Move Better, Feel Better: A Movement Based Approach to Soft Tissue Mobilization for the Upper Body: Summary 40
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 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 Research: Proposed Benefits: • Neurophysiological effect: May stimulate inhibitory neural pathways by creating a “counterirritation” that temporarily increases pressure pain thresholds: ○ Gait theory, DNIC or CMP, neuroplasticity (pain mapping) • Mechanical effects : Suction force produces a stretch and compression on the tissue,
causing dilation and rupture of the superficial capillaries (reddish colored circles): ○ Marks are not bruises ○ Does not break up fascia adhesions Application: • Different type of cups (plastic, glass, silicone): ○ Silicone is more gentle and glides better for dynamic treatments • Static cupping both with and without patient movement • Dynamic cupping both with and without patient movement: ○ Lubrication can be used for dynamic cupping ○ Tissue distraction with movement (TDM) • “Wet cupping” is not a part of clinical practice for PTs • Apply for 30 seconds to 2 minutes first to assess for tissue response then progress treatment up to 10 minutes
• 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
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