HEMME APPROACH TO SOFT-TISSUE THERAPY

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40 lesions An injury or pathologic change in tissue. nonunion fracture A fracture that has failed to knit. osteoarthritis Degenerative joint disease characterized by degeneration of articular cartilage and overgrowth of bone. phlebitis Inflammation of a vein. rash A skin eruption that is normally red in color. recent surgery A condition characterized by acute trauma. rheumatoid arthritis An extension of synovial tissue over articular cartilage that causes deformity and disability. severe burns Serious tissue injury caused by thermal, chemical, electrical, or radioactive agents. severe hypertension Blood pressure judged to be significantly higher than normal. severe hypotension Blood pressure judged to be significantly lower than normal. synovitis Inflammation of a synovial membrane. thrombus A blood clot obstructing a vessel or cavity of the heart. vertebral artery disorder A dysfunction of the vertebral artery. vertigo A sensation that objects are spinning or whirling around the person (objective vertigo) or the person is moving around in space (subjective vertigo). <strong>HEMME</strong> Approach to Soft-Tissue Therapy
41 PAIN Pain is often defined as the perception of an unpleasant or disquieting sensation. Most people seek therapy because of pain and most patients judge the effectiveness of therapy by how it affects their pain. Patients are more likely to complain about pain than loss of function. In severe cases, pain becomes a disease in its own right, with characteristic signs and symptoms. An understanding of pain is invaluable to a therapist since pain is often the only indicator of underlying pathology. Left untreated, pain is a frequent cause of physical and psychological disability. Pain results from stimulation of specialized nerve endings called nociceptors that are sensitive to noxious stimuli such as changes in temperature (thermosensitive), mechanical stress (mechanosensitive), or noxious chemicals (chemosensitive). Nociceptors transmit a signal to the central nervous system that alerts the organism to actual or potential tissue damage. Nociceptors have myelinated axons that respond to thermal or mechanical stimuli or unmyelinated axons (polymodal receptors) that respond to all three types of noxious stimulation—thermal, mechanical, and chemical. Though very little is completely understood about pain receptors, two of the most common causes for soft-tissue pain are spasm and ischemia. In terms of mechanical stress, tension and compression can both cause pain. Passive movements are more likely to cause pain by stressing inert tissues such as ligaments and fascia, while active movements are more likely to cause pain by stressing contractile structures such as muscles, tendons, or aponeuroses. When traumatized, tissues release pain-producing substances such as (1) histamine, (2) serotonin, (3) bradykinin, (4) proteolytic enzymes, and (5) potassium ions. Injured tissues also release arachidonic acid, which stimulates production of prostaglandins. Steroids and salicylates such as aspirin (acetylsalicylic acid) relieve pain by interfering with the production of prostaglandins. Methyl salicylate is found in oil of wintergreen. Pain can be beneficial when it protects the body from tissue damage by causing the victim to withdraw from a harmful stimulus or to remove the stimulus. When tissue damage becomes so severe that pain receptors are destroyed, the absence of pain makes it difficult for victims to avoid injury. <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 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: 39 cardiac decompensation Failure o
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
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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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