Dr. James Cyriax developed Cyriax techniques in the early 1900s as a systematic approach to soft tissue injuries. The techniques involve selective tissue tension testing to diagnose lesions, followed by treatments like deep friction massage, passive movements, and active exercises. Deep friction massage uses longitudinal or transverse forces to separate tissue fibers and relieve pain. Passive movements can be graded from low-force range-of-motion to high-velocity small-amplitude thrusts. Active exercises prevent immobilization effects and maintain tissue integrity. Together, Cyriax techniques aim to accurately diagnose and beneficially treat soft tissue disorders.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
There are evidence in History of treatment by Passive stretching techniques.
Over past 30-40 years many therapists have worked to identify and learn the techniques which are are more suitable and effective for the patient’s problem.
Joint mobilisations and manipulations techniques are used to safely stretch or snap structures to restore normal joint mechanics with less trauma.
Myofascial release refers to the manual
technique for stretching the fascia and
releasing bonds between fascia and
Lintegument, musles,and bones, with the goal of
eliminating pain, increasing range of motion
and balancing the body.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
There are evidence in History of treatment by Passive stretching techniques.
Over past 30-40 years many therapists have worked to identify and learn the techniques which are are more suitable and effective for the patient’s problem.
Joint mobilisations and manipulations techniques are used to safely stretch or snap structures to restore normal joint mechanics with less trauma.
Myofascial release refers to the manual
technique for stretching the fascia and
releasing bonds between fascia and
Lintegument, musles,and bones, with the goal of
eliminating pain, increasing range of motion
and balancing the body.
Cyriax, a manual therapy technique, used to treat the soft tissue related pain. invented by James Cyriax who also coined the term "orthopedic medicine". There are various techniques described by Cyriax under the concept which are; infiltration, deep friction massage, manipulation and traction.
Muscle energy technique, a manual therapy technique with a long term history and 8 variations which can be used in various condition to treat muscle as well as joints. This slide show consists of detailed history, variations/types and summary of MET in detail.
Basic Introduction about Joint Mobilisation and Manipulation, This article gives clear notes for the students to understand the Mobilisation techniques.
A type of manual therapy in which the muscle or the joint is altered and placed in a position of comfort for certain duration after which the pain disappears completely or gets reduced. this slide show explains about the principles, mechanism and Phases of PRT
This Presentation is about Mitchell relaxation technique also known a physiological relaxation technique Mitchell’s physiological relaxation technique is based on reciprocal inhibition and involves diaphragmatic breathing and a series of ordered isotonic contractions.
content from
(proprioceptive neuromuscular fascilitation article of Marymount University Fall 2009),
DPT AMIR MEMON (pnf presentation)
DPT AARTI SAREEM (pnf presentation)
Neurodynamics, mobilization of nervous system, neural mobilizationSaurab Sharma
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Co-ordination Exercise,Definitions,Nervous control,Motor pathway,Cerebral cortex,Kinesthetic sensation,Causes of Incoordination,Flaccidity
Spasticity ,Cerebellar ataxia,Loss of kinesthetic sensation,Types of coordination,Posterior column,Test for Incoordination.
Cyriax, a manual therapy technique, used to treat the soft tissue related pain. invented by James Cyriax who also coined the term "orthopedic medicine". There are various techniques described by Cyriax under the concept which are; infiltration, deep friction massage, manipulation and traction.
Muscle energy technique, a manual therapy technique with a long term history and 8 variations which can be used in various condition to treat muscle as well as joints. This slide show consists of detailed history, variations/types and summary of MET in detail.
Basic Introduction about Joint Mobilisation and Manipulation, This article gives clear notes for the students to understand the Mobilisation techniques.
A type of manual therapy in which the muscle or the joint is altered and placed in a position of comfort for certain duration after which the pain disappears completely or gets reduced. this slide show explains about the principles, mechanism and Phases of PRT
This Presentation is about Mitchell relaxation technique also known a physiological relaxation technique Mitchell’s physiological relaxation technique is based on reciprocal inhibition and involves diaphragmatic breathing and a series of ordered isotonic contractions.
content from
(proprioceptive neuromuscular fascilitation article of Marymount University Fall 2009),
DPT AMIR MEMON (pnf presentation)
DPT AARTI SAREEM (pnf presentation)
Neurodynamics, mobilization of nervous system, neural mobilizationSaurab Sharma
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Co-ordination Exercise,Definitions,Nervous control,Motor pathway,Cerebral cortex,Kinesthetic sensation,Causes of Incoordination,Flaccidity
Spasticity ,Cerebellar ataxia,Loss of kinesthetic sensation,Types of coordination,Posterior column,Test for Incoordination.
Stretching for impaired mobility by Sayed MurtazaFakhryDon
The students should be able to know Impaired mobility stretching, and they also understand contractures, types of contractures, defining the mobility, flexibility, and hypo-mobility. THANK YOU
Dr Muntasir Mannan Choudhury
Dept of Hand and Reconstructive Microsurgery
Singapore General Hospital
Dept of Orthopedic Surgery
Senkang General Hospital
Mobility and Flexibility of soft tissues (muscles, tendons, fascia, joint capsule, and skins) surrounding the joint along with adequate joint mobility, are necessary for normal ROM.
Mobility: is the ability of segments of the body to move through range of motion for functional activities.
Flexibility: is the ability to move a single joint or series of joints smoothly and easily through an unrestricted, pain –free ROM.
Muscle energy techniques are manual techniques involving the muscles own energy to lengthen the muscle fibres and remove the sustained contractions that cause the Trigger points.
•Two aspects of MET are-
i.their ability to relax an overactive muscle.
ii.their ability to enhance stretch of a shortened muscle or its associated fascia when connective tissue or viscoelastic changes have occurred.
There are 2 forms of MET:
1. Autogenic inhibition
Post isometric relaxation
Post facilitation stretching
2. Reciprocal inhibition
MECHANISM OF ACTION
Muscle energy is a direct and active technique; meaning it engages a restrictive barrier and requires the patient’s participation for maximal effect.
•A restrictive barrier describes the limit in the range of motion that prevents the patient from being able to reach the baseline limit in his range of motion. As the patient performs an isometric contraction, the following physiologic changes occur:-
i.Golgi tendon organ activation results in direct inhibition of the agonist’s muscles.
ii.A reflexive reciprocal inhibition occurs at the antagonistic muscles.
iii.As the patient relaxes, agonist and antagonist muscles remain inhibited allowing the joint to be moved further into the restricted range of motion.
BENEFITS OF MET:
•Restoring normal tone in hypertonic muscles
•Strengthening weak muscles
•Preparing muscle for subsequent stretching
•Improved joint mobility
INDICATIONS
•Movement restriction due to muscle tightness.
•Muscle hyperactivity.
•Myofascial restrictions.
CONTRAINDICATIONS
•Fracture
•Severe sprain
•Severe strain
•Open wounds
•Severe osteoporosis
•Avulsion injury
•Metabolic bone
•Unconscious patient
•Non cooperative patient
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
2. Introduction
• Cyriax is one of the form of diagnostic and treatment based
approach of manual therapy.
• It is both invasive and non-invasive technique which depends
type, extent and position of the disorder present.
• Cyriax method of diagnosis is mainly by “Selective Tissue
Tension’’ which is basically application of specific amount of
applied pressure on selective tissue which is to be assessed and
treated.
3. History
• Dr James H Cyriax (1904-1985), an orthopedic surgeon in London, was
the first to approach the study of soft tissue injuries in a systemic way.
4. Principles
• The Principles of Cyriax concept are :
1. All pain arises from a lesion.
2. All treatment must reach the affected site.
3. All treatment must exert a beneficial effect on the affected site.
5. Examination by Selective Tissue Tension Test
• Three principles for examination by Selective Tissue Tension Test.
1. Passive movements test the function of the inert structures.
2. Capsular patterns differentiate between joint conditions and other
inert structure lesions.
3. Isometric contractions test the function of the contractile tissues.
6. • It includes muscles and its
attachment.
• Pain may be elicited by active
contraction as well as passive
stretching in opposite
directions.
Contractile
Structure
• These tissues posses no inherent
capacity to contract and relax.
• Extreme range of active
movements will stretch the
structures causing pain.
• Testing a muscle in its neutral
position eliminates the pain of
impingement and instability.
Non-
contractile
9. treatment
• Treatment depends largely on the existing type of disorder and can be
categorized as: Traumatic, inflammatory, degenerative, internal
derangement, functional disorders, psychogenic pain.
• The types of treatment options are:
1. Deep friction
2. Passive movements
3. Active movements and proprioceptive training
10. 1. Deep Friction Massage
• There are two forms of treatment.
1. The longitudinal in which the application of force runs parallel to fibers of the
soft tissue structures.
2. The transverse friction massage in which the force is applied perpendicular to
the fibers, separate each fiber, assisting in alignment of newly-formed collagen
during healing.
Friction
• Should be applied with sufficient sweep to reach all the affected tissue and
• Should produce movement between the individual connective tissue fibers of the
affected structure.
• The main goal of friction is to move fibers in relation to each other and adjacent
structures, called Sweep.
11. Amount of pressure: The amount of pressure applied depends on
three elements:
1. The depth of the lesion: increased pressure must be applied to
deeper structures.
2. The ‘age’ of the lesion: recent sprains and injuries require only
preventive friction because crosslinks or adhesions have not had
time to form. In long-standing cases more pressure is needed to get
rid of these.
3. The tenderness of the lesion: Pain can be avoided by starting with a
minimal amount of pressure – just enough to reach the lesion – and
progressively increasing the force as treatment proceeds.
12. Duration and frequency:
1. Usually given for about 10–20 minutes and on every second day.
2. Massage immediately after an injury should be of very low intensity and short
duration.
3. Treatment is stopped once the patient is pain-free during daily activities and
functional tests are totally negative.
Effects
1. Increased blood supply relieves pain.
2. By moving the painful structure to and fro, helps to free it from adhesion.
3. The structures moved in the limitation of normal behavior but not stretched.
4. It increases tissue perfusion at damaged area and stimulates mechanoreceptor
cells.
5. Friction itself is a painful technique.
13. Position of the Patient
• The patient's position must be comfortable, and the lesion must be
within finger's reach,
• Full relaxation is necessary for a muscle belly to access a deeply
seated lesion.
• Tendons with a sheath must be
kept taut.
Friction to the infraspinatus tendon:
counterpressure is by the fingers
14. Position of the Therapist and the Hands
• The therapist should avoid flexed positions.
• Movement is generated in the shoulder and conducted via elbow and
forearm to the digits.
Friction to the supraspinatus tendon:
counterpressure is by the thumb.
15. Three main techniques can be distinguished.
1. To-and-fro Movements
2. Pronation-supination
3. Pinch Grip
16. 1) To-and-fro movements
• These are used in the treatment
of dense, round or flat collagenous
bundles (tendons or ligaments)
and in the treatment of tenosynovitis.
• Movement is with the arm; friction
is given by use of the pulpy part of the finger
• Counterpressure is usually provided
to enable a good sweep.
17. 2) Pronation-supination
• Used where the lesion is difficult to reach
• For Example: the anterior aspect of the Achilles tendon
• Is performed with the pulpy part of the third finger reinforced by the
index finger.
• No counterpressure is given.
18. 3) Pinch grip
• Normal technique for a muscle belly
which is fully relaxed.
• The pinch is between the thumb and
the other fingers
• By drawing the fingers upwards over
the affected area, the therapist feels
the muscle fibers escape from the grip
until only skin and subcutaneous tissue
remain.
19. 2. Passive movements
• Treatment by passive movement is otherwise known as mobilization.
• Depending on its velocity and the range of movement, it can be
graded as:
1. Grade A
2. Grade B
3. Grade C
20. Grade A mobilization is a passive movement performed within the
pain-free range.
I. To promote healing of injured connective tissue: Grade A mobilizations
are applied early in the treatment of sprained ligaments to promote
orientation of the regenerating fibers.
II. Distractions at the shoulder: Gentle and rhythmical grade A movements
stretch the arthritic joint capsule fibers longitudinally, stimulate the
mechanosensor mechanisms in the joint and so inhibiting
somatosympathetic reflexes that are co-responsible for the
vasoconstriction, muscle spasm, pain and increased inflammation of the
joint.
III. Reduction of an intra-articular displacement in a peripheral joint:
elements of traction combined with joint rotations/movements in the
less painful direction and repeated several times with progressively
increasing force.
21. Grade B mobilizations are passive movements performed to the end of the possible
range indicated by an end-feel. All stretching and traction techniques are grade B
mobilizations.
I. To maintain a normal range at the joint: Passive Movements with gentle
stretching of the capsule, starting as soon as possible after the onset of
paralysis, injury or surgery to prevent loss of capsular elasticity.
II. To stretch the capsule of a joint: Useful in all ‘non-irritable’ capsulitis where
the condition is characterized by capsular pattern with hard-elastic end-feel.
Stretching aims at restoring mobility and function by breaking micro-adhesions
and stretching of shortened capsule.
III. To stretch a muscle: Children with short calf muscles can be helped by
sustained stretching followed by full relaxation and active contraction of the
muscle.
IV. Traction: Traction is used to separate articular surfaces from each other. Can be
used for reducing a displaced fragment by increasing joint space, pain
reduction, relax of the muscle.
22. Grade C mobilization is a minimal thrust with a high velocity and over a small
amplitude performed at the end of the possible range OR end-feel. Another word
for grade C mobilization is manipulation.
I. Rupture of ligamentous adhesions: Small ligamentous adhesions from
immobilizations can be ruptured by a high-velocity, small-amplitude thrust
manipulation, along with intensive deep transverse friction. The joint is
stretched as far as possible in the limited direction and manipulated with a
single firm thrust, during which a typical ‘snap’ is often heard.
II. Rupture of tenoperiosteal adhesions: Adherent and disorganized scar tissue
which causes a self-perpetuating inflammation in conditions like Tendinitis
(e.g. Tennis Elbow) can be ruptured to produce a permanent elongation of the
tendon.
III. To reduce a bony subluxation: A subluxation of one of the carpal bones or of
the cuboid bone can easily be reduced by digital pressure combined with
translatory movement during traction.
23. Contraindications to forced movements
• Capsular inflammation
• Muscle spasm: Grade C mobilizations is absolute Contraindication.
Grade B mobilizations may be used.
• Severe osteoporosis: Grade B and C mobilizations should always be
carried out with caution for fear of avulsion fracturing.
• Joints and ligaments not under voluntary tension control: This is the
case for the acromioclavicular, the sternoclavicular and the sacroiliac
joints and the sacrococcygeal ligament.
24. 3. Active movements
• Physical activity is also the primary stimulus for the repair of
musculoskeletal tissues especially during immobilization on skeletal
muscle, tendon, ligament, joint capsule and articular cartilage.
• These are in the form of :
a. Simple active movements to gain or preserve normal range in a joint
b. Isometric contractions
c. Isotonic contractions
d. Coordination exercises
e. Electrical contractions
25. • Immobilization can lead to :
a. Capsular and ligamentous tightness or adhesion
b. Muscle shortening and wasting
c. Development of arthritis
• Moving the joint early in injured as well as non injured direction helps
to maintain tissue integrity.
• Simple active movements to gain or preserve normal range in a joint