what are the passive direct soft tissue techniques?
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
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)
The sustained inhibitory pressure over a hypertonic myofascial structure
what are few mechanism for soft tissue outside of the 5 usual ones ?
What re the clinical pearls of successful techniques ?
being lateral and never on top of the spinous processes
never sliding on the skin
The thurst technique
passive and direct
you engage the restrictive barrier
What are some contraindication of HVLA
advance rheumatoid arthritis
fractures/dislocations/ spinal or joint instability
Klippel Feil syndrome
Vertebrbasilar or carotif pathology
Acute, local, or inflammatory arthridities
Malignancy invlving the bone of the soft tissue
Myelopathy , cauda equina or other spinal pathology
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
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