HEMME APPROACH TO SOFT-TISSUE THERAPY

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14 THREE CHARACTERISTICS OF SOFT-TISSUE IMPAIRMENT • Inflammation of soft-tissue • Replacement of muscle tissue by connective tissue • Pain SEVEN REASONS WHY PAIN CYCLES ARE DIFFICULT TO TREAT • The mechanisms that cause pain cycles are difficult to locate. • Pain cycles are both chronic and acute at the same time. • Muscular imbalance perpetuates pain cycles. • Reflexogenic activity perpetuates pain cycles. • Setbacks and reversals are common when treating pain cycles. • The methods for treating soft-tissue injuries are often deficient. • More research is needed to validate methods of therapy. HEMME Approach to Soft-Tissue Therapy
15 HEMME APPROACH Soft-tissue therapy cannot be effective without some type of systematic approach that progresses logically from problem to solution. The HEMME APPROACH was created to satisfy this need. The word HEMME (pronounced hem as in hem and me as in me) is an acronym that stands for H E M M E HISTORY EVALUATION MODALITIES MANIPULATION EXERCISE More than just a series of steps, the HEMME APPROACH is based on what system theory refers to as a plain language model. Language models are used when complex ideas cannot be formulated mathematically. The purpose of a language model is to simplify the process of converting knowledge into action and measuring the results. Language models can be used to (1) identify problems, (2) collect information, (3) formulate theories, and (4) test possible solutions by using feedback. The six steps that hold the model together like glue are: (1) ENTER PATIENT (4) OBJECTIVES SATISFIED (2) ALTERNATIVES (5) OBJECTIVES NOT SATISFIED (3) FEEDBACK (6) OUTSIDE INFORMATION In the HEMME APPROACH model (HEMMEGON), the five basic steps HISTORY, EVALUATION, MODALITIES, MANIPULATION, and EXERCISE are in bold letters and the other six steps are in outline letters. The starting point, the step titled ENTER PATIENT, is boxed. HEMME 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 and 10: ix Section Page NEUROMUSCULAR THERA
Page 11 and 12: 1 INTRODUCTION Soft-tissue therapy
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: 13 CHAPTER SUMMARY THREE SIGNS OR S
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
Page 61 and 62: First, separate the problem into pa
Page 63 and 64: 53 MODALITIES Modalities are used i
Page 65 and 66: changes in temperatures. This expla
Page 67 and 68: The term hunting reaction implies t
Page 69 and 70: Contraindications specifically for
Page 71 and 72: 61 CHAPTER SUMMARY FOUR INDICATIONS
Page 73 and 74: 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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