Active care exam 2 pt 2

self-myofascial release

ELDOA

CARs

PAILs and RAILs

neuromobilization

are other what?

mobility techniques

mobility technique typically performed using a piece of equipment such as a foam roller, tennis ball, etc. that helps release a tight/facilitated muscle

self-myofascial release

can a patient perform self-myofascial release on there own or do they need direction?

can be performed on their own

self-myofascial release recommended duration

30-120 seconds per muscle group recommended

what mobility technique utilizes active rotation movements at outer limits of ROM for each individual joint in order to stimulate articular adaptations ; involves patient actively moving through their ROM and utilizing usable ROM under muscular neurological control rather than holding a static stretch?

CARs

controlled articular rotations (CARs) are controlled with ________

tension

what are PAILs and RAILs

progressive angular isometric loading

regressive angular isometric loading

active component ensure that usable ROM is achieved

can be applied to any stretch

time under tension matters

are key components that differentiate ___ and ____ from other stretching/mobility techniques?

PAILs and RAILs

what are the basics on how to perform PAILs/RAILs

1st rep involves 2-min initial hold followed by 10-20 second progressive cx and 10-20 second regressive cx (repeat 2-4x)

longitudinal osteo-articular decompression stretching which is a postural self-normalizing technique designed for widening the space within chosen articulation and correcting structural imbalances

ELDOA method

creating fascial tension to fix vertebra below and contraction in extreme range to normalize vertebra above

Explains how is the _____ method accomplished?

ELDOA

put tension into fascia that encases the muscles in order to normalize length and function of fascial chains is the goal of what?

ELDOA

focus on elongating the spine

incorporating tension within the fascial network

maintaining good stability/positioning throughout

BREATHE

are keys to what method?

ELDOA

spinal malpositioning

scoliosis

disc pathologies

radiculopathy symptoms

is the primarily use of what method?

ELDOA

fascia and CT around spine

space between vertebra

fascia and CT of extremities

Are the goals of ELDOA method is to create what?

normalization

what mobilization technique places tension on the nerve distally and then proximally in an alternating pattern to provide nerve gliding of lengthening via joint movements?

neuromobilization

when there is suspected nerve involvement in patients symptoms and patient exhibits positive neurodynamic test is when what is indicated?

neuromobilization

nerves are 80% connective tissue

nerves may exhibit increased or decreased length in response to loads/movement

nerves are susceptible to entrapment and adhesion

Are all good reasons to perform what?

nerve flossing

facilitate neural gliding

reduce adhesion between nerve and surrounding tissue

enhance neural vascularity

improve axoplasmic flow

may modulate central sensitization and peripheral pain mechanisms in MSK disorders

All explains what ____ ____ does?

Nerve flossing

a neurodynamic maneuver whose purpose is to produce a sliding movement of neural structures relative to their adjacent tissues

-performed by placing tension on one end of the nerve and reducing tension on the other end of the nerve

slider

neurodynamic maneuver that produces an increase in tension in neural structures

-relies on natural viscoelasticity of nervous system

perfumed by placing tension (elongating) both ends of nerve simultaneously

tensioner

what is a general recommendation for frequency and repetition of nerve flossing?

3-5x per day and/or when symptoms present

10-15 reps

what is the goal of neural mobilization?

increase excursion of nerve while reducing strain

what are the 2 most important components of assessment of muscles?

movement is king (functional assessments are best, ROM is important)

palpation is queen

what are the different types of palpation?

screening, snapping, flat, pincer

what type of palpation is a digital exam of a muscle to determine absence or presence of palpable bands and tender trigger points using flat and/or pincer palpation

screening palpation

what type of palpation is like plucking a guitar string at a 90 degree a gel to assess taut bands and twitch response

snapping palpation

what type of palpation is a firm compression against underlying structure with a flat contact?

flat palpation

what type of palpation uses a pincer grasp and roll the muscle between the fingertips?

pincer palpation

tenderness, tight cord/band, radiating pain, tender fibrous beaded chains, tender nodules with radiating pain, tender cx muscle bundles, hypertonicity, spasm, trigger points

Are all examples of what?

abnormal muscle palpation findings

myoneural units of muscle that are expressing aberrant neurologic tone at rest

-the sensitized neural structures produce neurogenic inflammation causing a localized vasodilation and inflammatory response around affected motor units

-initially a response to poor joint mechanoreception or segmental stability and are an attempt to compensate

trigger point

a cluster of numerous microscopic loci of intense abnormality that are scattered throughout the nodule

TrP (tender nodule)

hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band

Explains where what is located?

trigger points

what type of trigger points are always tender, cause pain in a referral pain that is not related to palpation of a muscle, has pain associated with movement, prevents full lengthening of a muscle, weakens the muscle an mediates a local twitch response?

active TrP

what type of trigger point is painful only when compressed/palpated

latent TrP

manual therapies

MET and PNF stretches

end range mobility concepts

treating underlying dysfunction and removing negative stimulus and biomechanical load from tissues

stabilization exercise

are examples of how to treat what?

Trigger points

improve tissue extensibility

increase ROM

mobilize/manipulate soft tissues and joints

induce relaxation

change muscle fxn

stabilize joint complex

modulate pain

reduce soft tissue swelling, inflammation or movement restrictions

are goals of performing what?

manual therapies

any technique that involves kinesthetic input and manipulation or interaction with tissues

manual therapies

mechanical stimulus and biomechanical effects

neurophysiological mechanism

peripheral mechanism

spinal mechanism

supraspinal mechanism

are the 5 paradigms for explaining the therapeutic effects of _______?

Manual therapy

influence pain modulation

produce rapid, short-term changes

contribute to improved somatoperceptual touch

Are benefits of what?

manual therapy

increase rate and amount of blood flow to and from an area

increase cellular activity in the region (fibroblasts/mast cells)

increase histamine response

separate/break down collagen cross-links and stretch CT/muscle fibers

facilitate reflex changes in chronic muscle holding pattern

alter spinal reflex activity

improve soft tissue function and ROM following injury

shorten recovery period

are the underlying mechanisms of what?

IASTM

what angle should an IASTM tool be held?

45 degrees

what duration should IASTM treatment be performed?

60-120 seconds

besides passive/static treatment, what other ways can you use IASTM

dynamically by having patient go through repetitive ROM or functional movement pattern

scanning/diagnostic

warming

sweeping

cross friction

deep tissue

pin/stretch

are the 6 most helpful what?

IASTM stroke types

what technique uses providers hands to identify aberrations in tissue texture, tension and movement, continuing until the provider determines the root cause then once condition is targeted, combines precise touch with specific patient movements to restore proper function and relieve pain?

active release technique

use soft contact

begin active, work longitudinally

use active motion when possible

use slow motion

evaluate patient tolerance

evaluate tissue tolerance

work along direction of venous and lymph flow

alternate days

Are all guidelines for what?

Pin and stretch

utilizing manual therapies early in tx is most individuals ned to progress to more active tx

should be part of a multi-modal approach to care

should be considered similar to analgesics (short term pain relief)

are evidence supported uses for what?

manual therapies