traction

• a drawin (pulling) tension applied to a body segment; a distraction
• used to reduce signs or symptoms of cervical or lumbar spinal compression and to help bones or tissues to realign

seperations of 1-2 mm per interveterbral space

bones grow according to the stresses and strains placed on them

• promotes stretch
• fast-may overload the ligament
• slow- provides gradual stretching

• dec central pressure
• encourage disc bulge to resume a more central positon
• better fluid exchange

• distraction of jt surfaces
• inc mobility
• dec pain

• stretch muscle tissues
• cause reflex relaxation
• inc blood flow
• dec pain

dec pressure on the nerve roots by opening up intervetebral foramen

• continuous
• static
• intermittent
• manual
• positional
• inversion

• aplied with constant force
• several hours daily
• reduce muscle spasm and muscular pressure on lumbar spine
• little or no intervertebral seperation

• a.k.a sustained traction
• more wt
• short duration
• achieves seperation of intervertebral discs
• relax muscle
• stretches soft tissue

• applies traction with on/off timing
• 15-60 sec cycle
• 20-30 min duration
• seperates bony surfaces
• stretches muscle and ligaments
• mobilize jt

• usually done to cervical but can be applied to lumbar
• applied by therapist
• 15-60 sec duration

• positioning the body in a way that will affect bony relationships
• usually lateral trunk bending to open vertebral foramen on one side

• traction by force of gravity
• pt hang upside down from upper thighs/pelvis
• 5-15 min duration
• monitor for abnormal blood pressure/HR

• nerve root impingement
• subacute pain
• DJD
• jt hypomobility
• paraspinal muscle spasm

• absolute- spinal infection, spinal cancer, spinal cord pressure, RA, osteoporosis
• relative- ligamenous strain, acute stages of injury, traction anxiety, cardiac or respiratory insufficiency, pregnancy, tempero-mandibular jt dysfunction

• friction- mvmt
• direction- mobility
• position- realign

• split table reduces friction
• harness requires pelvic and rib belt
• neutral spine allows for most intevertebral opening
• no seperation w/o 1/4 of pt body wt

• <10 sec- min seperation; inc facet mvmt; activate jt and muscles receptors
• >10 sec- longer lasting seperation; stretch muscles and ligaments
• disc protocal- 60 on 20 off
• 5-30 min
• disc 8-10 min

• allow for some head flexion- maximizes pull from occiput
• rope angled 15-30 degrees
• supine position
• 25-40 lbs
• intermitent (if they have mvmt) 60 hold 10-15 restor static ( no mvmt)
• treatment time 5-10 min disc 20 min other problems

over door sitting positon and static

• prone- static- none- 8-10 min
• supine- static- none 8-10 min
• prone or supine- intermittent- long hold short rest- 15-20 min

supine or prone- static- none if intermittent long hold short rest- 15 min

supine 90/90- static (fixed) intermittent (mobility)- none or 15-15 on/off- 15-20 min

supine, prone, or sidelying- static or inter- long hold short rest, short hold short rest if mobility needed- 15-20 min

supine 90/90- inter- mobility or short hold long rest for irratation- 15-20

prone- inter- mobility 15/15- 15-20 min

90/90- fixed static; mobility inter 15/15- 15-20 min