HEMME APPROACH TO SOFT-TISSUE THERAPY

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vi PREFACE This manual is a "why and how-to book" that teaches the powerful and productive principles behind soft-tissue therapy and how to apply them. These principles are taken from physical medicine, osteopathy, chiropractic, and physical therapy, and then uniquely applied to soft-tissue therapy. No other book has ever compiled, organized, or summarized the principles of soft-tissue therapy the way they appear in this manual. By learning the principles behind trigger point therapy, neuromuscular therapy, connective tissue therapy, range-of-motion stretching, and exercise, practitioners will be able to provide patients with the best care possible. The principles in this step-by-step manual are simple to use, yet more powerful in some cases than either medication or surgery. Practitioners will learn how to help patients who have never been able to find help before and give them a chance to live normal, productive lives. This manual is organized around the acronym HEMME. This acronym completely summarizes the five major steps in soft-tissue therapy: • History: medical history. • Evaluation: physical evaluation. • Modalities: thermotherapy, cryotherapy, and vibration. • Manipulation: trigger point therapy, neuromuscular therapy, connective tissue therapy, and range-of-motion stretching. • Exercise: therapeutic exercise. The HEMME APPROACH is a problem-solving approach. History and Evaluation define the problem that Modalities, Manipulation, and Exercise solve. Understanding the HEMME APPROACH is the first major step toward mastering the art and science of soft-tissue therapy. The five main goals of soft-tissue therapy are (1) reduce pain, (2) increase or maintain a pain-free range of motion, (3) increase or maintain strength, (4) improve the quality of movement, and (5) restore normal function. The HEMME APPROACH was designed specifically to achieve these goals and do it effectively without hours of memorizing useless information or years of pointless study. The power behind the HEMME APPROACH is getting to the point and keeping it simple. HEMME Approach to Soft-Tissue Therapy
vii TABLE OF CONTENTS Section Page INTRODUCTION ........................................................................................ 1 PAIN CYCLES .......................................................................................... 4 CHAPTER SUMMARY................................................................................. 13 HEMME APPROACH............................................................................... 15 HEMMEGON.............................................................................................. 18 CHAPTER SUMMARY................................................................................. 19 HISTORY .................................................................................................... 20 CHAPTER SUMMARY................................................................................. 25 EVALUATION ........................................................................................... 26 MUSCLE TESTING...................................................................................... 29 CONTRAINDICATIONS ............................................................................... 38 PAIN ......................................................................................................... 41 CHAPTER SUMMARY................................................................................. 47 ALTERNATIVES...................................................................................... 49 CHAPTER SUMMARY................................................................................. 52 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: v HEMME Approach to Soft-Tissue The
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 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
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47 CHAPTER SUMMARY FOUR CLASSICAL M
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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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