-
what are some contraindications to soft tissue
- fractures
- open wounds
- soft tissue or bony infections
- abscesses
- DVT
- Coagulopathy
- Neoplasm
- Directly over the site of recent operation
-
what are the passive direct soft tissue techniques?
- Traction
- Linear stretching
- Lateral stretching
- Deep pressure
-
what is traction
- A linear force to draw structures apart
- the attachment point of the myofascial structures that are being treated are longitudinally separated
-
What is Linear stretching
- A kneading motion.
- Direct force is applied to the long axis of the body
-
Lateral stretching
- A kneading motion
- unlike linear stretching the attachment point of the muscles are held in a a stationary position and the central portion of the structure is stretched perpendicular to the long axis of the structure ( bow stringing)
-
Deep pressure
The sustained inhibitory pressure over a hypertonic myofascial structure
-
what are few mechanism for soft tissue outside of the 5 usual ones ?
- Effleurage
- Petrissage
- Tapotement
- Skin rolloing
-
What re the clinical pearls of successful techniques ?
- comfort
- being lateral and never on top of the spinous processes
- never sliding on the skin
-
HVLA
- The thurst technique
- passive and direct
- you engage the restrictive barrier
-
What are some contraindication of HVLA
- advance rheumatoid arthritis
- Down syndrome
- Achondroplastic dwarfism
- Chiari molformation
- fractures/dislocations/ spinal or joint instability
- joint fusion
- Klippel Feil syndrome
- Vertebrbasilar or carotif pathology
- Acute, local, or inflammatory arthridities
- Joint infection
- Malignancy invlving the bone of the soft tissue
- Myelopathy , cauda equina or other spinal pathology
-
BLT
- a physiological point in which the the proprioceptive infor allos the body to equalize the stresses extend on an articulation in all directions
- The proposed mechanism the ligaments of a joint are normally on a balanced, reciprocal tension an do not relax throughout the range of motion. The elements have not been strained.
-
contraindication of BLT LAS
- They are similar to those of the other methods
- one additional would be aortic aneurysm
-
How to perform Thoracic Lumbar BLT on T8NSLRR
- If patient is supine.
- you first think that BLT is passive indirect. This means we will be moving into the dysfunction
- physician felt hand is place under the patient at T8 on the Left transverse process. ( index and 3rd finger)
- the left chest wall is pulled to the right
- the left hand detects the beginning of the left side-bending of T8 before T9 is engaged.
- the physician lift up in the left transverse process with the palpating hand to induce right rotation, while still pulling the patient to the left.
- pt hold their breathe at the balance
- reassess.
-
Counter strain
- passive indirect
- we are focused on tender points that respond to positional release technique
-
Absolute contraindications of counter-strain
- treatment position brought on abnormal neurological and/ vascular symptoms
- Exacerbation of potential life-threatening symptomatology by treatment position
-
Relative contraindications of counter-strain
- Patient who cannot voluntarily relax or severely ill patient
- upper cervical hyperrotation or hyperextension
- inability to tolerate classical treatment position
- sever acute rheumatological flare
- signs of apprehension
-
special considertions in regards to position for counterstrain
- with the tender point in in the anterior typically flexion is requires
- when in posterior extension is required
- when lateral side bending and rotation is required typically
-
where is AL1 located
medial to the ASIS
-
where is AL2 located
Medial to the AIIS
-
where is AL3 located
lateral to the AIIS
-
where is AL4 located
inferior to the AIIS
-
where is AL5 located
Anterior, superior aspect of the pubic ramus later to the pubic symphisis
-
What are the posterior lumber tender points in counterstrain
- PL1-PL5 spinous processes
- PL1-PL5 transverse processes
- Quadratus Lumborum
|
|
