Therapeutic Principles

Positive effects on performance

- Faster muscle contraction and relaxation of both agonist and antagonist Muscles

- Improvements in the rate of force development and reaction time

- Improvements in muscle strength and power

-Lowered viscous resistance in muscles

-Increased blood flow to active muscles

- Enhanced metabolic reactions

- An increased psychological preparedness for performance

How long is a general warmup

Total warm up will last for 10-20 minutes

A slow active warmup

5-10 minutes of slow aerobic exercises

Specific parts of warmup

Begin doing sport specific related movements and exercising

RAMP protocol for warmup

Raise, Activate, mobilize, and potentiate

Dynamic flexibility

Available ROM during active movements, requires voluntary muscular actions

Static flexibility

range of a possible movement about a joint and its surrounding muscles during a passive movement

Factors that affect flexibility

Joint structure, Age and Sex, Muscle and Connective Tissue, Stretch tolerance, Neural control, Resistance training, Muscle bulk, Activity level

What is ROM controlled by

Frequency, duration, and intensity of stretching

Stretch Reflex

when muscles spindles are stimulated during a rapid stretching movement

Autogenic inhibition

active contraction before a passive stretch of the same muscle

Reciprocal inhibition

contracting the muscle opposing the muscle that is being passively stretched

Static Stretch

slow and constant, with the end position held for 15-30 seconds

ballistic stretch

Typically involves active muscular effort and uses a bouncing-type movement in which the end position is not held

dynamic stretch

a type of functionally based stretching exercise that uses sport-specific movements to prepare the body for activity

Causes of wounds

• Surgical incisions

•  Trauma

•  Pressure

•  Shearing Forces

•  Friction

  •  Poor Circulation

Risk Factors for developing a wound

• Broken Skin

• Age (young or old)

• Nutritional Status

• Stress

• Hereditary

• Disease process

• Medical Therapies (steroids, chemo, radiation, diuretics)

A break in the skin or mucous membrane

open wound

A wound created for a therapy purpose

intentional wound

center of gravity

Center of gravity (CoG) is Center of mass(CoM)

• Changes with motion

• Changes when weight is added to the body

• The lower the center of gravity, the more stable the object

The line of gravity runs which way through the center of mass

The line of gravity runs vertically through Center of Mass, used as a point of reference for posture discussion and can be used to determine stability.

How to get rid of chronic tissue

Debridement, which is the removal of this type of chronic tissue, through surgery, chemical, or autolytic. 

What are the phases of healing

Inflammatory, Proliferative, maturation

Inflammatory phase of healing

a clot forms and cells of inflammation debride injured tissue. Immediate to 0-4 days

Proliferative phase of healing

 epithelialization, fibroplasia, and angiogenesis occur; additionally, granulation tissue forms and the wound begins to contract. 2 days - 6 week

Maturation phase of healing

Collagen forms tight cross-links to other collagen and with protein molecules, increasing the tensile strength of the scar. 3 weeks to 2 years

Healing process

Hemostasis, inflammatory, fibroblastic repair, maturation remodeling

1st and 2nd line of defense

Neutrophils

macrophages

Neutrophils

enter the wound to fight infection and to attract macrophages.

Macrophages

break down necrotic debris and activate the fibroblast response

How collagen heal

Realignment of collagen fibers along lines of Tensile force to increase tensile strength. Type 1 collagen will be replaced by type 3 to form scar tissue. Collagen will lay randomly if no stress is placed.

Wollf’s law

Bone/soft tissue will respond to  physical demands placed, will align along stresses/tension

• Critical that bone/soft tissue be exposed to gradually increasing stresses – specific to activities

muscles in the body

650

purpose of muscles

generation of force and movement

3 big muscles

skeletal cardiac smooth

muscle tissue and the ability to reproduce blood cells

very little ability to reproduce

synonym for cell body

soma or perikaryon

Schwann cells

• responsible for myelination of axon

• Wraps itself as spirally around a short segment of axon

• Myelinate single axon

satellite cells

•  Flat cell that surrounds the cell bodies of neuron of PNS gangla

  • Regulate exchange of material between neuron cell bodies and interstitial fluid

Body tissue order in which therapeutic energy passes effects

epidermis,  adipose, muscular, nervous, connective

Epithelial tissue

tissue type that lines major organs and covers body surface

Involved in secretion, absorption, excretion, sensory reception

Cell response to stress

Adapts, becomes injured and recovers, dies

major categories of modalities

 Electrical, thermal, mechanical, light, manual, exercise

connective tissue components

GROUND SUBSTANCE, FIBERS, CELLs

matrix of connective tissue

• White fibers – contain collagen which gives the fibers flexibility and strength

•  Yellow fibers – contain elastin more elastic than collagen but not as strong

  •  Reticular fibers – thin, highly branched collagenous fibers that provide support

Inflammatory acute response phase

0-4 days

localized tissue repair response

• has a purpose

Hemostasis

Healing phase that shunts blood flow initially in the first secs to mins

General adaption syndrome

• Alarm Stage

  •  “Flight or fight” body fights for homeostasis- “Flight or fight” body fights for homeostasis

  • Increased BF, HR, SV

  • shunting occurs

  • Cortisol released

•  Resistance Stage 

  • Plateau in the bodies adaptation 

    •  Body continues to adapt to the stressor by using homeostatic resources to maintain its integrity

    • Longest phase of the general adaptation syndrome, lasting many days, months, or years

•  Exhaustion Stage

  • Body can no longer withstand the stressor

    •  Occurs when the body cannot withstand 

    •  Clinical—this stage may present as traumatic or overuse injuries

Flight or flight

BODY fights for homeostasis by increasing blood flow, heart rate, stroke volume

maturation remodeling

3 weeks to 2 years, a process in which new collagen forms which increases tensile strength to wounds, scar tissue is only 80% as strong as original tissue

5 cardinal sins of inflammation

• Pain

  • release of prostaglandin/bradykinin, damage to nerve receptors

• Heat/Increased tissue temp.

  •  vasodilation

• Redness

  • vasodilation

• Swelling

  • Increased capillary membrane permeability

• Loss of function

  • Body’s response to pain, swelling

inflammation occurs in what area

Can only occur in vascular areas!!

• Poorly vascularized areas heal poorly

• Areas unvascularized will/can not heal

clot formation

Platelets form initial plug in damaged BV

• Plasma protein conversion

• Completed within 48 hours

platelets

release epinephrine and thromboxane which causes the immediate vasoconstriction following damage

fascia

3D WEB Consisting of a watery extra cellular matrix (ground substance), elastin, and collagen fibers densely woven in all directions, and fibroblast cells

network of fascia

THREE WHOLE-BODY NETWORK (FASCIA, MYOFASCIAL, MUSCLE FIBERS)

layer of epithelial tissue does lymphatic tissue run through

simple squamous epithelium

parkinsons disease

decreases dopamine

Extracellular matrix in fascia anatomy

 FIBER, PROTEINS AND A FLUID PART, THE GROUP SUBSTANCE.

layers of fascia

superficial, deep, subserious

fascia line

lateral, spiral, deep, frontal, ipsilateral functional, arm

superficial back arm line

Trapezius, deltoid, lateral intermuscular septum, extensor group

Deep back arm line

Rhomboids, levator scapulae, rotator cuff, triceps, fascia along ulna, ulnar collateral ligaments, hypothenar muscles

Superficial front Arm Line

Pectoralis major, latissimus dorsi, medial, intermuscular septum, flexor group, carpal tunnel

Deep Front Arm Line

Pectoralis minor, clavipectoral fascia, biceps, radial fascia, radial collateral ligaments, thenar muscles 1

type 1 collagen

Exist to provide structure in bone, skin, tendons, ligaments, proper fascia

type 2 collagen

Exist in cartilage and intervertebral discs

type 3 collagen

Derives from mesenchymal cells. Thinner collagen fibrils, found in loose fascia and wound healing

cartilage

tough flexible tissue that lines joints

fibrous connective tissue

Tissue made up of tough protein fibers called collagen, fibroblast, found in tendons and ligaments

meningeal fascia

The fascia that surrounds the central nervous system

golgi tendon organ

Sensory receptor, detects changes in muscle tension at the junction point between the muscle and the tendon

common cause of chronic inflammation

OVERAGGRESSIVE REHAB

• foreign body, bacteria

• Microorganisms (TB, syphilis, staph)

• Autoimmune disease (rheumatoid arthritis)

• Continual microdamage to healing tissue

price- first aid treatment

protection rest ice compression elevation

blood content

plasma 55

rbc 45

platelets and wbc <1