Positional Release Therapy for Lower-Quarter Somatic Dysfunction

Clinical Guide to Positional Release Therapy for Lower-Quarter Somatic Dysfunction

• Lower-quarter injury incidence in athletic and recreational populations is high, with foot and ankle fractures and dislocations being the most common.
• Intrinsic factors such as anatomical alignment, muscle tightness, range of motion, strength, and tissue imbalance may have the greatest potential to be influenced by PRT.
• Somatic dysfunction may reduce strength and affect the stability and function of lower-extremity articulations and tissues, specifically at the foot.
• The role of foot type or posture for the predisposition of lower-quarter injuries such as Achilles tendinopathy, patellofemoral syndrome, medial tibial stress syndrome, and iliotibial band friction syndrome has received considerable attention.
• Most foot studies are retrospective and involve the analysis of static foot posture, which may lack clinical relevance once the patient ambulates.
• The literature suggests that altered foot posture may play a role in the predisposition of lower-extremity injury, but systematic reviews have yielded limited evidence to support the association.
• Age and body composition are easily assessed in the clinical environment, with the older population being more susceptible to foot injury and obesity increasing the risk of osteoarthritis and abnormal foot function.
• The majority of lower-quarter somatic dysfunction lesions are the result of compensatory biomechanical loading patterns, muscle imbalance, excessive weight, and prior injury.
• Somatic or myofascial lesion patterns often manifest from either functional or structural abnormality, which overloads the tissues.
• It is imperative that therapists consider other triggers in the assessment process to identify and address any underlying disease process, visceral facilitation, or neurological derangement.
• PRT research is starting to gain a footing on explaining how the therapy provides significant pain relief and correction of somatic dysfunction in various areas of the body, but the gaps in the PRT literature for lower-quarter somatic dysfunction are yet to be filled.
• Clinical experience and feedback from patients about what they value from their clinical experience with PRT will inform the positional release therapist about how to approach lower-quarter somatic dysfunction.