Physical Therapy: Muscle Tone Relaxation Techniques

Muscle Imbalance Syndromes

• Helps eliminate abnormal muscle tone, abolishes TrPs and tender points, and improves loss of motion due to altered muscle tone.

Treatment Procedure

• Patient is asked to imagine or barely contract the affected muscle and maintain it for 20-30 seconds to activate and fatigue TrPs.
• Patient then relaxes the muscle completely, allowing the limb to move to a new position, gaining ROM through relaxation instead of stretching.

Sensorimotor Training

• Increases proprioceptive flow in the sole of the foot, cervical spine, and SI joints.
• Stimulates the vestibulocerebellar system through balance training.
• Influences midbrain structures through primitive locomotor activities.

Sensorimotor Training Components

• Posture: progresses from supine and prone to quadruped, kneeling, and standing activities.
• Base of Support (BOS): challenges the BOS by progressing from two-leg to one-leg activities and altering its texture, firmness, or stability.
• Center of Gravity (COG): challenges include weight shifts, perturbations, movements of upper and lower extremities, oscillations, and spinal stabilization.

Sensorimotor Training Progression

• Three stages: static, dynamic, and functional, each with increasingly difficult challenges to posture, COG, and BOS.

Muscle Imbalances

• Short TFL (Tensor Fasciae Latae) may contribute to a superior-lateral shift of the patella.
• Weak gluteus medius and tight TFL may result in a superior-lateral shift of the patella.
• Short rectus femoris may contribute to a superior positioning of the patella in relation to the opposite knee.
• Hypertrophied vastus medialis may indicate repeated forced hyperextension of the knee joint.
• Tight pectoralis major and minor usually results in a rounded and protracted shoulder position.
• Flattening of the deltoid muscle suggests weakness or atrophy and may be associated with a dysfunction at the C3-C4 segment.
• Overactive SCM and scalene muscles may result from an impaired respiratory pattern.

Treatment of Muscle Imbalance Syndromes

• Normalization of peripheral structures outside the CNS to improve afferent information.
• Restoration of muscle balance between phasic and tonic muscle systems.
• Facilitation of afferent system and sensory motor training to improve coordination and mechanical loading.

Normalization of Peripheral Structures

• Local direct techniques include soft-tissue, neural tension, joint mobilization, lymphatic, and orthotic techniques.
• Soft-Tissue Techniques: useful in managing scars, adhesions, and contractures, and include soft-tissue mobilization, instrument-assisted soft tissue mobilization, cross-friction massage, and myofascial release (MFR).
• Neural Tension Techniques and Neurodynamics: aim to restore normal nervous system movement and function.

Neural Tension Techniques

• Neural mobilization techniques: passive or active movements that focus on restoring the ability of the nervous system to tolerate normal compressive, friction, and tensile forces.
• Clinical neurodynamics: the clinical application of mechanics and physiology of the nervous system as they relate to musculoskeletal function.
• Tensioning techniques and sliding techniques aim to mobilize the nervous system, but tensioning techniques are associated with a considerable increase in nerve strain.