralized
- adding a force vector mimics the pattern of trauma that caused the SD
- joint is moved back to a normal position as the tissues are moved through the restrictive barrier
still technique indications
SD assoc with mm hypertonicity and restricted ROM
still technique contraindications
- relative:
1. joint prosthetic
2. degenerative joint disease
3. radicular pain
4. osteoporosis
5. malignancy
6. stenosis
7. rheumatological disorder
8. congenital malformation - absolute:
1. hip prosthetic
2. shoulder injury
3. acute or chornic joint dislocation or separation
4. recent trauma
5. fracture less than 6 weeks old
6. recent wound
7. lack of patient consent
8. absence of SD
