LIGAMENTOUS ARTICULAR STRAIN OSTEOPATHIC MANIPULATIVE TECHNIQUES FOR THE BODY PDF

Ligamentous articular strain is the name given by William G. Sutherland, D. The term has since come to refer to a wide variety The osteopathic profession has developed many treatment modalities and approaches to manipulation. Ligamentous Articular Strain is the distillation of their work. The introductory chapters address the historical development of this approach, and review some of its scientific underpinnings.

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Ligamento-muscular Reflex Ligaments are not passive tissue. Ligaments are highly dynamic and non-stationary predictable organs. Afferent mechanoreceptors in ligaments trigger a ligamento-muscular reflex activation of associated muscles. It has been suggested that a reflex might exist between these sensory receptors in the ligaments and surrounding associated muscles. This Ligamento-muscular reflex may directly or indirectly alter the load inflicted on to a ligament.

Muscular activity elicited by this reflex allows muscles and ligaments to work together as a unit in maintaining joint stability. This reflex may play a role in the preservation of joint stability, inhibiting muscles that destabilize the joint or increasing antagonist co-activation to stabilize the joint.

Even many of our most popular anatomy texts still portray ligaments and muscles as separate tissues running from one bone to another, not connected to any surrounding tissues. In reality though, these and the surrounding tissues are inseparable.

In , van der Wal published a paper in which he determined that ligaments are mostly arranged in series with the muscles, not parallel.

For example, ACL ruptures and replacements can cause one or all of the quadriceps, hamstring and gastrocnemius muscles to become hypertonic as a result of a lack of the ligamento-muscular reflex. This hypertonic state is also due to the removal of the mechanoreceptors of the original ACL. A large percentage of the receptors are located near the ends of the ligaments as they attach into the sub-chondral layer.

This remnant is often removed in order to attach the substituted tissue. Although the stability of the joint has been re-established, patients regularly complain of not only having an increase in tonicity of the muscle groups, but also a deficiency in both proprioception and kinaesthetic awareness.

The manual therapist is then charged with the task of attempting various treatment techniques to reduce this hypertonicity. Their efforts are rarely successful and both the patient and therapist become frustrated and discouraged. Thus begins the circle of referral from one therapist to another. Ligamentous Articular Strain Technique L. Many of the techniques in the early 20th century were modified by therapists that wanted to focus on a quicker, more direct method of treating. Using L. The basic principles consist of disengaging the dysfunctional tissues from their protective position.

The practitioner follows the affected tissues into a position of exaggeration of the injury. This exaggeration leads to a state where all movement within the affected tissues halts. A release of tension within the tissue is felt, allowing the ligaments to draw the articulations back into a more normal balanced relationship.

Slowly disengaging the tissues, direct or indirect techniques the therapist exaggerates the permitted motions of the tissues to their end barrier. The reciprocal tension is a tension that is developed between the practitioner loading into the tissue and the tissue reciprocally loading back into the practitioner. The therapist now waits at this point of tissue exaggeration until he or she feels the ligaments draw the articulations back into a normal balanced position.

A re-assessment of the permitted motion in the tissues should confirm more suppleness and mobility along with an improvement in kinaesthetic and proprioceptive awareness. See Figures Figure 1. Hand placement for treatment of Annular Ligament. Figure 2. Sidelying position for treatment of Illiolumbar ligament. Figure 3. Figure 4. Hand placement on patient for treatment of C1 dysfunction. Chronic inflammation can build up over several weeks, months or years depending on dose-duration levels.

Rest and recovery of as long as two years only allows partial recovery, full recovery has never been reported. Reducing scar and adhesion formation using stretch and mobilization is especially important for internal tissue injuries and inflammation involving fascia and organs. Langevin et al. This approach could overall positively affect the functionality of the patient.

My experience with L. In our office, we treat a variety of injuries ranging from acute to chronic. These injuries lead to the symptoms described earlier in this article. Optimally, I prefer to treat in the acute stages of an injury. By attempting to create as optimal an environment for tissue healing as possible, patients have reported being less symptomatic.

Combining L. T with Prolotherapy treatment, administered by our Naturopathic Physician, creates an opportunity to prevent chronic issues from occurring thereby improving the quality of life for the patient. References 1 The Osteopathic Cranial Association. Journal of the Osteopathic Cranial Association. Strolling under the skin [DVD]. Ligaments: a source of musculoskeletal disorders. Journal of Bodywork and Movement Therapies, ;13 2 Cruciate ligament reflexes.

J Electromyogr Kinesiol.

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Ligamentous Articular Strain: Osteopathic Manipulative Techniques for the Body

Ligamento-muscular Reflex Ligaments are not passive tissue. Ligaments are highly dynamic and non-stationary predictable organs. Afferent mechanoreceptors in ligaments trigger a ligamento-muscular reflex activation of associated muscles. It has been suggested that a reflex might exist between these sensory receptors in the ligaments and surrounding associated muscles. This Ligamento-muscular reflex may directly or indirectly alter the load inflicted on to a ligament.

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Ligamentous Articular Strain: Osteopathic Manipulative Techniques for the Body: Revised Edition

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