Myofascial Technique Flashcards

1
Q

What is fascia composed of?

A
  • collagenous fibers interwoven in an irregular arrangement- made up of fibroblasts, fibroglia, collagen fibrils and elastic fibrils.
  • matrix contains prtoeglycans made up of polysaccharide chains containing : glucosamine, hyaluronic acid, chondroitin sulfate
  • loose connective tissue = areolar
  • stretchable
  • connects many adjacent structures of the body
  • acts like an elastic glue that permits movement
  • matrix of areolar tissue is a soft, thick gel mainly because it contains hyaluronic acid
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2
Q

glycosaminoglycans (GAGs): how are they created? what are they made of

A
  • are generated from fibrocytes in response to motion
  • Linear polymers of repeating disaccharide unit
  • Form milieu in which collagenous fibers provide form and stiffness of connective tissue
  • Are hydrophilic and determines the relative fluid content of connective tissue
  • More GAGs = more H2O binds to them.
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3
Q

What is Dense Irregular Fibrous tissue composed of? Where is it located

A
  • the bundles of collagenous fibers intertwine in irregular, swirling arrangements
  • forms a thick mat of strong connective tissue
  • can withstand stresses applied from any direction
  • forms the strong inner skin layer called the dermis
  • forms the outer capsule of organs as the kidney and the spleen
  • fascia that surrounds muscles
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4
Q

What is dense regular fibrous tissue? where is it found?

A
  • fibers are arranged in regular, parallel rows
  • flexible but great tensile strength when pulled from either or both ends
  • anchor muscle to bone
  • ligaments have a predominance of elastic fibers
  • arrangement permits arterial walls to be pushed out by blood pressure without breaking and then recoil to a smaller diameter when the blood pressure decreases
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5
Q

stress

A

force normalized dover the area on which it acts. normal stress is perpendicular to the cross-section. sheer stress is parallel.

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6
Q

strain

A

change in shape due to stress

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7
Q

stiffness

A

the ratio of a load to the deformation/strain it causes (the “tight” concept)

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8
Q

compliance

A

the inverse of stiffness (the “losse concept”)

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9
Q

What is “Creep” and how is it related to residual strain in connective tissues?

A
  • the continued deformation (increasing strain) of a viscoelastic material under constant load over time; release of stored kinetic energy

Creep is the tendency of a solid material to slowly move or deform permanently under the influence of stresses. It occurs as a result of long term exposure to levels of stress that are below the yield strength of the material.

  • An imposed constant load will result in relaxation of the tissue
  • glass being thicker at the bottom of the pane than at the top in very old windows

Residual Strain occurs due to reorganization at a molecular level.

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10
Q

how is hysteresis related to residual strain?

A

Hysteresis –”connective tissue response to loading and unloading in which the restoration of the final length of the tissue occurs at a rate and to an extent less than during deformation”

Hysteresis is the energy lost when the energy returned is not equal to the energy stored and represents residual strain.

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11
Q

Different force effects

A

Wolff’s Law: bones (and soft tissue) tend to deform along the lines of force placed on them.

Hooke’s Law: any strain/deformation placed on an elastic body is in proportion to the stress placed on it.

Newton’s 3rd Law: when 2 bodies interact, the force exerted by the first on the second is equal in magnitude and opposite in direction to the force exerted by the second body on the first body.

Pascal’s Law: pressure applied to a liquid at rest from any point is transmitted equally in all directions.

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12
Q

What are the MFR mechanisms?

A
  • Fascia is capable of changes in length (plasticity and elasticity), with associated changes of energy content (hysteresis).
  • MFR provides peripheral neuroreflexive alterations in muscle tone and neural facilitation, in part, by its influence on mechanoreceptors.
  • External forces applied to fascia facilitate restoration of normal structure and function.
  • The application of MFR allows for connective tissue plastic changes (creep) which are associated with release of energy. This may include heat, electromagnetic, and piezoelectric changes.
  • Tensegrity principles coupled with fascial bioelectric (piezoelectric) properties influence the anatomical and physiological responses of tissues to applied manipulative forces.
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13
Q

what effect does MFR have on gamma gain?

A

Taking the affected structure to the balanced position relaxes the intrafusal muscle fibers of the spindles lying within the tight, contracted muscle mass. The slow, steady return of the structure to the more neutral position allows a resetting of the gamma gain activity in the spindles of the muscle to a new, lower level.

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14
Q

Describe the difference between elastic and visco-elastic material.

A

Elastic

  • The amount of deformation is the same for a given amount of stress
  • Material returns to its original length or conformation when the stress is removed

Viscoelastic

  • Nonlinear properties due to the viscous nature
  • Magnitude of stress applied is dependent on the rate of loading
  • Stored mechanical energy not completely returned once stress removed
  • Surpassing the yield point leads to plastic deformation = molecular components are permanently displaced.Surpassing the yield point leads to plastic deformation = molecular components are permanently displaced.
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15
Q

what is the mechanical Viscoelastic model

A

fascia is not completely elastic, nor is it completely plastic - when elongation happens some energy is lost and some is retained after the application of tensile force = creep.

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16
Q

Discuss the tight-loose concept.

A

Involves bony skeleton (joints) as well as superficial and deep soft tissues
Pain is typically at loose sites as muscles are usually weak and inhibited
Tight areas are frequently tethered
Looseness suggests joint or soft tissue laxity

What has to be involved in creating a tethered or lax site??
Hooke’s Law: any strain/deformation placed on an elastic body is in proportion to the stress placed on it.

ex. If right knee is injured and is loose. The right ankle will be tight. The left knee will then be tight. And the left ankle will be loose

17
Q

Big Bandage of Fascial Continuum Model

A
  • tensegrity established throughout the entire body due to connected fascial lines composed of deep fascia
18
Q

Bioenergetic Model

A
  • What accounts for the change in energy content? (hysteresis)
  • Collagen is a Piezoelectric substance in bone and has been shown to affect growth/remodeling of bone
  • Negative charge stimulates osteoblasts
  • Positive charge stimulates osteoclasts

-Mechanical tension creates bioelectric current changes that guide the orientation of fibrin and collagen.

Piezoelectricity is current that is produce by the transformation of mechanical stress to electrical energy.
Piezoelectric substances act as transducers and are able to discharge electrical current when physically stressed.

19
Q

Goals of myofascial release

A

Relaxation of contracted muscles =
Release tightness or tethering

  • Decreases oxygen demand
  • Decreases pain
  • Normalizes ROM across a joint
  • Restore 3-D functional symmetry
  • Don’t aggravate hypermobility!

Increased circulation to area of ischemia

  • Improves oxygenation of tissues
  • Enhances removal of waste products

Increased venous drainage and lymphatic drainage

  • decreasing local edema - which decreases thick, haphazard deposition of collagen

All of these improve type and arrangement of collagen deposition

20
Q

What are complications to MFR?

A
  • Exceeding the limits of dysfunctional and injured tissue creates iatrogenic trauma layered on top of the somatic dysfunction and complicates the treatment and healing.
  • Temporary worsening of symptoms may occur the first day or two typical of post-exercise muscle soreness.
  • Older aged or debilitated patients, inflammatory conditions (auto-immune diseases, rheumatic conditions, fibromyalgia) are likely to experience post-OMT flare-ups.
  • Drinking more water, resting, soaking in a hot bath can help.
21
Q

MFR contraindications?

A

Absolute

  • Absence of somatic dysfunction
  • Lack of patient consent and/or cooperation

Relative

  • Fractures
  • open wounds,
  • acute thermal injury
  • soft tissue or bony infections
  • deep venous thrombosis (threat of embolism)
  • disseminated or focal neoplasm
  • recent post-operative states over the site of proposed treatment (wound dehiscence)
  • aortic aneurysm
22
Q

Direct vs. Indirect MFR treatment:

A

Direct:

Identifies the restrictive barrier in all planes.
Brings the body to the restrictive barrier and applies a corrective force (traction, compression, twist,)

Indirect:

Identifies the position of free motion in all planes = neutral.
Brings the body to the neutral place and waits for the body to initiate the corrective action.

MFR may be performed on various tissues including fascia, tendons, cicatrices (scars), internal organs, or visceral suspensory ligaments.
MFR decreases myofascial tone at a segmental level in treating spinal somatic dysfunction.