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Move Better, Feel Better: A Movement-Based Approach to Soft Tissue Mobilization for the Lower Body: Summary 13
CASE STUDY
John is a 45-year-old male who has low back pain with forward bending. At work he does a lot of standing, which sometimes causes sciatica in his right hamstring.
What type of IASTM technique could we use for John? Answer: • Gentle IASTM along paraspinals: ○ Progress to deeper strokes to reduce tone: neutral or prone → child’s pose/seated forward bending • Reduce sciatica: gentle strokes to right hamstring: ○ Progress to deeper stroke ○ Prone with knee bend
CUPPING
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 (cup is still) both with and without patient movement • Dynamic cupping (cup is moving) both with and without patient moving: ○ Lubrication should be used for dynamic cupping ○ AKA: 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
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 stand alone treatment
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 neurophysiologic effects to reduce pain
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