jimtrue.com : school : STT : STT30?: Introduction to Theory of Therapeutics
Posted by Jim True on February 13, 2007 10:47 PM. Last Updated February 13, 2007 10:47 PM
Disclaimer for all material noted here is at the bottom of this web page.
Pg 1 in the Black Book, 4 theory classes. Developing assessment skills in order to identify areas of soft tissue dysfunction. Goal is to treat the cause not the symptom. If we become better skilled at assessment, special tests and interview process
Assessment approaches
Therapeutic Intervention (from page 1)
Everything we learned in relaxation massage, can be utilized in therapeutic massage
Interview, intake, greeting, etc. Must be confident
Body language issues
Pain is primarily learned behavior. Everyone responds uniquely to pain. Which is why we say our client's 3 and our client's 6. Monitor their pain levels during their treatment and as a response to treatment.
What is pain? An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. This links body and mind.
Nociceptors - Pain receptors which can be affected by local tissue changes and by neural messages from the central nervous system. Can also be influenced by emotional suffering. Brain will often respond to stimulus in the way it has responded in the past.
Pain is also linked to our survival, presence of inflammation, warn us of injurous events, temperatures too hot and too cold.
Pain Threshold - first notice you're experiencing pain.
Pain Tolerance - patient can simply not experience any more of the pain.
Proven that women have a lower pain threshold so they feel it sooner, but they can take it longer. Men may not experience the pain as quickly, but have less tolerance.
Pain-Spasm-Pain Cycle (Pg. 4) - cycles involves shortening of the muscle and fascia as a result of an aggravating event. Shortening results in:
Maintenance regiment
Chart on page 4; localized and dermatonal (on top of the skin); important to know because you'll have different treatment protocols for acute & chronic pain. Chronic coolness to the tissue because there's less blood flow and less feeling in the area.
Aggravating events are either sudden or gradual onset stressors, physiological, behavioral, structural and emotional.
Sudden Onset Stressors to the body include:
Gradual onset is harder for the therapist to treat: because the therapist must do more in terms of detection, questioning, patient education and maintenance. Always requires more for the patient in terms of education and 'home' maintenance.
Therapeutic intervention is needed by a patient when...
When you work with patients in pain, it is important that a thorough assessment... client intake form, listening skills, consulting with client... several techniques to ensure the client is hearing ...
There are different categories and types of pain in the assessment process. Local Pain. RICE after a local trauma (Rest, Ice, Compress and Elevate for first 48 hours). Adaptive and Referred pain require more complex education in order to recognize. Chart on Page 7
Local pain is a local injury, local loss of fucntion
Adaptive pain is a dynamic of pain related to compensation. Muscle compensating for the work the affected muscle can't handle. Concept of overload and postural implications.
Referred Pain is a dynamic of pain related to TrP's. Pain ins experienced at a site distant to origin of problem. Viscerosomatic - organ and neurovascular - Heat helps to bring fresh blood in and ice takes the swelling down.
Dr. Janet Travell, MD Credited with greater understanding of Referred pain. Focus of research was in identifying the location, significance and role of Trigger Points in what she has called Myofascial Pain Syndromes.
Travell states we have 608 Trigger Points and some overlap with Acupressure Points.
According to Leon Chaitow, Trigger points began as local injuries which became tender points, then Latent Trigger Points and then Active Trigger Points.. Chart on Pg. 9
Trigger point pain is .... Sharp, throbbing, shooting often refers to nerve, vascular or inflammatory problems.
Travell and others believe that a trigger point occurs when a microtear in the sarcoplasmic reticulum occurs. Results in leakage of calcium and other irritants into the tissue. Because of the irritation of this metabolic imbalance, edema develops and congested circulation results in the area. The fibers shorten, and eventually taut bands develop within the muscle. It is within these taut bands that TrP's will be found. The taut bands can result in inhibited range of motion, and muscle weakness due to pain when full strength is sought.
Why do Trigger Points refer to another area? has to do with the role of fascia with its circulatory and lymphatic
Go over the different types of trigger points
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