Week 8 (Manual Therapy) Flashcards
Manual therapy techniques
Joint mobilisations
Soft tissue massage/therapy
Myofascial release
Trigger point therapy
Manual therapy can reduce pain through what mechanisms
Neurophysiological mechanisms
Relieve muscle spasm/improve muscle relaxation
Facilitate tissue healing
Manual therapy can reduce stiffness through what mechanisms
Increase joint ROM
Reduce reflex muscle facilitations
Facilitate movement (due to pain relief/muscle relaxation)
Increase tissue extensibility
What grade and amplitude to give to someone in pain only?
1-3 (usually grade 2)
Largest possible
What grade to give someone in primarily pain with little stiffness?
Grade 2-3
Largest possible
What grade to give someone who is primarily stiff with some pain?
Grade 3
Large or small
What grade to give someone who is stiff only?
Grade 3-5
Large or small
Grade 1 of joint mobilisation
Small amplitude movement performed at beginning of range
Grade 2 of joint mobilisation
Large amplitude movement performed within free range not moving into any resistance or stiffness
Grade 3 of joint mobilisation
Large amplitude movement performed up to the limit of range
Grade 4 of joint mobilisation
Small amplitude movement performed at the limit of range
What is a clinical indicator to do a joint mobilisation?
Non-contractile structures contributing to pain or restricting physiological or accessory movements
Contraindications to joint mobilisation
- Local malignancy
- Local bony infection
- Fracture/risk of fracture
- Spinal cord compression
- Cauda equina syndrome
- Active inflammatory arthritis
Treatment parameters of joint mobilisation
Grade 1-2 mobilisations typically slow for about 30 seconds per rep
Grade 3-4 mobilisations typically faster for about 45-60 seconds per rep
Soft tissue techniques
Soft tissue massage
Myofascial release
Trigger point therapy
Effleurage massages aim to
- Assist lymphatic drainage such as in chronic oedema to help move fluid around to drain to the lymphatic system
- Desensitise patient to your touch
- Influence muscle tone
Petrissage massage aims to
- Stimulate flow of venous and lymphatic fluid
- Increase tissue mobility
Myofascial release mechanism
Potentially rupture the abnormal cross-linkages between collagen fibres, stimulate fibroblasts synthesis of collagen and increase inter-fibre distance
Trigger point therapy mechanism
Equalising sarcomere length by pressure, needle, stretch or contraction
Contraindications and precautions to soft tissue techniques
- Malignancy
- Systemic or localised infection
- Acute circulatory condition
- Fracture/risk of fracture
- Open wounds
- Skin conditions
- Haematoma
- Active inflammatory arthritis
