Soft Tissue & Myofascial Release Lab 2 Flashcards
What are some Release enhancing maneuvers?(REMs)?
o Inhalation/Exhalation
o Leg Extension/Flexion
o Arm Abduction/Adduction
Direct/Indirect
Thoracolumbar MFR
Patient: Prone
-Physician: Stands beside the patient
-Place both hands palm down on the
Thoracolumbar junction B/L,fingers spread out slightly
-Engage tissues with a ventral force
-Move tissues inferiorly and superiorly, left
and right, and clockwise and counterclockwise, noting in which directions there is ease of motion and restriction of motion
-Either treat the direct (into restriction) or
indirect (away from restriction) barrier
-Consider utilizing REMs to enhance release
-Reassess
Thoracic Longitudinal
& Lateral MFR (aka lower thoracic under the shoulder)
- Patient: Lateral Recumbent
- Physician: Stands facing patient
- Caudad forearm contacts iliac crest, cephalad forearm contacts axilla, fingers contact medial aspect of erector spinae muscles
- Spread elbows apart while applying lateral traction on paraspinal muscles
- Have patient breath deep for activating force
- Reassess
Seated Paraspinal
Lumbar MFR
Patient: Seated
-Physician: Seated next to patient
- Palm on medial aspect erector spinae muscle group, other hand across patient’s chest grasping contralateral shoulder
-In repetitive fluid motion, apply force
anteriorly and laterally while depressing and translating erector spinae laterally until tissue
release
-Reassess
Lumbosacral MFR
-Patient: Prone
-Physician: Stands beside patient
-Place one hand over the inferior lumbar
segment and the other hand over the superior sacral segment
-Monitor inferior and superior glide, left and right motion, and clockwise and
counter clockwise motion, noting the direction of ease of motion or restriction of motion
-Treat indirect or direct barrier, Consider
utilizing REMs
-Reassess
Prone I-Sacral Release
Patient: Prone
-Physician: Standing next to patient
-Place bottom hand over sacrum with heel over base and fingers over apex. Place other hand on top in opposite direction.
-Evaluate pattern of restriction by rocking
sacrum into multiplanar direction, noting
laxity and restriction
-Treat indirect or direct barrier by stacking
dysfunction, Consider utilizing REMs
-Reassess
Upper Limb &
Shoulder MFR
- Patient: prone with arm dangling from the patient
- Physician: seated on the side of the involved upper limb
- Grasp the humeral head of the patient with both hands and monitor the tissues for tissue texture response to the following motions introduced through the humeral head: flexion/extension, IR/ER of the humerus, adduction/abduction of the humerus, protraction/retraction of the scapular, superior/inferior scapular motion, traction/compression
- Engage either for direct or indirect MFR. Follow the release until there is no more tissue creep
- Reassess
Elbow MFR
-Patient: seated or supine
-Physician: on side of the involved upper
limb
-Hold the patient’s hand with one hand and the proximal radius and ulna with the other hand
-Test elbow flexion/extension and forearm
supination/pronation to determine directions of laxity and restriction
-Indirect: gently and slowly move the elbow to its position of laxity, apply compression or traction between your hands to facilitate laxity, and follow any tissue release until it is competed
-Direct: slowly move the elbow into its
restriction and apply steady force until tissue give is competed
-Slowly return the elbow to neutral and retest motion
-Reassess
Still’s Wrist MFR
Patient: seated -Physician: standing, facing patient -Grasp carpal bones between thenar eminences -Test flexion/extension, ulnar/radial deviation for restriction/laxity -Stack restrictive barriers and instruct patient to make a fist and/or spread fingers widely for 5 seconds and then relax hand -Engage next restrictive barrier and repeat until no new restrictive barriers are encountered -Reassess
Hamstring
Hypertonicity
ME/MFR Tx
-Patient: Supine
-Physician: Standing on side to be treated
-With knee extended and contralateral ASIS
stabilized, flex patients hip until fascial
barrier is met
-Patient is then instructed to push leg
downward toward table while physician
resists for 3-5 seconds.
-Engage the next restrictive barrier and repeat
until motion is restored
*alternate technique with knee flexed can be
done for gluteus maximus hypertonicity
-Reassess
Iliotibial Band, Prone
Fascia Lata
-Patient: Prone
-Physician: Stands on opposite side of IT
band dysfunction
-Use caudad hand to grab foot or ankle, flex
knee to 90°.
-Palm of cephalad hand will contact lateral
thigh
-Rotate the foot and lower leg out laterally
-Simultaneously engaging the IT Band by
compressing cephalad hand into patients IT
Band, pulling posteromedialy
-Reassess
Iliotibial Band, Lateral
Recumbent
-Patient: Lateral recumbent
-Physician: Stands facing the front of the
patient
-Stabilize patient by placing cephalad hand on the posterolateral aspect of iliac crest
-Make a fist with caudad hand and place the flat portion of the proximal phalanges over the distal lateral thigh
-Engage tissue giving a slight downward
pressure into IT Band and slide fist
proximally towards the greater trochanter
region. Then move proximal to distal.
-Reassess
Knee MFR/INR
Patient: Supine
-Physician: Standing on same side of knee
being treated
-With Superior (Cephalad) hand, grasp distal femur to stabilize, with inferior (caudad) hand grasp tibia/fibula and use it as lever to examine for three-dimensional laxity and restriction
-Assess in full extension followed by flexion, IR/ER, Ab/Adduction
-Passively move LE to treat either Direct/indirect
-Reassess
Knee MFR
-Patient: Supine or seated
-Physician: Standing on same side of knee
being treated
-Grasp proximal leg with both thumbs on
tibial plateau between knees
-Move tibia into anterior/posterior,
medial/lateral glide, and IR/ER to determine
position of laxity and restriction
-Treat restrictive barrier directly or indirectly
-Reassess
Sprained Ankle
Indirect MFR
-Patient: supine
-Physician: at foot of the table
-Monitor fascial milieu or other individual
ligaments with cephalad hand
-Use caudal hand on forefoot to introduce:
inversion/eversion, plantarflexion/dorsiflexion, IR/ER. Then engage as many indirect barriers as possible and use the inherent mechanisms to release the fascia. Follow release until there is no
more tissue creep
-Reassess
