Move Better, Feel Better: A Movement Based Approach to Soft Tissue Mobilization for the Upper Body: Summary 34
Goal of Treatment: Stimulate Mechanoreceptors • Reduce pain via light touch with sharper edge (interstitial fibers): Use faster strokes • Reduce tone via slow, deep strokes with beveled side/dull edge (Ruffini): Move from superficial to deep, starting with tissue on slack: ○ The greater the angle of the tool, the more intense
• Facilitate muscle via faster medium-deep stroke with beveled side (Pacinian)
Upper Quarter Treatment Body Region Spine
Shoulder/Upper Arm
Elbow/Forearm
ROM exam: Before/after treatment
Cervical : Rotation, side bending, flexion, extension Thoracic : Side bending, rotation Pain and tone : Upper trap, levator scapula, paraspinals, suboccipitals
Shoulder : Scaption, functional IR, functional ER
Elbow : Flexion, extension with over pressure Wrist : Flexion, extension, supination, pronation (with over pressure) Pain : Around the epicondyles, triceps tendon, olecranon, junction along ulna/radius, between metacarpals Tone : Extensors, flexors, pronators, thenar/hypothenar eminence
Common muscles
Pain : Triceps, posterior deltoid, supraspinatus, infraspinatus, teres minor/major Tone : upper trap, ant/post deltoid, pectoralis
CASE STUDY
John is a 45-year-old male with neck pain that is worse with forward bending of his neck. At work he does a lot of reaching, which sometimes causes referred pain in his right upper arm. What type of IASTM technique could we use?
Answer: • Reduce pain: Gentle IASTM along paraspinals of cervico-thoracic area, upper trap, levator • Progress to reduce tone in the same areas—first in neutral (prone position) then seated with neck flexed • Additional treatments: IASTM to the upper arm, treating around the scapula while reaching
CUPPING
Research: • Altered local metabolic activity (inducing anaerobic metabolism) may contribute to pain-relieving effect (not strong research) • Activation of heme oxygenase system could account for local and systemic health benefits • Increased skin temperature can help with reducing pain • Greatest research supports neurophysio-logic effects to reduce pain
Pros
Cons
• Patients report relief and improved mobility • Can be an effective adjunct treatment • Research shows some support for pain relief
• No strong research • Might not be better than placebo • Not a standalone treatment
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