Manual soft hooks extracts
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    Manual soft hooks extracts Manual soft hooks extracts Document Transcript

    • Aponeurotic hooking technique: The Soft Hooks®INTRODUCTION 1. Why hooking? The connective fibrous tissue represents up to 60% of the bodily mass. Of different structures, it mainly features a unique fascia1.This fascial web must remain absolutely free.Stress at any single point involves the participation of the entire fascia.Either in case of a muscular contracture, tissue adhesions or fibrouscorpuscles, the release by means of a simple mechanical effect willbring relief.Soft hooks allow to painlessly remove those biomechanical troublesand to re-establish the natural configuration. 2. With what tools?1 Léopold Busquet, Les chaînes musculaires tome 1,2000. 1
    • Aponeurotic hooking technique: The Soft Hooks®The fingertip approach of underlying skin and tissue structures islimited by the thickness of the finger.A simple and precise tool can put that right.The soft hook: the real lengthening of the finger.The soft hook is made of a stainless steel wire of a chosen diameterwhich ensures the sharpness at tissue level.First and foremost it is painless. 2
    • Aponeurotic hooking technique: The Soft Hooks® 3. How?A few precisions:1. The hook does not replace the therapist’s hand but will be itsperfect auxiliary.2. Any action starts distant from pain and then gets closer to it.3. The palpating anatomy constantly guides the therapist.The ideal way to hold the tool is summed up in three points:- lay the tool in the commissure between thumb and forefinger-fold the forefinger on the handle- put the thumb in the opposite sideSimple exercise: go over an uneven surface to feel the vibration2.2 The flexion of the inox wire is limited by the resistance if the welding and by the handle 3
    • Aponeurotic hooking technique: The Soft Hooks®Look at the picture showing the best way to hold the tool as well asthe typical manoeuvreStandard movement: 1. The free hand palpates and judges the tissue wave which defines the curve of the hook to be used. 2. The forefinger will identify the place to hook. 3. The soft hook comes closer to that forefinger and receives the tissue wave for the patient’s maximum comfort. Palpating hand and soft hook both make some exploratory motions over the painful spot.A brisk pulling of the soft hook will free (the tendon) fromadhesions or separate the fibrositis 4
    • Aponeurotic hooking technique: The Soft Hooks® 4. When?To free the adhesions resulting from shock during a sports practice orfrom surgery or to remove inflammatory or neuralgic pains in thelocomotive system.The obvious relaxation of the muscles due to the transversemobilisation of the fibres and the effect of the inhibition of reflexpoints already represent a non-negligible treatment.The main counter-indications are clearly related to the skin andcirculatory condition of the patient.An excitable patient seems very sensitive to hooking.Suggested indications for hooking (non restrictive):Epicondylitis, medial epicondylitis, Achilles tendinitis, pubalgia,periostitis, muscle contracture, strain, tenosynovitis, keloids,Dupuytren postoperative, carpal tunnel, ulnar canal syndrome,occipitalgy, sciatica, lumbago, torticollis, PSH, ganglion cysts,algodystrophy 5
    • Aponeurotic hooking technique: The Soft Hooks® 5. Origin of the methodThis technique was developed by Kurt EKMAN, a Swedekinesiotherapist contributor of CIRIAX in London.He revealed the deficiencies and limits of palpation and manualtreatment of soft tissues.The adhesions and small deposits are difficult to palpate on the deepmyo-aponevrotic levels.He had the idea of creating tools which offered a better access to thepathogenic structures. 6
    • Aponeurotic hooking technique: The Soft Hooks® PRACTICE 7
    • Aponeurotic hooking technique: The Soft Hooks®A – INFERIOR LIMB1.- TIGHANATOMIC REMINDERThe tigh consists of three areas • Anterior region • Posterior region • Lateral regionEach area is joined by muscle groups with similar actions and iscrossed by a vascular-nervous pedicle.The whole member is covered by skin, a superficial and a deep fascia.It surrounds the muscles forming the intramuscular septa.Anterior region of the tigh • Quadriceps femoris muscle • Sartorius muscleFemoris vessels • Artery • Vein • Nerve 8
    • Aponeurotic hooking technique: The Soft Hooks®Medial region of the tigh(from inside to outside) • Sartorius muscle • Iliopsoas • Pectineus muscle • Adductor longus muscle • Gracilis muscleDeeper • Adductor brevis muscle (between ALM and GM)Buttocks area • Gluteus maximus • Gluteus medius • Gluteus minimus • Tensor fasciæ latæDeeper • Piriformis muscle • Sacrospinous ligamentPosterior region of the tighLong rear muscles • Semimembranosus muscle • Semitendinosus muscle • Biceps femoris muscleNerves • Sciatic nerve 9
    • Aponeurotic hooking technique: The Soft Hooks® • Posterior cutaneous nervePopliteal fossa (Knee pit)BoundariesInside • Semimembranosus muscle • Semitendinosus muscleOutside • Biceps femoris muscleInferior (with the plantaris muscle) • Medial and lateral heads of the gastrocnemius muscleContents • Popliteal vein and artery • Tibial nerveFloor • Popliteal muscle 10
    • Aponeurotic hooking technique: The Soft Hooks®HOOKINGSeparation of the anterior gracilis muscleInternal: the Sartorius muscleExternal: to the fasciæ latæSeparation of the Sartorius muscleVastus medialis muscle (teardrop muscle)Area of concentration Sartorius muscle – vastus medialis muscle – anterior gracilis muscle 11
    • Aponeurotic hooking technique: The Soft Hooks®Edge of the vastus lateralis muscle in contact with the anterior gracilismuscleReminder The vastus lateralis (side and rear) is covered by the FLTSeparation of the vastus lateralis from the short head of the biceps femoris muscle down the tighSeparation if the vastus lateralis from the long head of the biceps femoris muscle to the upper areaof the tigh 12
    • Aponeurotic hooking technique: The Soft Hooks®Key point Vastus lateralis – biceps femoris – gluteus maximusGluteus maximus, linked up with • long head of the biceps femoris muscle • semitendinous muscleAfterwards, separation of semitendinous / semimembranous muscles 13
    • Aponeurotic hooking technique: The Soft Hooks®Separation of the gracilis muscle with • Semimembranous muscle (popliteal area) • Sartorius muscle (just ahead it)Separation of the adductor magnus muscle (posterior side) • semitendinous, semimembranous • gracilis muscle (just ahead it)Key point Adductor longus – semimembranous – gracilis muscleAdductor longus • gracilis muscle • adductor brevis 14
    • Aponeurotic hooking technique: The Soft Hooks®PATHOLOGIESSTRUCTURES TO BE TREATEDPatellar hyperpressure • Buttocks • Tensor • Adductor • Patte d’OiePubalgia • Adductor longus • Adductor magnus • Gracilis • Gluteus maximus • Abdominal muscles (periosteum) • Hamstring • Piriformis • Psoas • Quadratus lumborum muscleMuscular strainHooking the periphery of the injure relaxes the contractureemphasizing this way the drainage with this defibrosing effect. 15
    • Aponeurotic hooking technique: The Soft Hooks®PATHOLOGIESSTRUCTURES TO BE TREATEDPatellar hyperpressure • Buttocks • Tensor • Adductor • Patte d’OiePubalgia • Adductor longus • Adductor magnus • Gracilis • Gluteus maximus • Abdominal muscles (periosteum) • Hamstring • Piriformis • Psoas • Quadratus lumborum muscleMuscular strainHooking the periphery of the injure relaxes the contractureemphasizing this way the drainage with this defibrosing effect. 15