opp exam 1
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general concepts of 10 step
•Used as a general screening exam to help prioritize regions for treatment.
–Does not yield specific somatic dysfunctions.
–In combination with TART changes, it gives clues on where somatic dysfunctions may
–Useful for observing the overall functional symmetry of a body region in both its
static and dynamic state.
–Useful for making global connections between body regions from a tensegrity viewpoint.
2.Standing Spine Sidebending Test
3.Standing Flexion Test
4.Seated Flexion Test
5.Seated Upper Extremity Motion
6.Seated Trunk Tests
7.Seated Cervical Motion
8.Supine Thoracic Cage Motion
9.Lower Extremity Motion
–Heel strike and toe off
always remember to do what during 10 step evaluation
reset the pelvis
leg in 4 shape
goals of soft tissue
1.Relax hypertonic muscles
2.Stretch passive fascial structures
3.Enhance circulation to local myofascial
4.Improve local tissue nutrition, O2, and removal of metabolic waste
5.Identify somatic dysfunction
6.Improve abnormal somato-somatic
and somatovisceral reflex activity
7.Observe tissue response to OMT
8.Improve local and systemic immune
9.Provide general state of tonic
10.Provide general relaxation
are along the longitudinal axis
are perpendicular to the longitudinal axis (like a bowstring)
are directed superficial to deep ususally over a specific area of tension (tender
treatment superficially from distal to proximal and peripheral to central.
petrissage and skin rolling
kneading/squeezing of muscle tissue breaking adhesive bands from the skin to
striking the belly of the muscle with the hypothenar edge of the hand.
goals of muscle energy treatment
the restraint of movement
respiratory and circulatory function
asymmetrically weakened muscles
isotonic muscle contraction
muscle is anchored only on one end and uses a consistent weight.
is to strengthen muscle by shortening origin and insertion of muscle under
the physician uses less force than the patient.
isolytic muscle contraction
of a muscle against resistance while forcing the muscle to lengthen.
therapeutic goal is to stretch fibrotic or chronically shortened myofascial
the physician’s force is greater than the patient’s
common type used in muscle energy techniques.
is contracted without shortening the muscle’s origin and insertion.
the physician’s force matches (or is the same as) the patient’s force.
theoretical basis of muscle energy
commonly used as a direct technique (a technique that is localized towards the
a isometric contraction, the muscle group is in a relaxed, refractory phase
which allows the muscle to be passively stretched to a new restrictive barrier.
principles of treatment (muscle energy)
•Position to the point of initial barrier resistance (feather edge)
•Physician establishes appropriate counterforce
introduces appropriate muscle energy effort
–Direction–Duration–Amount of force
•Patient must completely and voluntarily relax
•Pause for neuromuscular adaptation (post-relaxation phase)
•Reposition to the new restrictive barrier
until no futher change is obtained
•Reassess for appropriate change
key treatment concepts of muscle energy
1.This is not a wrestling match. Only use enough muscle strength to contract
2.Hold the isometric contraction at least 3-5 seconds.
3.Be sure to wait for the involuntary second wave of relaxation (post relaxation phase) before repositioning.
4.Reposition after each contraction (including the last).
5.Remember, the correction occurs during repositioning and not during the isometric contraction.
changes in adductor muscles (inner thigh)
restricted motion of abduction
general clinical findingsd of hypertonicity
hypertonic one way; restricted other direction/motion (move towards restrictive barrier)
ex: hypertonic adductor... preferred position is slightly adducted thigh, restricted abduction, dr pushes to sbduct, patient pushed to adduct
opp exam 1
ten step screening, soft tissue techniques, muscle energy