Lecture 6 - Indications and Contraindications of the Usage of OMT

The ___ ratio needs to be considered when selecting any treatment including ___, ___, and ___.

The RISK-BENEFIT ratio needs to be considered when selecting any treatment including TYPE/MODALITY, FREQUENCY, and APPLICATION.

___ contraindication = DO NOT utilize OMT

ABSOLUTE contraindication = DO NOT utilize OMT

___ contraindication = MAY use OMT

RELATIVE contraindication = MAY use OMT

___ engages continual palpatory feedback to achieve release of myofascial tissues.

MYOFASCIAL RELEASE engages continual palpatory feedback to achieve release of myofascial tissues.

Myofascial release can be ___ or ___, and usually involves taking the muscle and/or fascial tissue into multiple ___ of motion - either to the ___ or to the position of ___.

Myofascial release can be DIRECT or INDIRECT, and usually involves taking the muscle and/or fascial tissue into multiple PLANES of motion - either to the BARRIER or to the position of EASE.

Myofascial release model indications: ___ involving myofascial or other connective tissues

Myofascial release model indication: SOMATIC DYSFUNCTIONS involving myofascial or other connective tissues

Myofascial release absolute contraindications:

• ___ of somatic dysfunction

• Lack of patient ___ or ___

Myofascial release absolute contraindications:

• ABSENCE of somatic dysfunction

• Lack of patient CONSENT or COOPERATION

Myofascial release ___ contraindications:

• Absence of somatic dysfunction

• Lack of patient consent or cooperation

Myofascial release ABSOLUTE contraindications:

• Absence of somatic dysfunction

• Lack of patient consent or cooperation

___ contraindications:

• Fractures

• Open wounds

• Soft tissue or bony infections

• Abscesses

• Recent post-operative status (wound dehiscence)

• Aortic aneurysm

LOCATION-SPECIFIC contraindications:

• Fractures

• Open wounds

• Soft tissue or bony infections

• Abscesses

• Recent post-operative status (wound dehiscence)

• Aortic aneurysm

Overly aggressive myofascial release treatment is ___.

Overly aggressive myofascial release treatment is COUNTERPRODUCTIVE.

During myofascial release treatment, you must respect the limits of ___ tissues, as exceeding these limits creates a ___ event.

During myofascial release treatment, you must respect the limits of DYSFUNCTIONAL tissues, as exceeding these limits creates a TRAUMATIC event.

___ model: system of diagnosis and indirect OMT in which a tender point associated with an inappropriate proprioceptive firing is identified

COUNTERSTRAIN model: system of diagnosis and indirect OMT in which a tender point associated with an inappropriate proprioceptive firing is identified

Counterstrain model: system of diagnosis and ___ OMT in which a ___ associated with an inappropriate ___ firing is identified

Counterstrain model: system of diagnosis and INDIRECT OMT in which a TENDER POINT associated with an inappropriate PROPRIOCEPTIVE firing is identified

In the counterstrain model, the tender point is treated by using a position of ___ to cause ___ tissue release while simultaneously monitoring the tender point.

In the counterstrain model, the tender point is treated by using a position of EASE to cause SPONTANEOUS tissue release while simultaneously monitoring the tender point.

Counterstrain model indications:

• ___ or ___ somatic dysfunctions

• Somatic dysfunctions with a ___ component

• Somatic dysfunctions with primarily ___ tissue pain

Counterstrain model indications:

• ACUTE or CHRONIC somatic dysfunctions

• Somatic dysfunctions with a NEURAL component

• Somatic dysfunctions with primarily SOFT tissue pain

Counterstrain model ABSOLUTE contraindications:

• ___ of somatic dysfunction

• Lack of patient ___ and/or ___

• Inability to tolerate treatment ___

Counterstrain model ABSOLUTE contraindications:

• ABSENCE of somatic dysfunction

• Lack of patient CONSENT and/or COOPERATION

• Inability to tolerate treatment POSITIONING

Counterstrain model RELATIVE contraindications:

• Patient who cannot voluntarily ___

• ___ ill patient

• ___ artery disease in cervical spine

• Severe ___

Counterstrain model RELATIVE contraindications:

• Patient who cannot voluntarily RELAX

• SEVERLY ill patient

• VERTEBRAL artery disease in cervical spine

• Severe OSTEOPOROSIS

Counterstrain model location specific contraindications:

• Vertebral artery disease in the ___ spine

• Severe ___

Counterstrain model location specific contraindications:

• Vertebral artery disease in the CERVICAL spine

• Severe OSTEOPOROSIS

Counterstrain model safety and efficacy considerations:

• ___ reactions

• Reactions associated with patient ___

• Avoid positions that cause ___, ___, ___, and ___ pain

• Avoid extreme bending of the ___ spine

Counterstrain model safety and efficacy considerations:

• POST-TREATMENT reactions

• Reactions associated with patient POSITION

• Avoid positions that cause DISCOMFORT, DIZZINESS< PANIC, and NEUROGENIC pain

• Avoid extreme bending of the THORACOLUMBAR spine

High velocity/low amplitude model:

• Technique employing ___, therapeutic force of ___ duration that travels a ___ distance within the ___ range of motion of a joint

• Engages the ___ barrier in one or more planes of motion to elicit release of restriction

High velocity/low amplitude model:

• Technique employing RAPID, therapeutic force of BRIEF duration that travels a SHORT distance within the ANATOMIC range of motion of a joint

• Engages the RESTRICTIVE barrier in one or more planes of motion to elicit release of restriction

High velocity/low amplitude indications:

• ___ (___) somatic dysfunctions (___)

• Firm, distinct ___ barriers

High velocity/low amplitude indications:

• ARTICULAR (JOINT) somatic dysfunctions (TART)

• Firm, distinct ARTICULAR barriers

High velocity/low amplitude ABSOLUTE contraindications:

• ___ cervical

• ___, ___, ___, or ___ instability

• ___

• ___

• Surgical ___

• ___ insufficiency

• ___ joint disease

• Joint ___

• Bony ___

• Patient ___

High velocity.low amplitude ABSOLUTE contraindications:

• UPPER cervical

• FRACTURE, DISLOCATION, SPINAL, or JOINT instability

• ANKYLOSIS

• SPONDYLOSIS

• Surgical FUSION

• VERTEBROBASILAR insufficiency

• INFLAMMATORY joint disease

• Joint INFECTION

• Bony MALIGNANCY

• Patient REFUSAL

High velocity/low amplitude LOCATION SPECIFIC contraindications:

• Acute herniated ___

• Acute ___

• Acute ___/severe muscle ___/strain/sprain

• ___

High velocity/low amplitude LOCATION SPECIFIC contraindications:

• Acute herniated NUCLEUS PULPOSUS

• Acute RADICULOPATHY

• Acute WHIPLASH/severe muscle SPASM/strain/sprain

• SPONDYLOLISTHESIS

High velocity/low amplitude safety and efficacy considerations:

• Proper ___ of somatic dysfunction and treatment ___ are key

• Proper ___ decreases injury risk

• ___ = avoid anatomic barrier

• ___ artery protection in cervical HVLA = ___ combine serve extension with rotation

High velocity/low amplitude safety and efficacy considerations:

• Proper DIAGNOSIS of somatic dysfunction and treatment SETUP are key

• Proper LOCALIZATION decreases injury risk

• LOW AMPLITUDE = avoid anatomic barrier

• VERTEBRAL artery protection in cervical HVLA = NEVER combine severe extension with rotation