Comprehensive Guide to Manual Therapy Techniques
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This guide provides insights into hands-on techniques such as massage, myofascial release, and joint mobilization used for evaluation and treatment, with focus on fascia pathology and trigger point therapy. Learn about neural mobilization and more.
Comprehensive Guide to Manual Therapy Techniques
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Presentation Transcript
chapter6 Manual Therapy Techniques
Manual Therapy • Hands-on technique is used to evaluate, treat, and improve a patient’s status. • Art and skill are involved. • Practice is required. • Objective evidence-based analysis of effectiveness is difficult.
Massage • Systematic and scientific manipulation of soft tissue for remedial or restorative purposes • Effects • Physiological • Mechanical • Types • Effleurage (see figure 6.1) • Pétrissage (see figure 6.2) • Friction (see figure 6.3) (continued)
Massage (continued) • Indications • Precautions • Contraindications • Application
Myofascial Release • Related to massage • Various techniques with many different names • Pressure and tissue stretch used to obtain desired results
Fascia • Surrounds all tissue • Superficial layer • Deep layer • Subserous fascia: not affected by manual treatment • Contains elastin, collagen, cellular components, ground substance • Has high tensile strength, can be deformed
Fascia Pathology • Results from acute or chronic deformation forces • Alters function • May cause pain, deformation, loss of motion, reduced function • Changes posture • Requires neuromotor readjustment • Increases risk of injury
Myofascial Release Techniques • Various strokes: J-stroke, oscillation, wringing, stripping, arm pull, leg pull, longitudinal release • Precautions • Contraindications • Possible neurogenic responses
Myofascial Trigger Points • Based primarily on work by Simons and Travell • A trigger point is a focus of hyperirritability that refers pain and occasional autonomic reaction. • Taut band with a central nodule • Active trigger point: refers pain without activity • Latent trigger point: refers pain only when palpated
Trigger Points • Do not follow neurological patterns • Do not have same type of pain as neurologically-based pain • Dull ache of various intensities • Specific referral pattern • Increase in pain with activity or irritation • Relief provided by short periods of rest, heat
Figure 6.15 Effect of Trigger Point Release on Neural Pathways
Trigger Point Treatment • Ice- or spray-and-stretch • Ischemic compression • Both followed by gentle stretches • In some cases injections by physician
Joint Mobilization • Purposes: • Relieve pain • Restore joint mobility • Various techniques • Arthrokinematics • Roll • Slide (glide) • Spin • Compression and distraction
Figure 6.25a Grades of Movement in a Normal and a Restricted Joint
Figure 6.25b Grades of Movement in a Normal and a Restricted Joint
Joint Mobilization • Indications • Contraindications • Precautions
Neural Mobilization • Used as a last resort • Used with caution • Susceptible sites of neurofascial restriction • Symptoms • Treatment