Topic 1 - Muscle Resting Tension Flashcards
Massage techniques have a number of ________, all are not relevant for every patient or circumstance.
Outcomes
We can use massage techniques that relate to both ___________ and wellness goals.
Impairments
We can structure our massage to produce some ________ and not others. We can measure these in various ways.
Outcomes
We must determine through our intake, assessment and tissue response what the most appropriate ______ of ______ is to treat our patients.
Course of Action
Fill in the blanks related to layer palpation of soft tissue (from superficial to deep):
1) _____
2) Adipose Tissue
3) ___________ Fascia
4) Adipose Tissue
5) _____ Fascia
6) _________
7) Muscle
1) Skin
2) Adipose Tissue
3) Superficial Fascia
4) Adipose Tissue
5) Deep Fascia
6) Epimysium
7) Muscle
What are 4 characteristics that can help us differentiate between the layers of soft tissue when palpating?
1) Hardness
2) Density
3) Texture
4) Mobility
The ability of skeletal muscle to shorten with force, causing the structure to which they are attached to move.
Contractibility
The capacity to respond to stimulus, which is normally from nerves that we consciously control.
Excitability
The ability of a muscle and its associated fascia to undergo lengthening deformation during the movement of a joint through its anatomic range.
Extensibility
T/F - After contraction, skeletal muscles can be stretched to the normal resting length and beyond to a limited degree.
True
The ability of skeletal muscle to recoil to their original resting length after they have been stretched.
Elasticity
Showing both viscous, plastic and elastic behaviour.
Viscoelasticity
For a ____________ stretch, some of the length that the tissue gains during the stretch will remain when one releases the tensile force.
Viscoelastic
Some functions of skeletal muscle include:
- Produce ______ and maintain body position
- ____ production
- Support _______ and protect internal organs
- Create sphincters that allow for orifices to open and close
Motion
Heat
Viscera
A type of contraction in which the tension generated is insufficient to overcome the external load on the muscle and the muscle fibres lengthen as they contract.
Eccentric Contraction
A type of contraction in which the tension in the muscle remains constant despite a change in muscle length.
Isotonic Contraction
A type of contraction in which muscle tension is sufficient to overcome the load and the muscle shortens as it contracts.
Concentric Contraction
The extent to which a muscle conforms to the expected anatomical and biological norms.
Muscle Integrity
The resting tension and responsiveness of muscle to passive elongation or stretch.
Muscle Tone
Force generated by muscle contraction.
Muscle Power
Ability to sustain a contraction over time.
Muscle Endurance
Ease of movement and ROM of the joints.
Mobility
Maintenance of structural integrity of the joints.
Stability
Tissue that supports, protects and gives structure to other tissues and organs in the body. It stores fat, helps move nutrients and other substances between tissues/organs and helps repair damaged tissue. Made up of cells, fibres and a gel-like substance.
Connective Tissue
Types of __________ tissue include:
- Bone
- Cartilage
- Fat
- Blood
- Lymphatic tissue
Connective
A band or sheet of connective tissue, primarily collagen, beneath the skin that attaches to, stabilizes, encloses and separates muscles and other internal organs. Classified by layer, function and/or anatomical location.
Fascia
Superficial, deep and visceral/parietal are 3 types of ______.
Fascia
T/F - All connective tissue is fascia, but not all fascia is connective tissue.
False - All FASCIA is CONNECTIVE TISSUE, but not all CONNECTIVE TISSUE is FASCIA.
A loss or abnormality of the affected individual’s body structures or functions that occurs as a result of the initial or subsequent pathophysiology. Something is not acting like we would expect it to.
Impairment
___________ can be psychological, physiological and/or anatomical in nature.
Impairments
The various anatomic structures and systems of the body.
Body Structures
The physiologic functions of anatomic systems, such as support viscera or maintain posture.
Body Functions
___________ are often the product of an injury, poor posture, a medical condition/pathology and/or stress.
Impairments
Impairments can be from an ________ or _________ onset.
Immediate
Insidious
Taking into consideration the whole person, including things like their psychological state, level of stress and support systems.
Biopsychosocial Model
When developing a _________ ____, it is essential that the therapist is able to identify the relevant impairments that cause or contribute to a patient’s complaint.
Treatment Plan
A massage is ________ to the patient’s individual presentation, thus avoids delivering a generic treatment protocol that is unlikely to meet the needs of your patient.
Specific
Results from a complex interaction between contractile and biomechanical contributors.
Muscle Resting Tension (MRT)
What are the 4 biomechanical contributors of muscle resting tension?
1) Water
2) Connective Tissue
3) Myofibril
4) Adipose
What are the 3 contractile contributors of muscle resting tension?
1) Spasm
2) Trigger Points
3) Unnecessary Muscle Tension
A biomechanical contributor of muscle resting tension contained in associated vessels and in the interstitium, restrained in compartments formed by connective tissue.
Water
A biomechanical contributor of muscle resting tension within the muscle that clinicians can palpate, such as fascia and scars.
Connective Tissue
A biomechanical contributor of muscle resting tension that is technically controlled by the nervous system. Provide very little resistance to palpation when not contracting.
Myofibril
A biomechanical contributor of muscle resting tension that gives little resistance to pressure during palpation.
Adipose
Contractile contributors all involve _________ shortening, which has been referred to as active tone or _____________.
Myofibril
Hypertonicity
T/F - Healthy muscles should exhibit little active tone at rest.
True
A contractile contributor of muscle resting tension that is an involuntary contraction of a muscle resulting in increased muscular tension and possible shortness that cannot be released voluntarily.
Muscle Spasm
Some reasons for ______ _____ pain include:
- Ischemia
- Metabolic imbalance
- Mechanical overload of muscle & nociceptors
Muscle Spasm
A contractile contributor of muscle resting tension that may be considered a form of neuromuscular dysfunction, consisting of soft-tissue and sensory abnormalities that involve both the PNS & CNS.
Myofascial Trigger Points
A contractile contributor of muscle resting tension that is unwitting muscular contraction under voluntary control. It is common with situational stress or when injury is present.
Unnecessary Muscle Tension
T/F - A person can relax an unnecessarily tensed muscle if they are made aware of it.
True
A more encompassing name as it includes the non-contractile components as well as the contractile components and nervous system.
Tissue Resting Tension
Refers to the passive tonus or tension of skeletal muscle that comes from its intrinsic molecular viscoelastic properties. It is intrinsic viscoelastic tension within the body’s kinematic chains.
Myofascial Tone (aka. Resting Skeletal Muscle Tone)
T/F - Myofascial tone functions separately from fascial tissues and ligamentous structures and is part of the networks of tensional tissues.
False - Myofascial tone functions INSEPARABLY from fascial tissues and ligamentous structures and is part of the networks of tensional tissues.
A diagnostic tool for evaluating the electrical activity produced by skeletal muscles.
Electromyography (EMG)
The CNS-independent component resulting from intrinsic molecular interactions of the actin & myosin filaments in sarcomeric units of skeletal muscle and myofibroblast cells. Refers to the tension in parallel elastic component.
Passive Tension
T/F - Myofascial tone is not considered active tone.
True
___________ of the body will alter the muscle resting tension. MRT varies greatly from person to person, muscle to muscle and in an individual muscle depending on a persons state of ______ or ________ health.
Impairments
Mental
Physical
The following are results of increased ______ _______ tension:
- Stiffness
- Hypomobility
- Pain
- Alterations in level of function
Muscle Resting
The vital low-level, passive tension and resistance to stretch that contributes importantly to maintain postural stability in balanced equilibrium positions.
Postural Tone
T/F - Good posture should not require much muscular effort.
True
The tension developed by the contractile element, initiated by cross bridge formation and movement of thin and thick filaments.
Active Tension
A common musculoskeletal impairment that can be caused by scarring, fascial restrictions, abnormal connective tissue density, joint capsule restrictions, inflammation, strains, trigger points, muscle spasm, edema and/or swelling.
Tissue/Joint Mobility & Joint Integrity Issues
A common musculoskeletal impairment that can be caused by impairments of strength, power and endurance.
Muscle Function/Performance Issues
A common musculoskeletal impairment that can be caused by holding patterns and spasm.
Elevated Muscle Resting Tension
A common musculoskeletal impairment that has to do with ________ changes.
Postural
A decrease in mobility/movement (restricted motion) of a joint or body part. Reduced range of motion can be the result of impairments of the soft tissue and joints.
Hypomobility
An increase in mobility/movement of a joint. Increased range of motion can be the result of impairments of the soft tissue and joints.
Hypermobility
Usually the results of brain lesions (upper motor neuron), brainstem lesions and/or and basil ganglia lesions (e.g. Parkinson’s).
Hypertonicity
When soft tissue dysfunction is present, they can be located anywhere between the normal physiological ________, can limit the available _____ of motion and can change the _______ of movement.
Barriers
Range
Quality
T/F - Apprehension does not limit movement.
False - Apprehension CAN also limit movement.
What are 3 ways therapists can examine and assess muscle resting tension?
1) Palpation
2) Range of Motion
3) Visual Observation
The therapist generally palpates __________ into the tissue at various ______ and makes a judgement on the quality of the tissue.
Vertically
Depths
Some things to consider during tissue _________ include:
- Stiffness/Firmness
- Density
- Deformability
- Volume
Palpation
The degree of resistance when palpating the tissue.
Stiffness/Firmness
The degree of compactness of a substance. It helps us to determine the type of tissue we are on.
Density
The change of shape of a tissue or structure when it is subjected to pressure.
Deformability
The amount of space occupied by an object measured in three dimensions.
Volume
T/F - Changing a muscle’s position from shortened to lengthened results in decreased fluid pressure within the muscle, which changes the tone of the muscle.
False - Changing a muscle’s position from shortened to lengthened results in INCREASED fluid pressure within the muscle, which changes the tone of the muscle.
T/F - Consistency of interrater reliability of palpation is not found.
True
T/F - Massage can produce slow changes in MRT.
False - Massage can produce RAPID changes in MRT.
Findings will show increased or decreased movement, and it may also show change in the expected function of the structure being assessed.
Range of Motion
Will include changes in contour, bulk and holding patterns of the structure being assessed.
Visual Observation
Some steps we can take to treat elevated ______ _______ tension include:
- Determine the causes
- Assess using palpation
- Treat using appropriate techniques (e.g. neuromuscular)
- Engage tissues you wish to change
- Create a general sedative effect
Muscle Resting
Some possible ___________/findings having to do with elevated MRT include:
- Increased palpable/observable tension
- Reduced tissue extensibility
- Feeling of stiffness
- Decreased use of associated area
- Compensatory changes
- Reduced joint ROM
- Postural changes
- Pain
Impairments
Some __________ that may be contributing to pain and movement issues related to MRT include:
- Inflammation
- Mechanical overload of the muscle & irritation of nociceptors
- Ischemia, metabolic imbalance & microcirculation changes
- Referral & trigger points
- Spasm
- Anxiety & emotional stress
- Chronic pain
Mechanisms
Some _____ of treatment for student clinic include:
- Normalize resting muscle tension
- Decrease/eliminate holding patterns
- Increase extensibility/movability of tissue
- Decrease trigger points
- Increase joint mobility
- Increase joint integrity
- Increase feelings of relaxation
- Increase body awareness
Goals
T/F - The initial aim of treating unnecessary muscle tension is to increase the client’s awareness of it.
True
_______ movement techniques often assist the client in releasing unnecessary muscle tension.
Passive
_______ tension can be reduced using various massage techniques once the client has released unnecessary muscle tension.
Resting
___________ techniques can help reduce pain and tension when applied for long periods of time.
Superficial
_____________ techniques are most useful when attempting to reduce MRT and you must contact the tissue you are trying to affect.
Neuromuscular
T/F - Myofascial release, direct myofascial and frictions are all neuromuscular techniques.
False - Myofascial release, direct myofascial, and frictions are all connective tissue techniques.
__________ ______ techniques are useful to gain mobility of connective tissue and can be applied as superficial or deep.
Connective Tissue
Heat, stretching and progressive relaxation are considered _____________ modalities for treating MRT.
Complementary
Not concerned specifically with addressing impairments, but balancing of the mind, body and spirit, as well as improving the client’s self-perception of their well being.
Wellness Interventions
Often if the tight antagonist is _________, the weak and inhibited muscle spontaneously increases in ________.
Stretched
Strength
Some general ________ goals for student clinic include:
- Optimize functioning of any body part/system
- Prevention of injury
- Improved body awareness
- Enhanced mental focus
- Enhanced ability to deal with stress
- Self-nurturing
- Increased energy
- Improved sleep
- Improved ADLS
- Enhanced well-being
- Increased relaxation
- Improved coping skills
Wellness
