9780443062704

Clinical Applications of Neuromuscular Techniques; The Upper Body, Volume 1

by
  • ISBN13:

    9780443062704

  • ISBN10:

    0443062706

  • Format: Hardcover
  • Copyright: 2000-10-23
  • Publisher: Elsevier Health Sciences
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List Price: $110.00

Summary

This volume presents the theories, validation and techniques of manual treatment for both chronic and acute neuromuscular pain and somatic dysfunction. The book takes a regional approach to treatment, providing a structural review of each area including ligaments and functional anatomy. It then examines each muscle and joint for a particular region, and includes step-by-step protocols for each muscle to be treated, giving particular reference to the treatment of trigger points. This text ensures the safe and effective application of soft tissue techniques and provides an invaluable source of reference to all manual therapy students and practitioners.

Table of Contents

List of boxes
xv
Forewords xvii
Preface xxi
Acknowledgements xxiii
Connective tissue and the fascial system
1(14)
The fascial network
2(1)
Fascia and proprioception
2(1)
Fascia: collagenous continuity
2(1)
Further fascial considerations
3(1)
Elasticity
3(3)
Plastic and elastic features
4(2)
Trigger points, fascia and the nervous system
6(1)
Summary of fascial and connective tissue function
6(4)
Fascial dysfunction
10(1)
Restoring gel to sol
11(1)
Therapeutic sequencing
11(4)
Muscles
15(14)
Essential information about muscles
16(1)
Types of muscle
16(1)
Muscle energy sources
17(1)
Muscles and blood supply
17(3)
Major types of voluntary contraction
20(1)
Terminology
20(1)
Muscle tone and contraction
20(1)
Vulnerable areas
21(1)
Muscle types
21(1)
Cooperative muscle activity
22(2)
Muscle spasm, tension, atrophy
24(1)
Spasm
24(1)
Contracture
24(1)
Increased stretch sensitivity
25(1)
Viscoelastic influence
25(1)
Atrophy and chronic back pain
25(1)
What is weakness?
25(1)
Trick patterns
26(1)
Joint implications
26(1)
When should pain and dysfunction be left alone?
26(1)
Beneficially overactive muscles
27(1)
Somatization -- mind and muscles
27(2)
But how is one to know?
27(2)
Reporting stations and the brain
29(14)
Proprioception
29(1)
Fascia and proprioception
30(1)
Reflex mechanisms
30(2)
Local reflexes
32(1)
Central influences
32(1)
Neuromuscular dysfunction following injury
32(1)
Mechanisms which alter proprioception
32(1)
An example of proprioceptive dysfunction
33(2)
Rectus capitis posterior minor (RCPMin) research evidence
34(1)
Neural influences
35(4)
Effect of contradictory proprioceptive information
35(1)
Neural overload, entrapment and crosstalk
35(1)
Manipulating the reporting stations
35(4)
Therapeutic rehabilitation using reflex systems
39(1)
Conclusion
39(4)
Causes of musculoskeletal dysfunction
43(12)
Adaptation -- GAS and LAS
43(1)
Posture, respiratory function and the adaptation phenomenon
44(1)
Making sense of the picture
45(2)
Example
46(1)
Postural and emotional influences on musculoskeletal dysfunction
47(3)
Postural interpretations
47(1)
Contraction patterns
47(1)
Emotional contractions
48(1)
`Middle fist' functions
48(1)
`Upper fist' functions
48(1)
Cautions and question's
49(1)
Postural imbalance and the diaphragm
50(1)
Respiratory influences
50(3)
Summary of effects of hyperventilation
50(1)
Neural repercussions
51(1)
Tetany
52(1)
Biomechanical changes in response to upper chest breathing
52(1)
Additional emotional factors and musculoskeletal dysfunction
53(1)
Selective motor unit involvement
53(1)
Conclusion
53(2)
Patterns of dysfunction
55(10)
Upper crossed syndrome
55(1)
Lower crossed syndrome
56(1)
Chain reaction leading to facial and jaw pain: an example
57(1)
Patterns as habits of use
57(1)
The big picture and the local event
58(1)
Janda's `primary and secondary' responses
58(1)
Recognizing dysfunctional patterns
59(1)
Functional screening sequence
60(3)
Prone hip extension test
60(1)
Trunk flexion test
60(1)
Hip abduction test
61(1)
Scapulohumeral rhythm test
62(1)
Neck flexion test
62(1)
Push-up test
63(1)
Trigger point chains
63(2)
Trigger points
65(20)
Ischemia and muscle pain
69(1)
Ischemia and trigger point evolution
69(1)
Trigger point connection
70(1)
Facilitation -- segmental and local
70(2)
How to recognize a facilitated spinal area
71(1)
Local facilitation in muscles
71(1)
Lowering the neural threshold
72(1)
Different models for the evolution of trigger points
72(2)
Awad's analysis of trigger points
72(1)
Improved oxygenation and reduced trigger point pain -- an example
72(1)
Nimmo's receptor-tonus techniques
72(1)
Simons' current perspective
73(1)
Key and satellite trigger points
74(1)
Trigger points and joint restriction
75(1)
Trigger points associated with shoulder restriction
75(1)
Other trigger point sites
75(1)
Testing and measuring trigger points
75(5)
Basic skill requirements
75(2)
Needle electromyography
77(1)
Ultrasound
77(1)
Surface electromyography
77(1)
Algometer use for research and clinical training
77(2)
Thermography and trigger Points
79(1)
Clinical features of myofascial trigger points
80(5)
Developing skills for TrP palpation
80(2)
Which method is more effective?
82(3)
Inflammation and pain
85(10)
The inflammatory response
85(1)
Acute (lag) phase of the inflammatory response
85(1)
Regeneration phase
86(1)
Remodeling phase
86(1)
Difference between degenerative and inflammatory processes
86(1)
Muscles and pain
86(2)
Reflex effects of muscular pain
88(1)
Source of pain
88(2)
Is it reflex or local?
88(1)
Radicular pain
88(1)
Are the reflexes normal? What is the source of the pain?
89(1)
Neuropathic pain
89(1)
Differentiating between soft tissue and joint pain
90(1)
When should pain and dysfunction be left alone?
90(2)
Somatization
91(1)
How is one to know?
91(1)
Pain management
92(3)
Gunn's view
92(1)
Questions
92(1)
Pain control
92(3)
Assessment, treatment and rehabilitation
95(12)
A biomechanical example
96(1)
`Looseness and tightness' as part of the biomechanical model
96(2)
Lewit (1996) and `loose-tight' thinking
97(1)
Soft tissue treatment and barriers
97(1)
Pain and the tight-loose concept
97(1)
Three-dimensional patterns
98(1)
Methods for restoration of `three-dimensionally patterned functional symmetry'
98(1)
Managing soft tissue dysfunction
98(1)
Manipulating tissues
99(1)
Nutrition and pain: a biochemical perspective
99(3)
Nutritional treatment strategies
100(1)
Specific nutrients and myofascial pain
100(1)
Allergy and intolerance: additional biochemical influences on pain
100(1)
Treatment for `allergic myalgia'
101(1)
Anti-inflammatory nutritional (biochemical) strategies
101(1)
Psychosocial factors in pain management: the cognitive dimension
102(1)
Guidelines for pain management
102(1)
Group pain management
102(1)
The litigation factor
102(1)
Other barriers to progress in pain management
103(1)
Stages of change in behavior modification
103(1)
Wellness education
103(1)
Goal setting and pacing
103(4)
Low back pain rehabilitation
104(1)
Concordance
104(1)
Patient advice and concordance (compliance) issues
104(3)
Modern neuromuscular techniques
107(22)
Neuromuscular therapy -- American version
108(11)
Biomechanical factors
108(1)
Biochemical factors
109(1)
Psychosocial factors
109(1)
Biomechanical, biochemical and psychosocial interaction
110(1)
NMT techniques contraindicated in initial stages of acute injury
110(1)
NMT for chronic pain
110(1)
Palpation and treatment
111(7)
Treatment tools
118(1)
European (Lief's) neuromuscular technique (NMT)
119(10)
NMT thumb technique
120(1)
Lief's NMT finger technique
121(1)
Use of lubricant
122(1)
Variations
122(1)
Variable ischemic compression
122(1)
A framework for assessment
123(1)
Integrated neuromuscular inhibition technique
124(5)
Associated therapeutic modalities and techniques
129(30)
Hydrotherapy and cryotherapy
131(4)
How water works on the body
131(1)
Warming compress
131(1)
Alternate heat and cold: constitutional hydrotherapy (home application)
132(1)
Neutral bath
133(1)
Alternate bathing
133(1)
Alternating sitz baths
133(1)
Ice pack
134(1)
Ice coolants as a form of trigger point treatment
134(1)
Integrated neuromuscular inhibition technique
135(3)
INIT method 1
136(1)
INIT rationale
136(1)
Ruddy's reciprocal antagonist facilitation (RRAF)
137(1)
Lymphatic Drainage techniques
138(1)
Massage
138(2)
Petrissage
138(1)
Kneading
139(1)
Inhibition
139(1)
Effleurage (stroking)
139(1)
Vibration and friction
139(1)
Transverse friction
139(1)
Effects explained
140(1)
Mobilization and articulation
140(2)
Notes on sustained natural apophyseal glides (SNAGs)
141(1)
Muscle energy techniques (MET) and variations
142(3)
Neurological explanation for MET effects
142(1)
Use of breathing cooperation
143(1)
Use of eye movement
143(1)
Muscle energy technique variations
143(2)
Myofascial release techniques (MFR)
145(2)
Exercise 1 Longitudinal paraspinal myofascial release
146(1)
Exercise 2 Freeing subscapularis from serratus anterior fascia
146(1)
Positional release techniques (PRT)
147(6)
The proprioceptive hypothesis
147(1)
The nociceptive hypothesis
148(1)
Resolving restrictions using PRT
148(1)
Circulatory hypothesis
149(1)
Variations of PRT
149(4)
Rehabilitation
153(1)
Additional stretching techniques
153(6)
Facilitated stretching
153(1)
Proprioceptive neuromuscular facilitation (PNF) variations
154(1)
Active isolated stretching (AIS)
154(1)
Yoga stretching (and static stretching)
154(1)
Ballistic stretching
154(5)
The cervical region
159(78)
The vertebral column: a structural wonder
159(7)
Cervical vertebral structure
162(1)
The upper and lower cervical functional units
163(3)
Movements of the cervical spine
166(2)
Upper cervical (occipitocervical) ligaments
167(1)
Lower cervical ligaments
168(1)
Assessment of the cervical region
168(19)
Landmarks
169(1)
Functional features of the cervical spine
170(1)
Muscular and fascial features
170(1)
Neurological features
171(1)
Circulatory features and thoracic outlet syndrome
171(1)
Cervical spinal dysfunction
171(3)
Assessments
174(5)
Assessment becomes treatment
179(2)
Assessment and treatment of occipitoatlantal restriction (C0--C1)
181(1)
Functional release of atlantooccipital joint
182(1)
Translation assessment for cervical spine (C2--7)
182(1)
Treatment choices
183(1)
Alternative positional release approach
184(1)
SCS cervical flexion restriction method
184(1)
SCS cervical extension restriction method
185(1)
Stiles' (1984) general procedure using MET for cervical restriction
185(1)
Harakal's (1975) cooperative isometric technique (MET)
186(1)
Cervical treatment: sequencing
187(50)
Cervical planes and layers
187(1)
Posterior cervical region
188(1)
Upper trapezius
188(2)
NMT for upper trapezius in supine position
190(1)
MET treatment of upper trapezius
191(2)
Myofascial release of upper trapezius
193(1)
Variation of myofascial release
194(1)
NMT: cervical lamina gliding techniques-supine
195(1)
Semispinalis capitis
196(1)
Semispinalis cervicis
196(1)
Splenii
197(1)
NMT techniques for splenii tendons
198(1)
Spinalis capitis and cervicis
199(1)
NMT for spinalis muscles
200(1)
Longissimus capitis
200(1)
Longissimus cervicis
200(1)
Iliocostalis cervicis
200(1)
Multifidi
201(1)
Rotatores longus and brevis
201(1)
Interspinales
201(1)
NMT for interspinales
202(1)
Intertransversarii
202(1)
Levator scapula
203(2)
NMT for levator scapula
205(1)
MET treatment of levator scapula
205(1)
Suboccipital region
206(1)
Rectus capitis posterior minor
207(1)
Rectus capitis posterior major
208(1)
Obliquus capitis superior
208(1)
Obliquus capitis inferior
208(1)
NMT for suboccipital group -- supine
209(2)
Platysma
211(1)
NMT for platysma
212(1)
General anterior neck muscle stretch utilizing MET
212(1)
Sternocleidomastoid
213(2)
NMT for SCM
215(1)
Treatment of shortened SCM using MET
216(1)
Suprahyoid muscles
217(1)
Infrahyoid muscles
217(1)
Sternohyoid
218(1)
Sternothyroid
218(1)
Thyrohyoid
219(1)
Omohyoid
219(1)
NMT for infrahyoid muscles
219(2)
Soft tissue technique derived from osteopathic methodology
221(1)
Longus colli
221(1)
Longus capitis
222(1)
NMT for longus colli and capitis
223(1)
MET stretch of longus capitis
224(1)
Rectus capitis anterior
225(1)
Rectus capitis lateralis
225(1)
NMT for rectus capitis lateralis
226(1)
Scalenes
226(2)
NMT for scalenes
228(2)
Treatment of short scalenes by MET
230(2)
Cervical lamina -- prone
232(1)
NMT for posterior cervical lamina-prone position
232(1)
NMT for posterior cranial attachments
233(4)
The cranium
237(58)
Cranial structure
237(26)
Occiput
238(5)
Sphenoid
243(3)
Ethmoid
246(2)
Vomer
248(1)
Mandible
249(3)
Frontal
252(2)
Parietals
254(2)
Temporals
256(4)
Zygomae
260(1)
Maxillae
260(1)
Palatines
260(3)
Cranial treatment techniques
263(32)
Muscles of expression
263(1)
Mimetic muscles of the epicranium
264(1)
Occipitofrontalis
264(1)
Temporoparietalis and auricular muscles
264(1)
NMT for epicranium
265(1)
Positional release method for occipitofrontalis
266(1)
Mimetic muscles of the circumorbital and palpebral region
266(1)
NMT for palpebral region
267(1)
Mimetic muscles of the nasal region
267(1)
NMT for nasal region
268(1)
Mimetic muscles of the buccolabial region
268(1)
NMT for buccolabial region
268(1)
Muscles of mastication
269(1)
External palpation and treatment of craniomandibular muscles
269(1)
NMT for temporalis
269(7)
NMT for masseter
276(2)
Massage/myofascial stretch treatment of masseter
278(1)
Positional release for masseter
278(1)
Lateral pterygoid
278(1)
NMT for medial pterygoid
279(1)
Stylohyoid
279(1)
External palpation and treatment of styloid and mastoid processes
280(1)
Intraoral palpation and treatment of craniomandibular muscles
281(1)
Intraoral NMT applications
281(1)
Temporalis
282(1)
NMT for intraoral temporalis tendon
282(1)
Masseter
282(2)
NMT for intraoral masseter
284(1)
Lateral pterygoid
284(1)
NMT for intraoral lateral pterygoid
285(1)
Medial pterygoid
286(1)
NMT for intraoral medial pterygoid
287(1)
Musculature of the soft palate
287(1)
NMT for soft palate
288(1)
Muscles of the tongue
289(1)
NMT for muscles of the tongue
290(1)
Suprahyoid muscles -- the floor of the mouth
291(1)
NMT for intraoral floor of mouth
292(3)
Shoulder, arm and hand
295(126)
Shoulder
295(82)
Key joints affecting the shoulder
296(6)
Janda's perspective
302(7)
Therapeutic choices
309(4)
Infraspinatus
313(1)
Levator scapula
313(1)
Latissimus dorsi
314(1)
Pectoralis major or minor
314(1)
Supraspinatus
314(1)
Subscapularis
314(1)
Upper trapezius
315(1)
Is the patient's pain a soft tissue or a joint problem?
315(1)
The Spencer sequence
315(5)
Treatment
320(1)
Trapezius
320(5)
NMT for upper trapezius
325(1)
NMT for middle trapezius
326(1)
NMT for lower trapezius
326(1)
NMT for trapezius attachments
327(1)
Lief's NMT for upper trapezius area
328(1)
MET treatment of upper trapezius
328(1)
Myofascial release of upper trapezius
328(1)
Levator scapula
329(1)
NMT for levator scapula
330(1)
MET treatment of levator scapula
331(1)
Rhomboid minor and major
331(2)
NMT for rhomboids
333(1)
MET for rhomboids
334(1)
Deltoid
334(1)
NMT for deltoid
335(1)
Supraspinatus
336(1)
NMT treatment of supraspinatus
337(1)
MET treatment of supraspinatus
338(1)
MFR for supraspinatus
339(1)
Infraspinatus
339(1)
NMT for infraspinatus
340(1)
MET treatment of short infraspinatus
340(1)
MFR treatment of short infraspinatus
341(1)
PRT treatment of infraspinatus
341(1)
Triceps and anconeus
342(1)
NMT for triceps
342(2)
MET treatment of triceps
344(1)
NMT for anconeus
345(1)
Teres minor
345(1)
NMT for teres minor
345(1)
PRT for teres minor
346(1)
Teres major
346(2)
NMT for teres major
348(1)
PRT for teres major
349(1)
Latissimus dorsi
350(1)
NMT for latissimus dorsi
351(1)
MET treatment of latissimus dorsi
352(1)
PRT for latissimus dorsi
352(1)
Subscapularis
353(2)
NMT for subscapularis
355(1)
MET for subscapularis
356(1)
PRT for subscapularis
356(1)
Serratus anterior
357(1)
NMT for serratus anterior
358(1)
Pectoralis major
359(4)
NMT for pectoralis major
363(1)
MET for pectoralis major
364(1)
Alternative MET for pectoralis major
365(1)
MFR for pectoralis major
366(1)
Pectoralis minor
366(1)
NMT for pectoralis minor
367(1)
Direct (bilateral) myofascial stretch of shortened pectoralis minor
368(1)
Subclavius
369(2)
MFR for subclavius
371(1)
Sternalis
371(1)
Coracobrachialis
372(1)
NMT for coracobrachialis
372(2)
MFR for coracobrachialis
374(1)
PRT for coracobrachialis
374(1)
Biceps brachii
374(2)
NMT for biceps brachii
376(1)
MET for painful biceps brachii tendon
377(1)
PRT for biceps brachii
377(1)
Elbow
377(12)
Humeroulnar joint
378(1)
Humeroradial joint
378(1)
Radioulnar joint
378(1)
The ligaments of the elbow
379(1)
Biceps reflex
380(1)
Brachioradialis reflex
380(1)
Triceps reflex
380(3)
Treatment
383(1)
Brachialis
383(1)
NMT for brachialis
383(1)
Triceps and anconeus
384(1)
NMT for triceps
384(1)
NMT for anconeus
384(1)
Brachioradialis
385(1)
NMT for brachioradialis
385(1)
MFR for brachioradialis
385(1)
Supinator
385(1)
NMT for supinator
386(1)
MFR for supinator
387(1)
Pronator teres
387(1)
NMT for pronator teres
387(1)
MFR for pronator teres
387(1)
PRT for pronator teres
388(1)
Pronator quadratus
388(1)
NMT for pronator quadratus
389(1)
Forearm, wrist and hand
389(32)
Capsule and ligaments of the wrist
390(1)
Ligaments of the hand
390(3)
Key (osteopathic) principles for care of elbow, forearm and wrist dysfunction
393(1)
Ganglion
394(1)
Carpal tunnel syndrome
394(4)
Carpometacarpal ligaments
398(1)
Metacarpophalangeal ligaments
398(1)
Range of motion
398(1)
Thumb ligaments
399(2)
Anterior forearm treatment
401(1)
Palmaris longus
401(2)
Flexor carpi radialis
403(1)
Flexor carpi ulnaris
403(1)
Flexor digitorum superficialis
403(1)
Flexor digitorum profundus
404(1)
Flexor pollicis longus
405(1)
NMT for anterior forearm
405(2)
MET for shortness in extensors of the wrist and hand
407(1)
PRT for wrist dysfunction
407(1)
MFR for areas of fibrosis or hypertonicity
408(1)
Posterior forearm treatment
409(1)
Superficial layer
409(2)
Extensor carpi radialis longus
411(1)
Extensor carpi radialis brevis
411(1)
Extensor carpi ulnaris
411(1)
Extensor digitorum
411(1)
Extensor digiti minimi
412(1)
NMT for superficial posterior forearm
412(2)
Deep layer
414(1)
Abductor pollicis longus
414(1)
Extensor pollicis brevis
414(1)
Extensor pollicis longus
414(1)
Extensor indicis
415(1)
NMT for deep posterior forearm
415(1)
Intrinsic hand muscle treatment
416(1)
Thenar muscles and adductor pollicis
417(1)
Hypothenar eminence
417(1)
Metacarpal muscles
418(1)
NMT for palmar and dorsal hand
418(3)
The thorax
421(34)
Structure
421(2)
Structural features of the thoracic spine
421(1)
Structural features of the ribs
422(1)
Structural features of the sternum
422(1)
Posterior thorax
423(6)
Identification of spinal levels
423(1)
Spinal segments
423(1)
Palpation method for upper thoracic segmental facilitation
424(1)
Red reflex assessment (reactive hyperemia)
424(1)
Biomechanics of rotation in the thoracic spine
425(1)
Coupling test
425(1)
Observation of restriction patterns in thoracic spine
426(1)
Breathing wave assessment
426(1)
Breathing wave -- evaluation of spinal motion during inhalation/exhalation
426(1)
Passive motion testing for the thoracic spine
427(1)
Flexion and extension assessment of T1--4
427(1)
Flexion and extension assessment of T5--12
427(1)
Sideflexion palpation of thoracic spine
427(1)
Rotation palpation of thoracic spine
428(1)
Prone segmental testing for rotation
428(1)
Anterior thorax
429(6)
Respiratory function assessment
429(3)
Palpation for trigger point activity
432(1)
Alternative categorization of muscles
432(1)
Rib palpation
433(1)
Specific 1st rib palpation
433(1)
Test and treatment for elevated and depressed ribs
433(1)
Rib motion
433(1)
Tests for rib motion restrictions
433(2)
Discussion
435(1)
Thoracic treatment techniques
435(20)
Posterior superficial thoracic muscles
435(3)
NMT: posterior thoracic gliding techniques
438(2)
NMT for muscles of the thoracic lamina groove
440(1)
Spinalis thoracis
441(1)
Semispinalis thoracis
441(1)
Multifidi
441(1)
Rotatores longus and brevis
442(1)
NMT for thoracic (and lumbar) lamina groove muscles
443(1)
PR method for paraspinal musculature: induration technique
444(1)
Muscles of respiration
445(1)
Serratus posterior superior
445(1)
Serratus posterior inferior
445(1)
Levatores costarum longus and brevis
446(2)
Intercostals
448(1)
NMT for intercostals
448(1)
Influences of abdominal muscles
449(1)
NMT assessment
449(1)
PR of diaphragm
449(1)
MET release for diaphragm
450(1)
Interior thorax
450(1)
Diaphragm
450(2)
NMT for diaphragm
452(1)
Transversus thoracis
452(3)
Index 455

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Reviews for Clinical Applications of Neuromuscular Techniques; The Upper Body, Volume 1 (9780443062704)