Week 11 Soft Tissue Mobs/ Mechanotherapy Flashcards

1
Q

Treatment goals for Soft Tissue Mobilization

A
  1. Increase pain threshold
  2. Improve mobility of soft and connective tissue
  3. Stimulate circulation/Improve energy transport/facilitate healing
  4. Improve flexibility
  5. Improve coordination
  6. Decrease neuromuscular excitability
  7. Restore joint mobility
  8. Remove lactic acid
  9. Improve motor firing
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2
Q

Effleurage with emollient

A
  • Typically warm up touch
  • Glides over the skin lightly without attempting to move deep muscle masses
  • often used to accustom the patient to physical contact, distribute lubrication, assess for areas of spasm/ soreness/trigger points , improve blood flow and pain threshold
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3
Q

Petrissage: with emollient

A

Consistent kneading the presses and rolls the muscle/tendon/ligament/fascia
- the area is gently squeezed, lifted and relaxed in a kneading fashion
- this deeper technique aimed at improving adhesions between skin, muscle, fascia and connective tissue

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4
Q

Knuckling with emollient

A
  • Use of dorsal surface of digits, MCPS, IPs and deeper stroking technique for improving fascial mobility, tension and adhesions (large area)
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5
Q

Stripping with emollient

A
  • Use thumb supported digit, pisiform for deep stroking technique for improving fascial mobility, tension, and adhesion
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6
Q

Fascial Stretching without emollient

A
  • Glides over the skin lightly without attempting to move the deep muscle masses
  • Often used to accustom the patient to physical contact, distribute lubrication, assess for areas of spasms/soreness/trigger points, improve blood flow and pain threshold
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7
Q

Skin rolling: without emollient

A
  • Lift separate skin from underlying fascia and muscle in order to improve soft tissue mobility, sensitivity and improve circulation
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8
Q

Strain-counter strain: without emollient

A
  • Clinician locates a tender point or muscle and moves the patient passively into a position of ease or comfort
  • They accomplished by markedly shortening the muscle or tissue
  • The position is passively maintained for 90 seconds or until sensitivity/symptoms improve
  • Slow return to neutral position after
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9
Q

Position Release: without emollient

A
  • Begin with strain-counter strain then add submaximal acupressure to trigger point
  • Can continue to work toward passively positioning the patient into greatest ease or comfort while pressure is held for 90 seconds
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10
Q

Trigger Point Massage: without emollient

A
  • Using tip of any digit , pirigotm or olecranon process slowly build circular pressure/strokes on palpated trigger point for 1-5 minutes or until sensitivity/symptoms improve
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11
Q

trigger point Acupressure:

A
  • using tip of any digit, pisiform, olecranon process, palpate the desired trigger point
  • Add progressive static central pressure to the center of the trigger point for 60-90 seconds or until sensitivity/symptoms improve
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12
Q

Active Release

A
  • Same technique as acupressure for trigger point but will add additional movement above or below the trigger points to allow tension/lengthening of the muscle to occur. Static acupressure is held while the patient actively moves to increase stretch or tension for 3-5 repetitions or until symptoms improve
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13
Q

Cross friction Massage

A
  • Placing tendon/muscle/scar on slight stretch and massage using progressive deep perpendicular strokes
  • often painful
  • Used tendinopathies, chronic over-use injuries and scar tissue
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14
Q

Contraindications for Soft Tissue Mobilization

A
  1. Malignant tumor
  2. skin condition
  3. open wound
  4. Acute inflammation
  5. Impaired sensation
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15
Q

Precautions for Soft tissue Mobilizations

A
  1. Circulatory dysfunction
  2. Abnormal end feel
  3. Joint effusion
  4. Presence of neurological signs sx
  5. Osteoporosis
  6. pregnancy
  7. Dizziness
  8. Steroid and anticoagulant use
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16
Q

Mechanotransduction

A
  • the process whereby the body converts mechanical forces ( exercise, deep friction massage, weight bearing) into a cellular response which ultimately produces a structural change
17
Q

3 phases of Mechanotransduction

A
  1. Mechanocoupling
  2. cellular communication
  3. response
18
Q

Instrument assisted Soft Tissue Mobilization (IASTM): what is it

A

Use of instruments to achieve effects and benefits of soft tissue mobilization
- Specifically designed instruments to aid the clinician in the detection and treatment of soft tissue dysfunction
- Instruments designed to detect and amplify the feel of the soft tissue restrictions to the hands

19
Q

Theories of Effects of IASTM:

A
  1. Gate theory: desensitization of pain fibers
  2. Improved nerve metabolism and conduction efficiency
  3. redistribution of interstitial fluid - fluid dynamics
20
Q

Tool vs. The hands the different factors

A
  1. Contact area- finger are blunt instruments
  2. Amplification effect of tool for tissue irregularities
  3. Fatigue factor- protect therapist’s hands
  4. Efficiency of treatment
  5. Your hands are still involved when using a tool and guide the treatment application
21
Q

Indications for IASTM:

A
  1. Tendinopathies- epicondylalgia-Achilles, patellar
  2. Fascial syndrome- plantar fasciitis, ITB syndrome, trigger finger
  3. Myofascial pain syndromes
  4. trigger points
  5. Ligament pain syndromes- MCL, LCL, AC ligaments , UCL
  6. Scar tissue adhesions
  7. Edema Reduction
  8. entrapment syndromes- carpal tunnel, ulnar entrapment, TOS
22
Q

Contraindications IASTM:

A

Patient tolerance
open wounds
unhealed suture site
over malignancy
Over inflammatory skin conditions
Over unhealed fracture site
Aneurysm
Osteomyelitis
Advanced Osteoporosis
Advanced diabetes
Myositis ossification
Localized infection
Obstructive edema
Uncontrolled hypertension

23
Q

Precautions IASTM:

A

Anti-coagulant medicine
Cancer
varicose veins
burn scars
anemia
rheumatoid arthritis
pregnancy
Kidney disease
Osteoporosis
Diabete
Fibromyalgia
Connective tissue disorder

24
Q

How long should your spend during IASTM on each lesion

A

30-60 seconds
<10 minutes per area

25
Q

Post treatment Outcomes

A
  • improve ROM - Flexibility with less pain
  • Decrease pain occurring during functional movement
  • Localize lesion- decrease palpable tissue texture abnormality
26
Q

T/F you regress the dosage of IASTM if the patient reports an adverse reaction

A

True

27
Q

Shorter/ faster strokes of the IASTM=

A

Ideal to facilitate inhibited muscle tissue

28
Q

Longer/Slower strokes of the IASTM =

A

ideal to release hypertonic/facilitated muscle tissue

29
Q

Do you want the tissue on slack or tension?

A

Slack- allows deeper penetration but typically less aggressive than when tissue is on tension

30
Q

What angle should the tool be kept at on most strokes

A

30-60 degrees

31
Q

Stroke: Swee

A