Week 11 Mechanotransduction and IASTM Flashcards
describe palliative interventions.
they have no lasting effect, make patient feel better in the short term
describe supportive intrventions.
address risk factors, biomechanical impairments, and functional limitation
describe corrective interventions.
produce structural change in pathology
what is mechanotransduction?
the process whereby the body converts mechanical forces into a cellular response, which ultimately produces a structural change
what are the three phases of mechanotransduction?
-mechanocoupling: overload prescribed or performed
-cellular communication: happens at the level of the cell
-response: the structural change
how does mechanocoupling work?
-an eccentric overload causes a physical deformation of the tendon cell via stimulation of integrins
-integrins communicate extracellular activity to intracellular
-integrin message sends mechanical message to nucleus (signal transduction)
-causes DNA upregulation
-mRNA is transcribes and DNA message is carried into cytoplasm
-message is translated into a cellular response (protein synthesis)
what training considerations should you consider when looking at eccentric vs concentric?
-decreases myostatin (inhibits hypertrophy) and increases IGF-MGF in muscle (ecc > conc)
-eccentric decreases myostatin and increase myogenin (promoted hypertrophy)
-eccentric increases MGF mRNA found on biopsy
-increased IGF mRNA with eccentric
-slow eccentric produces increased serum GH 15 min after
-12 weeks eccentric achilles reversed degeneration
what is IASTM?
-the use of instruments to achieve effects and benefits of soft tissue mobilization
-instruments are designed to detect and amplify the feel of the soft tissue restrictions to the hands
what are the 5 theories on the effects of IASTM?
-breaking of cross links - mobilizing adhesions
-mechanotransduction: fibroblast activation, proliferation and maturation, type III collagen production replaced by type I, re-starting stalled healing process
-desensitization of pain fibers (Gate theory)
-improved nerve metabolism and conduction efficiency
-redistribution of interstitial fluid - fluid dynamics
what are the indications for IASTM?
-tendinopathies
-fascial syndromes
-myofascial pain syndromes
-trigger points
-ligament pain syndromes
-scar tissue adhesion
-edema reduction
-entrapment syndromes
what are the contraindication for IASTM?
patient tolerance, open wounds, unhealed suture site, over malignancy, over inflammatory skin conditions, over un-healed fracture site, aneurysm, osteomyelitis, advanced osteoporosis, advance diabetes, myositis ossificans, localized infection, obstructive edema, uncontrolled hypertension
what are the precautions for IASTM?
anticoagulant medicine, cancer, varicose veins, burn scars, anemia, rheumatoid arthritis, pregnancy, kidney disease, possible increase protein load, osteoporosis, diabetes, fibromyalgia, connective tissue disorder
what is the recommended treatment protocol for IASTM?
-warm up target tissue/area
-perform IASTM (less is more, <10 min per area, 30-60 seconds per lesion)
-exercise the treatment area (low-load, high repetition resistive for acute conditions, eccentric for chronic, stretching and elongating as appropriate)
-ice application
what are the anticipated post-treatment outcomes of IASTM?
-improve ROM, flexibility with less pain
-decrease pain occurring during functional movement
-localize lesion - decrease palpable tissue texture abnormality
what is sweeping IASTM?
sweeping stroke where the tool contact points moving in one direction at the same rate either a linear or curvilinear path