Traction

may reduce pain originating form joint injury or inflammation or from nerve root compression

• lumbar 50% body weight
• cervial 7% body weight

• can increase the length of the soft tissues in the area
• increasing the length of soft tissues can help with
• spinal joint distraction or reduction of disc protrusion
• increasing spinal ROM
• decrease pressure on the faccet joints

Facilitates reaxation of the paraspinal muscles

• traction is a means tot mobilize joints in order to increase joint mobility or decrease joint related to pain
• joint mobility increased due to stretching of the surrounding soft tissue

• Disc duldge or herniation
• nerve root impingment
• joint hypemobility
• subacute joint infalmmation
• papaspinal muscle spasm

• where motion in contraindicated
• with acute injury or inflammation
• joint hypermobility or instability
• peripheralization of symptoms with traction
• uncontrolled hypertension
• spinal infections or caner
• spinal cord pressure
• rheumatoid arthritis
• osteoporosis
• prolonged steroid use
• recent frature

• ligamentous strains and joing hypermobility
• acute stages of injury
• traction anxiety
• cardiac or respiratory insufficiency
• pregnancy
• displacement of annular ligametn
• medial disc protrusion
• severe pain fully relieved by treaction
• dentures

• symptoms become more severe
• peripheralize
• increase in distribution
• progress to other domains
• pain changed to weakness numbness or tingling

• decreased pain with decreased neurological signs usually are an indication that the condition is resolving
• increased central pain decreased peripheral pain

• Decreased pain but increased in neuroligical signs indicate increased pressure to a nerve root, causing sensory deficits motor weakness or both
• Decreased central pain with increased peripheral pain indicate increased nerve root irritation

• Use of electric and weighted mechanical devices
• self traction
• positional traction
• manual tracion
• inversion techniques
• auto traction
• cottrell 90/90 tracion

• can be applied to the lumbar and cervial spine
• electric mechanical traction units can apply atatic or intermittent traction

same amount of force is applied throughout the treatment session

Tracion force alternated between two set point every few seconds thourghtout the treatment session

• Flexion
• upper lumbar and lower thoracic

neutral or extension

• flexion, rotation and side bending can be adjusted for patient comfort and to direct forece to disiered area
• flexed focuses on the lower cervical spine
• extendes focuses on the upper cervial spine
• max elongation of posterior structures is achieved with 25-30 degrees of flexion

• force resisting motions between 2 surfaces
• amoutn of resistance depends on magnitude of force compressing objects togeher
• to overcome friction a forece of 1/4 the body weight is nexissary with lumbar traction
• split tractin table eliminates friction

• force and time well controlled readily graded and replicable
• once applied does not require the clinician to be with the pt
• electrical mech traction devices like over the door treaction are inexpensive and convenient for independent use by the pt at home

• expensive electric machanical devices
• time consuming to set up
• lack of pt control or participation
• restriction by belds or halter poorly tolerated by some
• mobilized broad regions of the spine rate than individual spinal segments potentially creating hypermobility in normal joint

a form of traction tat uses gravity and the weight of the pt body or foece exterted by the pt to exert a distractive force on the spine

• sitting
• between corner counters
• overhead bar
• door
• supine

• minimal or no equipment needed
• easy for pt to perform
• easy for pt to control
• can be performed in many environments and thus many times during the day

• low maximum force therefore may not be effective
• requires strong injury free upper extremities
• can't be performed on the cervical spine
• no research data to support
• pt my have good posture awareness

• involves prolonged placement of the pt in a postion that places tension on one side of the lumbar spine only
• doesn't cause joint distraction it may help with muscle spasm and stretch soft tissue

• requires no equipment or assistance
• inexpensive
• can be applied by the pt at home
• low force not likely to aggravate an irritable condition
• position easily adjustable

• low force not likely to be effective here joint distaction is required
• requires agility and skill by the pt to perform correctly
• no research

• the application of force by the therapist in the direction to distract the joints
• used on cervical and lumbar
• classified as manual therapy
• allows the therapist to feel the patients reaction
• exact amout of force can't be quantified or aniticipated by the pt
• can be limited by therapist strength and fatigue

• no equipmetn required
• short setup time
• force can be finely graded
• clinicaian is present throughout trreatment
• can be applied briefly to determine if mechanical traction should be used
• can be used with pt who do not tolerate being placed in halters or belts

• limited max traction force
• amount of force can't be easily replicated or specifically recorded
• can't be applied for prolonged period of time
• required a skilled clinician

• Intermittent tractin is usually performed for 20-30 mins
• Sustained traction is done for 3-30 mins at low weights
• may be done daily, twice daily, or 2-3 times a week

• type
• area
• position
• type of halter
• max force
• total treatment time
• response to treatment
• in intermittent used hold and relax times