Soft Tissue & MFR Techniques Lecture

Question 1

What does soft tissue entail?

Answer 1

Fascia, muscles, organs, nerves, vasculature, lymphatic tissue

Question 2

What is Fascia? What is NOT fascia?

Answer 2

It is a complete system with blood supply, fluid drainage, and innervations which is composed of irregularly arranged fibrous elements of varying density which is all involved in tissue protection and healing of surrounding systems.

It is NOT tendons, ligaments, or aponeuroses

Question 3

What are the 4 fascial layers?

Answer 3

Pannicular fascia, axial and appendicular fascia, meningeal fascia, and visceral fascia

Question 4

What is pannicular fascia?

Answer 4

The outermost layer of fascia derived from somatic mesenchymal and surrounds entire body with exception of the orifices

the outer layer is adipose tissue and the inner layer is membranous and is generally adherent to the outer portion

Question 5

What is Axial and appendicular fascia?

Answer 5

It is internal to the pannicular layer and is fused to the panniculus

It surrounds all of the muscles, periosteum of bone, and peritendon of tendons

Question 6

What is meningeal fascia?

Answer 6

It surrounds the nervous system, including the dura

Question 7

What is visceral fascia?

Answer 7

Surrounds the body cavities (i.e. pleural, pericardial, and peritoneum)

Question 8

What is viscoelastic material?

Answer 8

Any material that deforms according to rate of loading and deformity

Question 9

What is stress vs. strain?

Answer 9

Stress is the force that attempts to deform a connective tissue structure

Strain is the percentage of deformation of a connective tissue

(during cyclic loading of tendon, the stress-strain curve gradually shifts to the right)

Question 10

What is hysteresis?

Answer 10

The energy lost in the connective tissue system between loading and unloading the tendon

Question 11

What is creep?

Answer 11

Connective tissue under a sustained, constant load (below failure threshold) which will elongate (deform) in response to the load

Question 12

What is ease?

Answer 12

The direction in which the connective tissue may be moved most easily during deformational stretching

Question 13

What is bind?

Answer 13

A palpable restriction of connective tissue mobility

Question 14

What is the concept of a “fascial sweater” or fascial continuity?

Answer 14

Fascial restrictions in one area of the body, will create connective tissue restrictions (pulls) at a distance away from the site of the initial restriction

If you pull at one corner, it can affect different regions, like pulling on a sweater

Question 15

What is Newton’s Third Law?

Answer 15

When 2 bodies interact, the force exerted by one is equal in magnitude and opposite in direction to the forces exerted by the other

Question 16

What is Hooke’s Law?

Answer 16

The strain (deformation) placed on an elastic body is in proportion to the stress (force) placed upon it.

Question 17

What is Wolff’s Law?

Answer 17

Bone will develop according to the stresses placed upon it

[applies to fascia too]

Question 18

What is Sherrington’s Law?

Answer 18

When a muscle receives a nerve impulse to contract, its antagonists receive, simultaneously, an impulse to relax

Question 19

What is a common compensatory pattern?

Answer 19

80% of healthy people have it

L/R/L/R

Head and neck compensates toward the left, shoulder and arm compensates to the right, chest and waist compensate to the left, and hip and leg compensate to the right

Question 20

What is an uncommon compensatory pattern?

Answer 20

20% of healthy people have it

R/L/R/L

Head and neck compensate to the right, shoulder and arm compensate to the left, chest and waist compensate to the right, and hip and leg compensate to the left

Question 21

What is an uncompensated pattern?

Answer 21

It is usually symptomatic and had a trauma involved

Anything that is not part of the RLRL or LRLR schema

Question 22

What are the 4 transition zones of the spine?

Answer 22

OA, C1, C2

C7, T1

T12, L1

L5 and sacrum

Question 23

What are the transverse restrictors?

Answer 23

Tentorium Cerebelli, Thoracic Inlet, Thoracolumbar diaphragm, and the pelvic diaphragm

Question 24

What are ST Relative contraindications?

Answer 24

Severe osteoporosis cannot have prone pressure techniques in the thoracocostal region, but lateral recumbent techniques are fine.

Acute injuries cannot have direct techniques that stretch acutely injury muscles, tendons, ligaments, or joint capsules

Question 25

What are ST Absolute contraindications?

Answer 25

Fracture/dislocation, neurologic entrapment syndromes, serious vascular compromise, local malignancy, local infection, or bleeding disorders

Question 26

What kind of traction is stretching vs kneading?

Answer 26

Parallel vs perpendicular, respectively

Question 27

What is Myofascial Release (MFR)?

Answer 27

A system of diagnosis and treatment first described by A.T. Still and his early students, which engages continual palpatory feedback to achieve release of myofascial tissues.

Question 28

What is Integrated Neuromusculoskeletal Release (INR)?

Answer 28

A treatment system in which combined procedures are designed to stretch and reflexively released patterned soft tissue and joint related restrictions

Question 29

What are some examples of REMs?

Answer 29

Breath holding, prone and supine simulated swimming, prone and supine pendulum arm swing maneuvers, R/L cervical rotation, Isometric limb and neck movements against the table/chair, and patient evoked movement from cranial nerves (eye, tongue, jaw, oropharynx)

Question 30

What are some indications for MFR?

Answer 30

Somatic dysfunction, when you can’t use HVLA or muscle energy, and when counterstrain may be difficult secondary to pt’s inability to relax

Question 31

What are relative contraindications of MFR?

Answer 31

Infection of soft tissue or bone, fracture/avulsion/dislocation, metastatic disease, soft tissue injuries (thermal, hematoma, or open wounds), post-op patient with wound dehiscence, rheumatologic condition involving instability of C-spine, or DVT/anti-coag therapy

Question 32

What are Absolute contraindications of MFR?

Answer 32

Lack of patient consent and absence of somatic dysfunction