HEMME APPROACH TO SOFT-TISSUE THERAPY

More documents

Recommendations

Info

If joints and the agonist are normal, the main factor limiting ROM is the tissue extensibility of the antagonist. If the antagonist fails to lengthen normally during contraction of the agonist, the joint's range of motion will be limited. This explains why active range-of-motion testing measures the strength of the agonist, the length of the antagonist, and the amount of motion available to a specific joint. The three main ways to increase the active ROM are strengthen the agonist, lengthen the antagonist, and loosen the joint. The following table defines active, passive, active-assisted, and resisted range-of-motion testing. Active range-of-motion testing: the force for the movement is provided by the patient without assistance or resistance from the examiner. Passive range-of-motion testing: the force for the movement is provided by the examiner without assistance or resistance from the patient. Active-assisted range-of-motion testing: the force for the movement is provided by the patient with some assistance from the examiner. Resisted range-of-motion testing: the force for the movement is provided by the patient and works against resistance from the examiner. For the safety of the patient, active, passive, and active-assisted range-ofmotion testing should always be done first, and resisted range-of-motion testing last. Active range-of-motion testing gives the examiner a chance to observe the patient's ROM with gravity as the only outside force. If the active ROM is normal, the final step is resisted range-of-motion testing. If the patient fails active range-of-motion testing, the next step is using passive range-of-motion testing to evaluate the ROM. If the patient's ROM is incomplete, the probable causes are joint dysfunction, spasm, or contracture. If the patient's range of motion is normal, active-assisted range-of-motion testing can be used to identify weakness. Possible causes for weakness are neurologic dysfunction, lack of motivation, pain, disuse atrophy, or fatigue. If a patient fails muscle testing at any level, it is normally better to stop and treat the problem than to continue with muscle testing. 30 <strong>HEMME</strong> Approach to Soft-Tissue Therapy
31 (1) Active Range-of-Motion Testing Postural muscles can be tested as a group by using active range-ofmotion testing against gravity. A patient who completes active range-ofmotion testing without incident can then be safely tested using resisted range-ofmotion testing. The following five tests evaluate the strength of muscle groups that are often connected with low back pain. • Upper abdominal muscles (without psoas): bent-leg sit-ups. • Upper abdominal muscles (with psoas): straight-leg sit-ups. • Lower abdominals: leg lifts. • Upper back muscles: upper body extension from prone position. • Lower back muscles: lower body extension from prone position. If the patient is unable to move a body part against gravity, the same movement should not be tested against manual resistance. Additional resistance may traumatize tissue and cause the patient needless discomfort. The next logical step is passive range-of-motion testing. If active range-ofmotion testing is normal, passive and active-assisted range-of-motion testing are optional. The tester can move directly from active range-of-motion testing to resisted range-of-motion testing. (2) Passive Range-of-Motion Testing If the examiner applies moderate force and finds the patient's range of motion is still restricted, the three most likely causes are joint dysfunction, spasm, or contracture. The way body parts feel as they reach the end of their range of motion will sometimes show which structure is most culpable, the joint or muscle. <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 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 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: 29 MUSCLE TESTING Manual muscle tes
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
Page 75 and 76: 65 B. Reciprocal Inhibition: when t
Page 77 and 78: experience another cycle: (1) pain
Page 79 and 80: 69 Table of Figures Figure 1: Belly
Page 81 and 82: HEMME Approach to Soft-Tissue Thera
Page 83 and 84: HEMME Approach to Soft-Tissue Thera
Page 85 and 86: 75 TRIGGER POINT THERAPY Trigger po
Page 87 and 88: cause spontaneous contraction of th
Page 89 and 90: • Third, trigger point therapy re
Page 91 and 92:
pressure that normally causes pain
Page 93 and 94:
83 TRIGGER POINT THERAPY VS. CROSS-
Page 95 and 96:
The immediate goal of neuromuscular
Page 97 and 98:
Facilitation techniques can reverse
Page 99 and 100:
89 FOUR WAYS TO INHIBIT A MUSCL
Page 101 and 102:
In situations where muscles are sho
Page 103 and 104:
antagonist, (2) relax the antagonis
Page 105 and 106:
stretch. The technique of stretchin
Page 107 and 108:
97 FACILITATORS Activation of Stre
Page 109 and 110:
concentration of muscle spindle cel
Page 111 and 112:
101 CONNECTIVE TISSUE THERAPY Of al
Page 113 and 114:
103 substance that limits tissue mo
Page 115 and 116:
105 Range-of-motion stretching and
Page 117 and 118:
107 the skin away from the patient'
Page 119 and 120:
109 STRETCHING Unlike the stretchin
Page 121 and 122:
111 Although measurements can be ta
Page 123 and 124:
113 The recommendations for regular
Page 125 and 126:
115 Whenever heat is used to facili
Page 127 and 128:
117 stretching be done slowly becau
Page 129 and 130:
119 CHAPTER SUMMARY THREE HEMME LAW
Page 131 and 132:
121 FOUR TYPES OF FORCE USED IN SOF
Page 133 and 134:
123 FOUR GOALS OF CONNECTIVE TISSUE
Page 135 and 136:
125 overstressed. Even though an ea
Page 137 and 138:
127 great enough to overcome extern
Page 139 and 140:
129 The most recent theories now su
Page 141 and 142:
131 Complete positive transfer is n
Page 143 and 144:
133 OBJECTIVES SATISFIED OR NOT SAT
Page 145 and 146:
135 SELECTED BIBLIOGRAPHY Alter, Mi
Page 147 and 148:
137 Clemente, Carmine D. 1981. Anat
Page 149 and 150:
139 Fryette, Harrison H. 1954. Prin
Page 151 and 152:
Kendall, Florence Peterson, Elizabe
Page 153 and 154:
143 Licht, Sidney, ed. 1965. Therap
Page 155 and 156:
145 Noback, Charles R., and Robert
Page 157 and 158:
Shriber, William J. 1975. A manual
Page 159 and 160:
149 GLOSSARY acute Short duration,
Page 161 and 162:
151 cocontraction Mutual contractio
Page 163 and 164:
153 exteroceptor A sense organ rece
Page 165 and 166:
155 hypomobility Decreased mobility
Page 167 and 168:
157 myofascial Involving muscles an
Page 169 and 170:
159 rebound tenderness Pain or disc
Page 171 and 172:
161 synergist A muscle functioning
Page 173 and 174:
163 6. What does the first letter o
Page 175 and 176:
165 16. Which structures are least
Page 177 and 178:
167 26. What is another name for st
Page 179 and 180:
169 36. Which concept explains why
Page 181 and 182:
171 46. Which word defines loss of
Page 183 and 184:
173 Hilton's law 43, 64, 74 Hooke's
Page 185 and 186:
I QUICK REFERENCE GUIDE FOR NEUROMU
Page 187 and 188:
III RECIPROCAL INHIBITION (RI) Prac
show all

HEMME APPROACH TO SOFT-TISSUE THERAPY

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?