HEMME APPROACH TO SOFT-TISSUE THERAPY

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x Section Page EXERCISE ................................................................................................ 124 THE OVERLOAD PRINCIPLE ..................................................................... 126 THE INTENSITY PRINCIPLE ...................................................................... 128 THE FREQUENCY AND DURATION PRINCIPLE........................................... 130 THE SPECIFICITY PRINCIPLE.................................................................... 130 THE TRAINING PRINCIPLE ....................................................................... 131 CHAPTER SUMMARY............................................................................... 132 OBJECTIVES SATISFIED OR NOT SATISFIED.............................. 133 BIBLIOGRAPHY..................................................................................... 135 GLOSSARY............................................................................................... 149 QUIZ .......................................................................................................... 162 INDEX....................................................................................................... 172 <strong>HEMME</strong> Approach to Soft-Tissue Therapy
1 INTRODUCTION Soft-tissue therapy is the manipulation of soft or superficial tissue for therapeutic purposes. According to most medical dictionaries, manipulation refers to any skillful and dexterous treatment involving the hands. Unlike chiropractic adjustments that are typically high-velocity, high-impact thrusting movements, the manipulations in soft-tissue therapy are low-velocity pushing or pulling movements. Since chiropractic physicians theorize that skeletal malpositions are corrected by forcefully moving bones "into place that are out of place," chiropractic adjustments are directed at the osseous tissues. Skeletal malpositions are also called subluxations. According to chiropractic theory, subluxations cause pressure on nerves or nerve roots that interferes with sensory or motor input. Chiropractors use high-velocity, high-impact manipulations to correct subluxations. Soft-tissue therapy postulates that alignment can be corrected by normalizing the soft-tissue components of the body that cause distortion. Manipulations in soft-tissue therapy are directed at muscles, fascia, tendons, or ligaments to relieve pain and correct myofascial dysfunction. Instead of dealing with bones out of place, soft-tissue therapy treats the causes of malposition such as spasm, contracture, trigger points, and weakness. Soft-tissue therapy can be done with or without electrical or mechanical devices. Thermotherapy, cryotherapy, and chemical preparations are optional. Like manipulations, modalities produce a combination of physical, physiological, and psychological effects. Modalities are most effective when used just prior to manipulation to control edema, reduce pain, relax spasm, or increase tissue extensibility. Since the effects of modalities without manipulation are seldom long-term, modalities are used to supplement, but not supplant, manipulation. The problems treated by soft-tissue therapy are called soft-tissue impairments. Soft-tissue impairments are similar to what osteopathic physicians call lesions or somatic dysfunctions. By definition, soft-tissue impairments are pathologic conditions that originate or manifest in soft tissue and prevent normal or customary function or usage of the body. These impairments are characterized by (1) pain, (2) limited range of motion, and (3) weakness and often cause incoordination and poor-quality movement. Soft-tissue impairments can result from many causes: trauma, disease, postural defects, muscular imbalance, abnormal movements, and overuse <strong>HEMME</strong> Approach to Soft-Tissue Therapy
Page 1 and 2: HEMME APPROACH TO SOFT-TISSUE THERA
Page 3 and 4: iii HEMME APPROACH SOFT-TISSUE ANSW
Page 5 and 6: v HEMME Approach to Soft-Tissue The
Page 7 and 8: vii TABLE OF CONTENTS Section Page
Page 9: ix Section Page NEUROMUSCULAR THERA
Page 13 and 14: These conditions point out three ch
Page 15 and 16: (D) Although pain cycles are seldom
Page 17 and 18: and protective muscle shortening ar
Page 19 and 20: Although "train, don't strain" is m
Page 21 and 22: The same trend applies to allopathi
Page 23 and 24: 13 CHAPTER SUMMARY THREE SIGNS OR S
Page 25 and 26: 15 HEMME APPROACH Soft-tissue thera
Page 27 and 28: whereas MODALITIES, MANIPULATION an
Page 29 and 30: 19 CHAPTER SUMMARY FIVE STEPS IN TH
Page 31 and 32: Since little can be done to change
Page 33 and 34: 23 MECHANISM OF INJURY F FORCE Dire
Page 35 and 36: 25 CHAPTER SUMMARY THREE WORDS THAT
Page 37 and 38: The sensitivity of the hand varies
Page 39 and 40: 29 MUSCLE TESTING Manual muscle tes
Page 41 and 42: 31 (1) Active Range-of-Motion Testi
Page 43 and 44: 33 (4) Resisted Range-of-Motion Tes
Page 45 and 46: pull of the muscle being tested, ot
Page 47 and 48: knows nothing of individual muscles
Page 49 and 50: 39 cardiac decompensation Failure o
Page 51 and 52: 41 PAIN Pain is often defined as th
Page 53 and 54: cases of soft-tissue pain and disab
Page 55 and 56: The distribution of pain within a s
Page 57 and 58: 47 CHAPTER SUMMARY FOUR CLASSICAL M
Page 59 and 60: 49 ALTERNATIVES The HEMME APPROACH
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First, separate the problem into pa
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53 MODALITIES Modalities are used i
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changes in temperatures. This expla
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The term hunting reaction implies t
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Contraindications specifically for
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61 CHAPTER SUMMARY FOUR INDICATIONS
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63 MANIPULATION Soft-tissue therapy
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65 B. Reciprocal Inhibition: when t
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experience another cycle: (1) pain
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69 Table of Figures Figure 1: Belly
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HEMME Approach to Soft-Tissue Thera
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HEMME Approach to Soft-Tissue Thera
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75 TRIGGER POINT THERAPY Trigger po
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cause spontaneous contraction of th
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• Third, trigger point therapy re
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pressure that normally causes pain
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83 TRIGGER POINT THERAPY VS. CROSS-
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The immediate goal of neuromuscular
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Facilitation techniques can reverse
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89 FOUR WAYS TO INHIBIT A MUSCL
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In situations where muscles are sho
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antagonist, (2) relax the antagonis
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stretch. The technique of stretchin
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97 FACILITATORS Activation of Stre
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concentration of muscle spindle cel
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101 CONNECTIVE TISSUE THERAPY Of al
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103 substance that limits tissue mo
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105 Range-of-motion stretching and
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107 the skin away from the patient'
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109 STRETCHING Unlike the stretchin
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111 Although measurements can be ta
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113 The recommendations for regular
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115 Whenever heat is used to facili
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117 stretching be done slowly becau
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119 CHAPTER SUMMARY THREE HEMME LAW
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121 FOUR TYPES OF FORCE USED IN SOF
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123 FOUR GOALS OF CONNECTIVE TISSUE
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125 overstressed. Even though an ea
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127 great enough to overcome extern
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129 The most recent theories now su
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131 Complete positive transfer is n
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133 OBJECTIVES SATISFIED OR NOT SAT
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135 SELECTED BIBLIOGRAPHY Alter, Mi
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137 Clemente, Carmine D. 1981. Anat
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139 Fryette, Harrison H. 1954. Prin
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Kendall, Florence Peterson, Elizabe
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143 Licht, Sidney, ed. 1965. Therap
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145 Noback, Charles R., and Robert
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Shriber, William J. 1975. A manual
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149 GLOSSARY acute Short duration,
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151 cocontraction Mutual contractio
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153 exteroceptor A sense organ rece
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155 hypomobility Decreased mobility
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157 myofascial Involving muscles an
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159 rebound tenderness Pain or disc
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161 synergist A muscle functioning
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163 6. What does the first letter o
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165 16. Which structures are least
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167 26. What is another name for st
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169 36. Which concept explains why
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171 46. Which word defines loss of
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173 Hilton's law 43, 64, 74 Hooke's
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I QUICK REFERENCE GUIDE FOR NEUROMU
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III RECIPROCAL INHIBITION (RI) Prac
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HEMME APPROACH TO SOFT-TISSUE THERAPY

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