Foundations of Manual Therapy

What are the effects of manual therapy?

reduce pain and increase soft tissue extensibility and ROM

What are indications for MT?

Pain is mild, intermittent, provoked by particular positions or motions, disappears quickly, relieved w/ rest, altered by changes w/ sitting/ standing posture

What are ABSOLUTE contraindications for MT?

systemic or localized infection, fever, acute circulatory condition, malignancy, open wound at treatment site, recent fracture, hematoma, inappropriate end feel or instability (manip), constant/ severe pain (even at rest, disrupts sleep), any condition not fully evaluated

What are indications for joint mobilizations and manips?

increasing joint extensibility and ROM, decrease pain, promote m. relaxation, increase m. performance

What are the 4 effects of joint mobilizations/ manips?

1) psychological 2) mechanical 3) neurophysical (sensory receptors) 4) chemical (endorphins)

OPP/ CPP is most joint congruency.

CPP

OPP/ CPP is best for load bearing and joints are more susceptible to injury from unexpected perturbations.

CPP

OPP/ CPP is least joint congruency.

OPP

OPP/ CPP is not best for load bearing but is a dynamically safe position and is optimal for joint distractions.

OPP

What is the treatment for high joint reactivity?

rest, motion in pain free range, oscillations, ice, TENS

What is the treatment for moderate joint reactivity?

progressive oscillations, gentle stretching, heat

What is the treatment for low joint reactivity?

static stretches, grades 3-4 mobs, manip

OPP of GH joint.

ABD 55, horiz ADD 30

CPP of GH joint.

full ABD and ER

Normal end feel of GH joint.

firm (ligament/ capsule)

OPP of HU joint.

70 flexion, 10 sup

CPP of HU joint.

full extension and sup

Normal end feel of HU joint.

hard (bony)

OPP of radiocarpal joint.

10 flexion, slight ulnar dev

CPP of radiocarpal joint.

full extension and rad dev

Normal end feel radiocarpal joint.

firm (capsular)

OPP hip joint.

30 flexion, 30 ABD, slight ER

CPP hip joint.

full extension, ABD, IR

Normal end feel hip joint.

firm (capsule)

OPP tibiofemoral joint.

25 flexion

CPP tibiofemoral joint.

full extension and ER tibia

Normal end feel tibiofemoral joint.

firm (capsular)

OPP talocrural joint.

10 PF

CPP talocrural joint.

full DF

Normal end feel talocrural joint.

firm (capsular)

OPP MTP.

Neutral, slight flexion

CPP MTP.

full extension

Normal end feel MTP.

firm (capsular)