CMTP General Protocol

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CMTP General Protocol
2011-05-03 20:14:00
Soma CMTP general protocols

CMTP General Protocols
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  1. General protocol rules (5)
    • 1: Superficial - Deep - Superficial
    • 2: General - Specific - General
    • 3: Proximal - Distal - Proximal
    • 4: Peripheral - Central - Peripheral
    • 5: Treat the antagonist
  2. Post assessment opening communications
    • a: check in on contraindications
    • b: any changes in condition since last visit
    • c: trigger point communication
    • d: explain treatment goals and techniques
    • e: permission to begin
  3. Purpose of resting position
    Hold until parasympathetic breathing is perceived (slow, deep breaths)
  4. Basic steps of general protocol
    • A: opening communications
    • B: resting position
    • C: stroking and initial dry warming
    • D: myofascial techniques
    • E: joint mobilization
    • F: lymphatic work
    • G: clearing
    • H: deeper warming (apply lotion)
    • I: treat area of dysfunction
    • J: passive stretching
    • K: referral zone
    • L: cross-fiber friction
    • M: superficial/ general closure
    • N: hydrotherapy
    • O: closing concerns/ comments
  5. Purpose of myofascial techniques
    Softens tissue of hypertonic structures and allows for deeper work wilthout creating kick-back response. Tissue shows hyperemia (warms, reddens) and is softer when palpated.
  6. Purpose joint mobilization
    Isolates and/or decreases guarding
  7. Lymphatic work
    When indicated, removes metabolic waste secondary to edema and inflammation
  8. Clearing
    Term used to describe a cross-fiber friction that is applied to nonropy tendon attachments to trigger Golgi Tendon Organ (GTO) response
  9. How to find trigger point
    • Muscle stripping (4-6 inches per second)
    • Cross-fiber palpation
    • Pincer grasp
  10. How to use muscle stripping to treat/release a trigger or tender point
    • a: isolate TP
    • b: activate tissue - 4 directional fiber application (plus sign)
    • c: treating rate - 1 inch per 3 seconds, start stroke before TP and end stroke after it
    • d: get initial pain number from client (PS 1-10)
    • e: Continue stripping for 8 - 12 seconds
    • f: Ask about referred pain
    • g: Get pain scale number again - if pain has lowered, continue slow muscle stripping until only pressure is felt locally and referral pain is gone but if pain number remains constant or is worse, then slowly stop muscle stripping, smooth out and leave area to return later