Topic 7 - Muscle Spasm

Question 1

Under normal circumstances when muscle contracts it is by a _________ effort by the person. The brain initiates the action, a signal is sent to the muscle through the _______ system and muscle contraction occurs.

Answer 1

Voluntary
Nervous

Question 2

An involuntary contraction of skeletal muscle that occurs and causes increased tension and pain.

Answer 2

Spasm

Question 3

The pain associated with a _____ results from:
- Ischemia & metabolic imbalance
- Mechanical overload of the muscle & irritation of nociceptors

Answer 3

Spasm

Question 4

If there is the presence of ______ concurrently with spasm, there will be other factors such as:
- Trauma (direct/indirect)
- Pain
- Inflammation
- Infection
- Emotional stress/tension
- Fatigue
- Cold
- Circulatory/metabolic changes
- Immobilization
- Nutritional deficiencies (e.g. dehydration)
- Mechanical stresses & postural adaptations

Answer 4

Injury

Question 5

What is the layperson term for a spasm?

Answer 5

Cramp/Stitch

Question 6

The prolonged contraction of a muscle in response to local circulatory and metabolic changes that occur when a muscle is in a continued state of contraction.

Answer 6

Intrinsic Muscle Spasm

Question 7

What are the 2 types of spasm?

Answer 7

1) Intrinsic
2) Protective (aka. Reflex Muscle Guarding, Muscle Splinting)

Question 8

Pain with _________ muscle spasm is the result of the altered circulatory and metabolic environment, so the muscle contraction becomes self-perpetuating.

Answer 8

Intrinsic

Question 9

Sustained muscle contraction in response to painful stimuli or injury. The primary cause of pain/injury is usually nearby or in the underlying tissues. Occurs primarily to limit movement of the involved tissues in order to protect it from further injury.

Answer 9

Protective Muscle Spasm (aka. Reflex Muscle Guarding, Muscle Splinting)

Question 10

__________ muscle spasm will typically resolve when the underlying cause of the initiating pain is relieved. If the underlying causes has been relieved and the spasm persists, it has become an _________ muscle spasm.

Answer 10

Protective
Intrinsic

Question 11

Possible impairments and findings related to _____ and MRT include:
- Pain
- Swelling/inflammation due to a traumatic mechanism
- Increased palpable and/or observable tension
- Reduced tissue extensibility
- Feeling of stiffness
- Decreased use of associated area
- Reduced joint ROM

Answer 11

Spasm

Question 12

Spasm produces ____ in one of 3 ways:
- Overloading parts of the muscle
- Subjecting nociceptors between active & non-active parts of the muscle to shearing forces
- Through ischemia

Answer 12

Pain

Question 13

In the case of someone describing pain or stiffness in a region, there is likely to be an increase in MRT and the possibility of _____ (in more acute presentations).

Answer 13

Spasm

Question 14

_____ can be:
- More acute or chronic in nature
- Whole muscle or just a segment
- Prominent depending on depth of muscle
- Observable (e.g. quiver) and palpable (e.g. tension, fibrous adhesions)

Answer 14

Spasm

Question 15

T/F - Muscle spasms are normal and will resolve on their own.

Answer 15

False - Muscle spasms are NOT normal and will resolve IF THE UNDERLYING CAUSE IS IDENTIFIED AND TREATED.

Question 16

In the case of a __________ spasm, treatment is not focused on eliminating a spasm, but on reducing it and appropriately treating the underlying cause.

Answer 16

Protective

Question 17

When treating muscle spasms, it is important to identify early ________ changes and other functional adaptations.

Answer 17

Postural

Question 18

Muscle spasms can lead to faulty ____________ and movement patterns can lead to decreased movement contributing to pain and injury.

Answer 18

Biomechanics

Question 19

Although increased MRT is often ______ in nature or simply due to increased levels of stress or muscular effort, the involved region should be appropriately examined to identify if musculoskeletal ___________ is present.

Answer 19

Benign
Dysfunction

Question 20

T/F - MRT is almost never altered in the presence of injury or dysfunction.

Answer 20

False - MRT is almost ALWAYS altered in the presence of injury or dysfunction.

Question 21

______ ROM can be reduced by either an increase in MRT or a muscle spasm (likely to be accompanied by pain).

Answer 21

Active

Question 22

A spasm is likely to result in a limitation of _______ motion, have an abrupt end feel and is likely to produce pain when the tissue is stressed.

Answer 22

Passive

Question 23

T/F - When muscles are in spasm, they may abruptly stop motion before the normal ROM is reached.

Answer 23

True

Question 24

Some treatment options for muscle _____ include:
- Hydrotherapy
- Connective tissue techniques (e.g. MFR, frictions)
- Massage

Answer 24

Spasm

Question 25

____ applications can be very useful when treating increased MRT because it has a general relaxing effect and softens non-contractile elements of the tissue prior to massage and connective tissue techniques.

Answer 25

Heat

Question 26

Heat applications are also useful when treating an _________ spasm and can be effectively utilized both prior to and following hands on soft tissue manipulation.

Answer 26

Intrinsic

Question 27

____ applications are useful when trying to interrupt the pain-spasm cycle because it has an analgesic effect that can reduce pain perception and reduce muscle spasm.

Answer 27

Cold

Question 28

In the case of a __________ spasm, only cold applications should be considered.

Answer 28

Protective

Question 29

These techniques are useful when treating MRT that has a connective tissue component involved. Reduced extensibility/mobility of the connective tissues will contribute to increased MRT.

Answer 29

Connective Tissue Techniques

Question 30

___________ massage techniques can help with reducing pain and muscle tension when they are applied for longer periods of time. _____________ techniques such as petrissage, muscle stripping and compression are useful when trying to reduce MRT.

Answer 30

Superficial Neuromuscular

Question 31

When massage is used to treat muscle spasm, superficial techniques are best applied to an _____ spasm. As it begins to reduce, more assertive petrissage may be applied progressively.

Answer 31

Acute

Question 32

T/F - A muscle in acute spasm should never be forcefully stretched because it introduces a high risk of muscle tear.

Answer 32

True

Question 33

As a spasm reduces, gentle __________ can be introduced and eventually progressed.

Answer 33

Stretching

Question 34

What are 4 specific techniques for muscle spasm?

Answer 34

1) Reciprocal Inhibition 2) Golgi Tendon Organ 3) Origin Insertion 4) Muscle Approximation

Question 35

This techniques is useful when attempting to reduce muscle spasm or gain ROM at a joint. It relies on the principle that when the muscle on one side of a joint is working to produce a movement, the muscle on the opposite side of the joint are neurologically inhibited.

Answer 35

Reciprocal Inhibition

Question 36

The following sequence describes how __________ __________ can be used: - Target muscle is taken to the restrictive/pathological barrier - 7-10 sec contraction of the antagonist muscle group at about 20% effort - After relaxation period, increase length to next barrier

Answer 36

Reciprocal Inhibition

Question 37

This technique can be used to help reduce muscle spasm or resting tension. The therapist it attempting to take advantage of a response that monitors the amount of tension a tendon is under and the nervous system causes the involved muscle to relax when it perceives an excessive amount of tension.

Answer 37

Golgi Tendon Organ

Question 38

By applying further tension to a tendon by bowing or deforming it, the therapist is attempting to take advantage of the _____ ______ _____ response.

Answer 38

Golgi Tendon Organ

Question 39

To apply the _____ ______ _____ technique: - Locate the tendon of the involved muscle - Increase tension on the tendon by applying specific compression as close to the MTJ as possible - Hold for 30-60 sec and monitor for muscle relaxation

Answer 39

Golgi Tendon Organ

Question 40

This technique uses specific compression and cross fibre petrissage along the attachments of a muscle. It is best suited for flat tendons and muscles that don't have a distinct and obvious tendon.

Answer 40

Origin Insertion

Question 41

This technique attempts tor educe tension on the muscle spindle, which monitors the amount of tension in a muscle and causes it to contract as a protective mechanism.

Answer 41

Muscle Approximation

Question 42

To apply the ______ _____________ technique: - Two ends of the muscle are passively brought closer together - Muscle is held in passively shortened position for 30 sec - Muscle is then slowly released and allowed to return to it's normal position

Answer 42

Muscle Approximation