Physical Therapy: Muscle Tone Relaxation Techniques

Study Notes

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

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.

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.

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.

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

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.

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.

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 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.