OMM lab 3

  1. 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
  2. what are the passive direct soft tissue techniques?
    • Traction
    • Linear stretching
    • Lateral stretching
    • Deep pressure
  3. what is traction
    • A linear force to draw structures apart
    • the attachment point of the myofascial structures that are being treated are longitudinally separated
  4. What is Linear stretching
    • A kneading motion.
    • Direct force is applied to the long axis of the body
  5. 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)
  6. Deep pressure
    The sustained inhibitory pressure over a hypertonic myofascial structure
  7. what are few mechanism for soft tissue outside of the 5 usual ones ?
    • Effleurage
    • Petrissage
    • Tapotement
    • Skin rolloing
  8. What re the clinical pearls of successful techniques ?
    • comfort 
    • being lateral and never on top of the spinous processes 
    • never sliding on the skin
  9. HVLA
    • The thurst technique 
    • passive and direct 
    • you engage the restrictive barrier
  10. 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
  11. 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.
  12. contraindication of BLT LAS
    • They are similar to those of the other methods 
    • one additional would be aortic aneurysm
  13. 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.
  14. Counter strain
    • passive indirect 
    • we are focused on tender points that respond to positional release technique
  15. Absolute contraindications of counter-strain
    • treatment position brought on abnormal neurological and/ vascular symptoms
    • Exacerbation of potential life-threatening symptomatology by treatment position
  16. 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
  17. 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
  18. where is AL1 located
    medial to the ASIS
  19. where is AL2 located
    Medial to the AIIS
  20. where is AL3 located
    lateral to the AIIS
  21. where is AL4 located
    inferior to the AIIS
  22. where is AL5 located
    Anterior, superior aspect of the pubic ramus later to the pubic symphisis
  23. What are the posterior lumber tender points in counterstrain
    • PL1-PL5 spinous processes
    • PL1-PL5 transverse processes
    • Quadratus Lumborum
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OMM lab 3