A Movement Company. That Dabbles in Tape

Transcription

1 To comply with professional boards/associations standards: I declare that I (or my family) do not have a financial relationship in any amount, occurring in the last months with a commercial interest whose products or services are discussed in my presentation. Additionally, all planners involved do not have any financial relationship. Requirements for successful completion are attendance for the full session along with a completed session evaluation. Vyne Education and all current accreditation statuses does not imply endorsement of any commercial products displayed in conjunction with this activity. Session 0: IASTM Redefined: Improving Function & Performance with Gentle Soft Tissue Techniques Milica McDowell, MS, DPT Leading the Way in Continuing Education and Professional Development. A Movement Company That Dabbles in Tape

2 We are going to challenge your current understanding New model in soft tissue manipulation Neurological effects RockBlades Mechanical effects Treatment vectors/rate/time/depth Fascial Chains (Tracing) Case Study Movement Pyramid This is a footer, so use it when you need it.

3 . Feeding the sensory system to improve motor output What We Think We Are Doing. Sensorimotor re-training 7 Limits Exist Only in the Mind 8 Efficiency 9

4 Criteria for Optimal Efficiency Stiffness Compliance 0 Debunked idea of fascial release (mechanical deformation of fascia) Dismisses traditional explanations of thixotropy and piezoelectric-effect-mediated adaptation Fascial toughness Concludes plastic fascial changes in response to moderate loading is impossible to conceive Dr. Robert Schleip 000lbs/sq The amount of pressure necessary to distort fascial tissue Three-dimensional mathematical model for deformation of human fasciae in manual therapy. Chaudry H, et al. J Am Osteopath Assoc. 008 Aug; 08(8):

5 Old School Aggressive and intense manual therapy with no regard for the state of the patient s nervous system is problematic No pain, no gain NEW SCHOOL Neurological Effects Movement & Faulty Maps Body mapping is the conscious correcting and refining of one s schema to produce efficient, graceful and coordinated movement Body map is one s self-representation in one s own brain if representation is accurate, movement is good If our representation is faulty, movement suffers. When our map is corrected, movement improves David Nesmith - Alexander Technique

6 Body Maps Precision Training Improving the Cortical Map 7 Connect the Dots Redefining body maps Modern rehabilitation will be via normalization of sensation, motor control and congruence of these factors NOI Group (Moseley, Butler) 8

7 Making the Invisible Visible Kinesthetic Cuing 9 Mechanisms Neurophysiological Mechanical 0 Feed the Brain 7

8 Good Movement requires good perception The Science of Perception Satellite Systems Visual Exteroceptive Interoceptive Vestibular Proprioception 8

9 Sensory Receptor Classification Proprioception: is the kinesthetic sense that enables us to sense the relative position of the parts of the body, posture, balance, and motion. Located in Muscles, tendons, joints, internal ear Exteroception: pertains to the stimuli that originates from outside the body Located at or near the body surface Interoception: is defined as sensitivity to stimuli originating inside of the body. Interoceptors: Free nerve endings Located in blood vessels, organs, and connective tissue (skin/fascia) Mechanoreception Connective tissue and fascia are highly innervated Often reported only to occur in muscles and joints The fascial network possesses approximately 0 times the sensory receptors as compared to its muscular counterpart ( van der wall 009) Includes many types of receptors: Golgi, Ruffini, Pacinian, Free nerve endings (Interoceptors) Fascia considered more of a perceptual organ than a mechanical organ. The nervous system is the most important target for influencing posture and movement. - Feldenkrais What Are We Treating? Fascia is the most important tissue for posture and movement. - Rolf BOTH! 7 9

10 The nervous system is the gate keeper to change. Stacey Thomas, LMT 8 Instrument Assisted Neurosensory Modulation IANSM 9 Pathological Adhesion? Pre Blades This is a footer, so use it when you need it. Post Blades 0 0

11 Driver s Education Grip: Standard Thumb Edge Skin Prep: Wet Emollient Dry No lubricant Treatment Variables Treatment Rate: Fast / Feathering Slow Fluid Capture Shearing Tangential Treatment Vector: Myofascial Chains Linear Non linear Treatment Depth: Angle of Approach Pressure (Grading of Touch) Tool Navigation Fine Tuning Edge Narrow Edge Finger Pads Blunt Edge Bottle Opener Hard Rock Groovy Rock Soft Rock Alternative Rock

12 Depth Gauge Grades Skin SubQ Sup Fascia Deep Fascia Muscle Trauma -: Very light (eyelid analogy) Depth Gauge Scale -: Moderate 7-8: Firm 9-0: Deep Angle of Approach Depth does not require over-pressure.

13 Content FREE zone. This is a footer, so use it when you need it. 7 Content FREE zone. This is a footer, so use it when you need it. 8 Content FREE zone. This is a footer, so use it when you need it. 9

14 Indications Limited motion Painful motion Motor dysfunction Lack of tissue glide Poor body representation 0 Contraindications Comprised tissue (open wound, infection, tumor) Active implants (pacemaker, internal defibr., PICC/pump lines) Deep vein thrombosis Over cervical carotid sinuses Patient unable to communicate Treatment Strokes Up Regulation Pain Modulation Tissue Glide Fluid Capture Down Regulation

15 It s easy to be heavy; hard to be light. G.K. Chesterton Not Necessary Proprioception: Sensory Receptor Classification The kinesthetic sense that enables us to sense the relative position of the parts of the body, posture, balance, and motion. Located in Muscles, tendons, joints, internal ear Exteroception: Pertains to the stimuli that originates from outside the body Located at or near the body surface Interoception: Defined as sensitivity to stimuli originating inside of the body. Interoceptors: Free nerve endings Located in blood vessels, organs, and connective tissue (skin/fascia)

16 Only a Fascia minority as of the Interoreceptive sensory nerve endings Organ in MSK fascia are myelinated mechanoreceptors concerned with proprioception Golgi Receptors, Paccini Corpuscles, or Ruffini Endings. 7 x more interoceptors than other mechanoreceptors Higher concentration in hairy skin Stimulation of these receptors result in activation of an area of the brain (Insula) associated with pain relief and sense of well being 0% of these receptors are low threshold receptors which are responsive to light touch, Painter s Brush Cotton Ball Feather stroke Interoception/Pain Relief 7 Interoreceptive Pathway Insula Wellbeing Center of Brain Thalamus Prebrachial Nucleus Lamina I of Spinal Cord Interoceptive C Fiber Endings Free Nerve Endings Fascia Hairy Skin 8

17 Technique : Feathering Use for pain Interoreceptor Stimulation (free nerve endings) 9 Alternative Scanning Process Useful to pay attention to the autonomic responses of each treatment Variable: Neurological cues: Warmth lightheadedness nausea pulsation sense of wellbeing facial expression breathing pupil dilation/constriction skin color changes temperature changes 0 Pain - Feathering. SCAN tissues targeted within workout.. IDENTIFY areas of tenderness/tightness = TARGET TISSUE. SUPERFICIALLY FEATHER pressure on target tissue for 0 seconds to tolerance. ADDRESS tissues up/down stream to target tissue = RIPPLE SCAN + IDENTIFY + FEATHER STROKES + RIPPLE This is a footer, so use it when you need it. 7

18 Depth Gauge.. Feather Stroke Rate 8

19 Technique : Up Regulation Use for pain/low activation Pacinian Stimulation (low threshold sensation) Pacinian corpuscles: Up-Regulation = Fast respond to rapid/oscillating mechanical pressure This improves tactile acuity and motor control Explain Pain - Moseley/Butler 7 9

20 Body Map Receptors & Tactile Acuity Pacinian mechanorecptors Primarily respond to rapid pressure changes Stimulating these receptors can result in improved proprioceptive feedback and controlled movement 8 Up Regulation - Fast/Oscillating. SCAN tissues that will be targeted in specific workout out.. IDENTIFY areas of tightness/tenderness = TARGET TISSUE. QUICKLY oscillate over the area for 0 seconds = RAPID STROKES. ADDRESS tissue up/down stream to target tissue = RIPPLE SCAN + IDENTIFY + RAPID STROKES + RIPPLE This is a footer, so use it when you need it. 9 Depth Gauge.. 0

21 Content FREE zone. Rate of Oscillation: Hz Level BPM This is a footer, so use it when you need it. Foot Ankle

22 Lower Leg Knee Down Regulate Up Regulate Tissue Response Pain Mitigation Shear

23 Nervous System fascia muscular pain performance movement articular 7 Content FREE zone. Past This is a footer, so use it when you need it Years 9

24 Content FREE zone. Future This is a footer, so use it when you need it. 7 0 What is Fascia? it s alive fascia senses richest sensory organ fascia transmits force globally common myofascial pathways for transmitting stability, strain, and response distributes strain continuous interconnected web a GPS system of strain distribution 7 Muscular strain is applied along traceable myofascial lines Credit: Thomas Myers - Anatomy Trains 7

25 In Summary. New perspective in manual therapy. Neurological tweaking of the brain. Navigating the human body. Fascial IASTM (IANSM). Scrape and tape model. Locking in the change via corrective strategies 7