Traction, Compression, and Soft Tissue Management

Vocabulary practice flashcards created from lecture notes covering spinal traction, therapeutic compression, classic soft tissue massage, and instrument-assisted soft tissue mobilization (IASTM).

Traction

The application of a mechanical force to the body in a way that separates, or attempts to separate, joint surfaces and elongates surrounding soft tissues.

Hippocratic Method of Traction

An ancient historical traction method utilizing a wooden frame, straps, and leverage to apply a spinal decompressing force.

Joint Distraction

The separation of two articular surfaces perpendicular to the plane of the articulation, reducing compressive forces on joint surfaces and widening the intervertebral foramina.

Intermittent Traction

A form of spinal traction featuring cyclical variations in force that cause small changes in muscle tension, producing muscle relaxation through stimulation of the Golgi tendon organ ($\text{GTO}$).

Static Traction

A continuous application of a steady traction force that induces muscle relaxation by stretching muscles for several seconds, making it the technique of choice during acute joint inflammation.

Lumbar Traction Parameters (Initial/Acute Phase)

A pulling force of $29\text{--}44\,lbs$, static hold/relax mode, and a treatment duration of $5\text{--}10\,minutes$.

Lumbar Traction Parameters (Joint Distraction)

A force equal to $50\%$ of patient body weight ($50\,lbs$), a $15/15$ hold/relax ratio, and a treatment duration of $20\text{--}30\,minutes$.

Lumbar Traction Parameters (Muscle Spasm & Soft Tissue)

A force equal to $25\%$ of body weight with a $5/5$ hold/relax time for muscle spasm or a $60/20$ hold/relax time for disc problems and soft tissue stretch, both lasting $20\text{--}30\,minutes$.

Lumbar Spine Traction Positioning

Patient positioning in supine with hips and knees flexed at $90^\circ$ to flatten the lumbar lordosis and effectively deliver force to the lumbar segments.

Cervical Traction Parameters (Initial/Acute Phase)

A pulling force of $7\text{--}9\,lbs$, static hold/relax mode, and a treatment duration of $5\text{--}10\,minutes$.

Cervical Traction Parameters (Joint Distraction)

A pulling force of $20\text{--}29\,lbs$ ($7\%$ of body weight), a $15/15$ hold/relax ratio, and a treatment duration of $20\text{--}30\,minutes$.

Cervical Traction Angles of Pull

Specific neck flexion angles targeting different cervical segments: $0\text{--}5^\circ$ for C1--C2, $10\text{--}20^\circ$ for C2--C5, and $25\text{--}30^\circ$ for C5--C7.

Hypertension Discontinuation Criteria during Cervical Traction

For patients with resting blood pressure $> 140/90\,mmHg$, cervical traction must be discontinued if systolic or diastolic blood pressure increases by $> 10\,mmHg$ or heart rate increases by $> 10\,bpm$.

Carotid Sinus Baroreceptors

Sensory pressure receptors located in the carotid sinus that monitor blood pressure and can trigger autonomic hemodynamic responses when stimulated during cervical interventions.

Compression (Therapeutic)

An inward-directed mechanical force that increases external pressure on the body or body part to control peripheral edema, improve venous and lymphatic circulation, shape tissues, or increase temperature.

Intermittent vs. Sequential Compression Garments

Intermittent compression uses a single-chamber non-segmented garment providing dynamic cyclical pressure, while sequential compression uses a multi-chamber segmented garment inflating sequentially from distal to proximal.

Intermittent Pneumatic Compression (IPC) Pump Parameters

Treatment parameters including inflation and deflation times, inflation pressure ($mmHg$), and total treatment time.

Absolute Contraindications for IPC Pumps

Conditions including symptomatic heart failure, pulmonary edema, recent/acute DVT, thrombophlebitis, pulmonary embolism, obstructed venous/lymphatic return, severe peripheral arterial disease, acute local skin infection, cellulitis, hypoproteinemia ($< 2\,g/dL$), acute trauma/fracture, and arterial revascularization.

Soft Tissue Massage

The purposeful manual manipulation of a patient's soft tissues by a clinician to promote healing and restore function.

Effleurage

A classic massage stroke characterized by slow, superficial, repetitive sliding and gliding hand movements over the skin.

Petrissage

A classic massage technique performed by lifting the skin and underlying soft tissues, then pressing, rolling, squeezing, and kneading them prior to release.

Tapotement

A classic massage technique consisting of percussion movements performed in a rapid, alternating manner.

Scar Massage

Soft tissue techniques (such as kneading, petrissage, skin rolling, deep transverse friction, and myofascial MFR) that apply lifting, broadening, and shear forces to break up scar adhesions.

Trigger Point (TrP)

A hyperirritable spot within a taut band of skeletal muscle or fascia that is painful on compression and gives rise to characteristic referred pain, motor dysfunction, and autonomic phenomena.

Trigger Point Pressure Release

A technique applying sustained compression to a trigger point using hands, the olecranon process, or tools for $20\text{--}60\,seconds$ to lengthen sarcomeres, gradually increasing pressure to the point of reported pain.

Myofascial Release (MFR)

A soft tissue intervention designed to relieve soft tissues from the abnormal grip of tight fascia, most commonly using myofascial spreads and mobilizations.

Transverse Friction Massage (TFM)

A repetitive, specific, non-gliding technique applied perpendicular to muscle, tendon, or ligament fiber striations without lubrication at $2\text{--}3\,cycles/s$ for $5\text{--}20\,minutes$ to break up adhesions and soften scar tissue.

Instrument-Assisted Soft Tissue Mobilization (IASTM)

A therapeutic technique using handheld ergonomic instruments as levers to treat soft tissue dysfunction, decreasing clinician fatigue while increasing treatment specificity.

IASTM Aggressiveness Variables

Treatment parameters where smaller instrument size, narrower edge, convex-on-convex shapes, faster strokes, longer strokes, steeper angles ($60\text{--}90^\circ$), and putting target tissue on stretch increase treatment aggressiveness.

Graston Technique Clinical Progression

A 3-stage progression: Session 1 evaluates tissue reactivity with gentle treatment; Session 2 implements full Graston Technique with stretching/strengthening; Session 3 through discharge modifies technique to maximize functional response.

CPT Code 97140

The primary Current Procedural Terminology billing code for Manual Therapy, recommended for Graston Technique therapy and manual soft tissue interventions.