Test 1 & 2 Chapters 1 - 13 Flashcards
Active Trigger Point
MTP that produces pain w/o digital compression, is tender, produces referred pain w/ or w/o ischemic compression Impedes flexibility, produces weakness, may elicit local twitch response w/ compression
Latent TP @ Chronic Stage
an Active TP that was never treated or was improperly treated may become this
A central TP is closely associated with this and located near the center of the muscle fibers
Dysfunctional endplates
TP that may develop in same muscle as main TP, in other muscles w/in the referred pain pattern & usually resolves once the main TP releases
Satellite TP
——— TP @ the musculo-tendinous junction or @ osseous attachment of the muscle that identifies the enthesopathy caused by unrelieved tension characteristic of the taut band that is produced by a ——- TP
Attachment & Central
TP that is usually w/o causing any spontaneous pain
Latent TP
Important component in assessment/evaluation of trigger point myo-fascial syndrome, especially w/ decision to make regarding appropriate muscle to treat
Biomechanics of the injury
1st component to be identified during assessment and evaluation for client w/ MTP syndrome
direction of external force applied
Causes of micro-trauma are
1) postural & skeletal asymmetries 2) Faulty posture 3) Habitually biomechanically poor body positions 4) Stressed body positions over prolonged time
3 essential steps used to determine the best course of treatment for client
Essential Criteria Confirmatory Criteria Myofascial assessment & evaluation
4 step process for essential criteria
1) Palpable taut band 2) Exquisite spot tenderness of a nodule in a taut band 3) Patient pain recognition 4) Painful range of motion at the end of range
2 step process for confirmatory criteria
Local Twitch response (LTR) Referred Pain Pattern (RPP)
1st step in myofascial assessment process
Take a history. Look for sudden onset from acute injury, trauma, overload stress, or gradual onset with chronic overload, microinjury, microtrauma, repetitive trauma.
Local twitch response can be identified by what
snapping palpation across taut band especially across fibers of the trigger point & active locus
Painful range of motion at the end of range.
common characteristic of MTP - Pain at attachments or muscle belly may be present during end of range of motion.
Modality w/in scope of massage beneficial in treatment of MTP syndrome
hot packs
progressive pressure technique requires use of hands or fingers & can be applied in these 2 forms of palpation
Flat & Pincer
Clinician should always be guided by these during Progressive Pressure Technique
Pain tolerance of client & Feedback
Key to treating trigger points is to
lengthen muscles fibers that are shortened by TP
Factors contributing to dysfunction or continued/prolonged condition
1) abnormal body positions 2) postural positions 3) skeletal asymmetries 4) activities that increase mechanical stresses
Effective TP therapy must always be followed by
Myofascial stretching exercises (MFS)
authors of Trigger Point Manual & authorities on TP therapy
Travell & Simons
Definition of acupuncture point
Precise points along meridians as defined by Chinese medicine
surrounds each muscle fiber, tendon, bone, nerve & vessel in body
connective fascial tissue
Role of Sarcoplasmic Reticulum
Store Ca2+ necessary for muscle contraction
considered functional unit of motor nervous system
motor neuron
4 components of motor unit
1) cell body of motoneuron 2) its axon 3) end plates 4) muscle fibers
4 hypotheses regarding pathogenesis & pathophysiology of MTP
muscle spindle hypothesis neuropathic process scar tissue dysfunctional end plates w/ energy crisis
Sliding filament theory describes muscle contraction as:
adjacent thick & thin filaments slide past each other propelled by cyclical interactions b/w myosin & actin of adjacent thin filaments
3 causes of micro trauma
over-stretching overloading over-shortening
chemical used as energy for muscle contraction
ACH
Symptoms associated w/ MTP b/c of nociceptive substances
referred pain occasional pain burning sensation tenderness of involved muscle
T/F Pain is fear #1 reason people visit Dr, power to affect 4 domains of physical, emotional, mental & social
True
Skeletal muscle = what % of total body weight
40%
components of successful appropriate accurate treatment
treatment on consistent basis method of treatment hand placement position of myofascial stretching & degree of stretching
Responsible for contributions to principles regarding imbalances & alternate treatment for MTP such as post-isometric relaxation technique.
Janda & Lewit
MTP can be found where
anywhere w/in muscle belly - pathological mechanism resides in dysfunctional endplates
protein of on/off switch in muscle contraction
troponin
micro-trauma can be result of
repetitive movement high-velocity movement stress positions
Result of free floating Ca2+ in vicinity of injury
sarcoplasmic reticulum rupture & continuous muscle contraction results
Substances that can sensitize muscle nociceptors, cause pain, severe hypoxia and tissue energy crisis
Bradykinins Prostalandins Histamines
