Move Better, Feel Better: A Movement-Based Approach to Soft Tissue Mobilization for the Lower Body: Summary 22
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
Lower Quarter Treatment Body Region Location
Treatment Technique
Lower thoracic/ lumbar spine
Paraspinals
Static with(out) movement: pin & stretch via cat cow, QL stretch in side lying, seated flexion, prone press up (4-6 cups) TDM clocking, long strokes, cross fiber both with and without movement (1-2 cups) Static with(out) movement (2-4 cups): pin & stretch in supine, PROM/AROM knee flexion in prone TDM with(out) movement (1-2 cups): wiggle, clocking, long strokes, cross fiber Static with(out) movement: pin and stretch over TFL and/ or ITB in side lying with hip ADD, PROM hip flexion and extension TDM with(out) movement (1-2 cups): clocking, cross fiber, or long strokes Static cupping: pin & stretch into hip ABD TDM with(out) patient movement: anchor proximally or distally and work away from the anchor. Move distally when stretching into ABD /proximally when contracting into ADD
Hamstrings
HS insertions or muscle belly
IT Band
Junction zones (anterior and posterior) Muscle belly, inferior insertion of muscle
Adductors
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