Integrated Neuromuscular Inhibition technique is Manual Physiotherapy Technique used for Acute and Chronic Pain, Sports Condition, Spasm, for Trigger Point and Tender point release, for weaker muscle, to strengthen muscle, to realease tightness of muscle, . this includes Muscle energy technique, Positional Release Technique/ srain-counterstrain and Ischemic Contraction.
Muscle Energy Technique (MET) with variant and techniques.Anjali Parmar
muscle energy technique with post-isometric contraction and reciprocal inhibition, isotonic and isokinetic contraction. with all variants and techniques described.
(zaid hijab) 4th stage
Rehabilitation of sciatica
Sciatica is a common pain syndrome, considering that ∼10% of low back pain
episodes, which have a lifetime cumulative incidence of 80%, will be accompanied
by sciatica. Nerve root compression by disc herniation is regarded as the most
frequent cause of sciatica.
College of
Health and medical technology
Baghdad
Department of
Physiotherapy & Rehabilitation
This presentation discusses different types of muscle stretching. It introduces muscle stretching and defines it as flexing or stretching a muscle to improve elasticity and tone. There are four main types of stretching discussed: static, dynamic, ballistic, and PNF. Static stretching involves holding a stretched position for 30 seconds to 2 minutes. Dynamic stretching occurs during movement. Ballistic stretching uses bouncing motions and can cause injury. PNF stretching enhances range of motion through isometric contractions of opposing muscles. The benefits of stretching include relief from pain, increased flexibility and range of motion, better circulation, relaxation, and improved posture and energy.
The chiropractors are using several techniques for alleviating the patients from the excruciating pain they feel. According to the requirements of the patients, the chiropractors are providing necessary treatments for alleviating the pain that occurred due to numerous reasons. So, go through the following slide to know about the different types of chiropractic adjustments provided by the chiropractors.
This document provides an overview of a presentation on pain management. It discusses the definition of pain, types of pain including acute and chronic pain, pain intensity scales, causes of pain including physiological, somatic and neuropathic pain, and the process of nociception, transduction, transmission, modulation and perception of pain. It also summarizes nursing management of pain assessment and diagnosis, pharmacologic approaches including different drug classes for various pain types, and non-pharmacologic pain management techniques such as exercise, traction, electrical stimulation, heat and cryotherapy.
Kinesio tape is a physical therapy tool that can help with a variety of issues like neck, back, shoulder, knee, and ankle pain. It was developed in 1979 by Dr. Kenzo Kase and uses heat-activated glue so it can stay on for a few days during exercise or showering. When applied properly by a trained professional, it can help reduce pain, improve muscle function, increase circulation, and prevent injuries. There are different application techniques for Kinesio tape depending on the desired outcome, such as relieving pain, reducing swelling, or supporting injured areas.
The document describes various techniques used in physical therapy for neuromuscular re-education and facilitation including proprioceptive neuromuscular facilitation, neurodevelopmental technique, sensory integration, Brunnstrom movement therapy, and Rood's technique. It provides details on how each technique is applied and the receptors and responses targeted through different stimuli like stretching, traction, touch, and movement.
Muscle Energy Technique (MET) with variant and techniques.Anjali Parmar
muscle energy technique with post-isometric contraction and reciprocal inhibition, isotonic and isokinetic contraction. with all variants and techniques described.
(zaid hijab) 4th stage
Rehabilitation of sciatica
Sciatica is a common pain syndrome, considering that ∼10% of low back pain
episodes, which have a lifetime cumulative incidence of 80%, will be accompanied
by sciatica. Nerve root compression by disc herniation is regarded as the most
frequent cause of sciatica.
College of
Health and medical technology
Baghdad
Department of
Physiotherapy & Rehabilitation
This presentation discusses different types of muscle stretching. It introduces muscle stretching and defines it as flexing or stretching a muscle to improve elasticity and tone. There are four main types of stretching discussed: static, dynamic, ballistic, and PNF. Static stretching involves holding a stretched position for 30 seconds to 2 minutes. Dynamic stretching occurs during movement. Ballistic stretching uses bouncing motions and can cause injury. PNF stretching enhances range of motion through isometric contractions of opposing muscles. The benefits of stretching include relief from pain, increased flexibility and range of motion, better circulation, relaxation, and improved posture and energy.
The chiropractors are using several techniques for alleviating the patients from the excruciating pain they feel. According to the requirements of the patients, the chiropractors are providing necessary treatments for alleviating the pain that occurred due to numerous reasons. So, go through the following slide to know about the different types of chiropractic adjustments provided by the chiropractors.
This document provides an overview of a presentation on pain management. It discusses the definition of pain, types of pain including acute and chronic pain, pain intensity scales, causes of pain including physiological, somatic and neuropathic pain, and the process of nociception, transduction, transmission, modulation and perception of pain. It also summarizes nursing management of pain assessment and diagnosis, pharmacologic approaches including different drug classes for various pain types, and non-pharmacologic pain management techniques such as exercise, traction, electrical stimulation, heat and cryotherapy.
Kinesio tape is a physical therapy tool that can help with a variety of issues like neck, back, shoulder, knee, and ankle pain. It was developed in 1979 by Dr. Kenzo Kase and uses heat-activated glue so it can stay on for a few days during exercise or showering. When applied properly by a trained professional, it can help reduce pain, improve muscle function, increase circulation, and prevent injuries. There are different application techniques for Kinesio tape depending on the desired outcome, such as relieving pain, reducing swelling, or supporting injured areas.
The document describes various techniques used in physical therapy for neuromuscular re-education and facilitation including proprioceptive neuromuscular facilitation, neurodevelopmental technique, sensory integration, Brunnstrom movement therapy, and Rood's technique. It provides details on how each technique is applied and the receptors and responses targeted through different stimuli like stretching, traction, touch, and movement.
Flexibility training techniques aim to increase range of motion and prevent injury. Static stretching, both passive and active, involves holding a stretched position for 20 seconds and can aid recovery. Dynamic stretching uses controlled movements to warm up. PNF stretching combines isometric contractions and relaxations to further increase range of motion beyond what static stretching allows. Examples of PNF techniques are contract-relax and contract-relax-antagonist-contract.
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.
Deep Tissue Massage Treatment.Dorado EstheticDoradoesthetic
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MYOFASCIAL RELEASE THERAPY AND TECHNIQUESManjumam2
Myofascial release is a manual therapy technique used by physiotherapists to address musculoskeletal pain and dysfunction by targeting the fascial system. This system consists of connective tissue surrounding muscles, bones, and organs. Myofascial release aims to alleviate tension within the fascia through gentle pressure to soften and elongate restricted areas, improving flexibility and function. Therapists rely on feedback from patients to guide treatment by releasing fascial restrictions and restoring tissue mobility.
Physiotherapy plays an important role in restoring patients after abdominal surgery through a variety of interventions. The goals of physiotherapy are to control postoperative pain, promote wound healing, prevent complications like atelectasis and DVT, and strengthen and mobilize weakened muscles. Treatments include breathing exercises, electrotherapy modalities like TENS and interferential therapy for pain management, soft tissue massage, and corrective positioning with passive and active movements to prevent stiffness. Physiotherapy aims to restore patients' optimum functional ability in both the short term to aid recovery and long term to improve strength, endurance, and functional capacity.
This document outlines physiotherapy management for patients with AIDS. The goals of treatment are to relieve pain, increase strength and endurance, and improve cardiovascular, pulmonary, and immune function. Interventions may include exercises, manual therapy, balance training, PNF, and desensitization techniques. Precautions like protective barriers and hand washing are important. A 12-week program combines aerobic exercise, resistance training, and manual therapy sessions 2-3 times per week.
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
This document provides guidance on principles of athletic rehabilitation. It discusses key phases of rehabilitation including immobilization, re-strengthening, and return to activity while maintaining a pain level of 0-2. It also covers different types of pain (mechanical, inflammatory, neuropathic) and matching treatments to the pain type. The summary emphasizes creating a pain-free healing environment, correlating injuries to possible biomechanical causes, and emphasizing teamwork in the rehabilitation process.
Compendio ejercicios estiramientos.
l síndrome del piramidal es una entidad poco conocida, pero representa una causa significativa y tratable de dolor lumbar, que es más frecuente en la tercera y cuarta décadas de la vida y en mujeres.
Se debe a una compresión del nervio ciático debido a la contractura del piramidal, que puede producirse entre este y el reborde del agujero ciático mayor o por el atrapamiento nervioso dentro del propio músculo.
En la mayoría de los pacientes (hasta un 50%) existe un antecedente traumático o contusión directa sobre
el glúteo.
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
Ap facilitatory and inhibitatory techniqueAnwesh Pradhan
This document discusses several sensory motor approaches used in neurophysiotherapy, including Rood's approach, PNF, neurodevelopmental approach, sensory integration, and Brunnstrom's movement therapy. It provides details on the theoretical basis, principles, techniques, and strategies of each approach. Rood's approach focuses on normalizing muscle tone through sensory stimulation to produce purposeful movement. PNF uses techniques like manual contacts, stretch, and traction to stimulate proprioceptors and facilitate desired movement. The neurodevelopmental approach was developed by Bobath and aims to modify abnormal movement patterns.
PNF (proprioceptive neuromuscular facilitation) is a technique that uses stimulation of proprioceptors to facilitate muscle response and increase range of motion. The hold-relax technique is a key part of PNF. It involves isometric contraction of the hypertonic muscle or its antagonist, holding for 15 seconds then relaxing. This lengthens the hypertonic muscle and increases range of motion.
To treat right torticollis, the therapist stands behind the patient in sitting and cups one hand under the chin while the other applies resistance to side flexion and rotation to the right.
Poor posture is caused by insufficient and unnecessary muscle effort. To re-educate posture, relaxation, mobility,
Massage therapy has a long history dating back thousands of years. It involves manipulating the soft tissues of the body through techniques like effleurage, petrissage, friction, tapotement, and vibration. The physiological effects of massage include relaxation, reduced muscle soreness, decreased anxiety, and increased blood flow. Massage can help reduce pain, swelling, and tension in the muscles and soft tissues.
This document provides an overview of chikitsa or massage therapy. It discusses the history and origins of massage, defines different types of massage strokes like effleurage, petrissage, friction and tapotement. It outlines the physiological effects of massage on circulation, metabolism, musculature and psychological state. Benefits of massage for conditions affecting muscles, tendons and joints are described. Points for proper massage technique and considerations for the masseur are also reviewed.
-MET is a type of osteopathic manipulative treatement used in osteopathic therapy, physical therapy, massage therapy and occupational therapy.
- A form of diagnosis and treatment in which the patient's muscles are actively used on request, from a precisely controlled position, in a specific direction, and against a distinctly executed physician counterforce. 1.Dr. TJ Ruddy:
first osteopathic doctor to use muscle energy in the
1940’s and 1950’s, he referred to it as resistive duction,
which he defined as a series of muscle contractions against
resistance; used techniques mainly in the C‐spine.2.Dr. Fred Mitchell, Sr.: has been titled the Father of
muscle energy.
-He took Dr. Ruddy’s principles and incorporated them into manual medicine to any body region/ articulation.
-He believed that pelvis was the key to musculoskeletal system.
Benefits of massage, Swedish massage, Massage presentation by samiullah, History of the Massage, Deep Tissue Massage, Hot Stone Massage, Purpose of Massage, Types of massage ppt, Purpose of the Massage, Physiological effects, Thai Massage, Contraindication of Massage
A chiropractic adjustment is a therapeutic treatment performed by a licensed chiropractor to realign the spine, correct body alignment, and reduce pain. During an adjustment, the chiropractor uses pressure to manipulate joints to treat conditions of the nervous system and musculoskeletal system. Chiropractic adjustments offer an alternative treatment to traditional medicine for relieving common issues like neck pain, lower back pain, headaches, and other pains and strains without surgery or medications. Chiropractic adjustments can benefit people of all ages as an effective treatment option.
The document discusses various relaxation techniques that can be used by athletes to improve performance, including progressive muscular relaxation, autogenic training, meditation, yoga, tai chi, biofeedback, hypnosis, hydrotherapy, sports massage, deep breathing, mental rehearsal, visualization, positive self-talk, exercise, music, and humor. These techniques help to reduce stress, anxiety, muscle tension, and arousal levels, allowing athletes to feel more in control and mentally prepared during competition. Regular practice is important to learn the techniques and make them automatic.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
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Flexibility training techniques aim to increase range of motion and prevent injury. Static stretching, both passive and active, involves holding a stretched position for 20 seconds and can aid recovery. Dynamic stretching uses controlled movements to warm up. PNF stretching combines isometric contractions and relaxations to further increase range of motion beyond what static stretching allows. Examples of PNF techniques are contract-relax and contract-relax-antagonist-contract.
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.
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Dorado Esthetic is your destination for all beauty and skincare. Explore our wide range of services, including facials, body treatments. A therapeutic massage technique called deep tissue massage concentrates on working on the muscles and connective tissue at a deeper level.For more details contact us.
MYOFASCIAL RELEASE THERAPY AND TECHNIQUESManjumam2
Myofascial release is a manual therapy technique used by physiotherapists to address musculoskeletal pain and dysfunction by targeting the fascial system. This system consists of connective tissue surrounding muscles, bones, and organs. Myofascial release aims to alleviate tension within the fascia through gentle pressure to soften and elongate restricted areas, improving flexibility and function. Therapists rely on feedback from patients to guide treatment by releasing fascial restrictions and restoring tissue mobility.
Physiotherapy plays an important role in restoring patients after abdominal surgery through a variety of interventions. The goals of physiotherapy are to control postoperative pain, promote wound healing, prevent complications like atelectasis and DVT, and strengthen and mobilize weakened muscles. Treatments include breathing exercises, electrotherapy modalities like TENS and interferential therapy for pain management, soft tissue massage, and corrective positioning with passive and active movements to prevent stiffness. Physiotherapy aims to restore patients' optimum functional ability in both the short term to aid recovery and long term to improve strength, endurance, and functional capacity.
This document outlines physiotherapy management for patients with AIDS. The goals of treatment are to relieve pain, increase strength and endurance, and improve cardiovascular, pulmonary, and immune function. Interventions may include exercises, manual therapy, balance training, PNF, and desensitization techniques. Precautions like protective barriers and hand washing are important. A 12-week program combines aerobic exercise, resistance training, and manual therapy sessions 2-3 times per week.
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
This document provides guidance on principles of athletic rehabilitation. It discusses key phases of rehabilitation including immobilization, re-strengthening, and return to activity while maintaining a pain level of 0-2. It also covers different types of pain (mechanical, inflammatory, neuropathic) and matching treatments to the pain type. The summary emphasizes creating a pain-free healing environment, correlating injuries to possible biomechanical causes, and emphasizing teamwork in the rehabilitation process.
Compendio ejercicios estiramientos.
l síndrome del piramidal es una entidad poco conocida, pero representa una causa significativa y tratable de dolor lumbar, que es más frecuente en la tercera y cuarta décadas de la vida y en mujeres.
Se debe a una compresión del nervio ciático debido a la contractura del piramidal, que puede producirse entre este y el reborde del agujero ciático mayor o por el atrapamiento nervioso dentro del propio músculo.
En la mayoría de los pacientes (hasta un 50%) existe un antecedente traumático o contusión directa sobre
el glúteo.
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
Ap facilitatory and inhibitatory techniqueAnwesh Pradhan
This document discusses several sensory motor approaches used in neurophysiotherapy, including Rood's approach, PNF, neurodevelopmental approach, sensory integration, and Brunnstrom's movement therapy. It provides details on the theoretical basis, principles, techniques, and strategies of each approach. Rood's approach focuses on normalizing muscle tone through sensory stimulation to produce purposeful movement. PNF uses techniques like manual contacts, stretch, and traction to stimulate proprioceptors and facilitate desired movement. The neurodevelopmental approach was developed by Bobath and aims to modify abnormal movement patterns.
PNF (proprioceptive neuromuscular facilitation) is a technique that uses stimulation of proprioceptors to facilitate muscle response and increase range of motion. The hold-relax technique is a key part of PNF. It involves isometric contraction of the hypertonic muscle or its antagonist, holding for 15 seconds then relaxing. This lengthens the hypertonic muscle and increases range of motion.
To treat right torticollis, the therapist stands behind the patient in sitting and cups one hand under the chin while the other applies resistance to side flexion and rotation to the right.
Poor posture is caused by insufficient and unnecessary muscle effort. To re-educate posture, relaxation, mobility,
Massage therapy has a long history dating back thousands of years. It involves manipulating the soft tissues of the body through techniques like effleurage, petrissage, friction, tapotement, and vibration. The physiological effects of massage include relaxation, reduced muscle soreness, decreased anxiety, and increased blood flow. Massage can help reduce pain, swelling, and tension in the muscles and soft tissues.
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-MET is a type of osteopathic manipulative treatement used in osteopathic therapy, physical therapy, massage therapy and occupational therapy.
- A form of diagnosis and treatment in which the patient's muscles are actively used on request, from a precisely controlled position, in a specific direction, and against a distinctly executed physician counterforce. 1.Dr. TJ Ruddy:
first osteopathic doctor to use muscle energy in the
1940’s and 1950’s, he referred to it as resistive duction,
which he defined as a series of muscle contractions against
resistance; used techniques mainly in the C‐spine.2.Dr. Fred Mitchell, Sr.: has been titled the Father of
muscle energy.
-He took Dr. Ruddy’s principles and incorporated them into manual medicine to any body region/ articulation.
-He believed that pelvis was the key to musculoskeletal system.
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1. By - Dr. Anjali Parmar
(MPT-MSSS,PGDYN,GPC,CFT,DFT)
physio_rehab_ap
INTEGRATED NEUROMUSCULAR
INHIBITION TECHNIQUE
INIT
2. physio_rehab_ap
INTEGRATED
NEUROMUSCULAR
INHIBITION
TECHNIQUE
Chitow described an integrated
sequence in which, after location of an
active trigger points, this receives
ischemic compression, followed by
positional release, followed by imposition
of isometric contraction which is either
stretched subsequently (post-
fascilitation stretch) or simultaneously
isolytic stretch.
This method is effectively deactivates
trigger points.
3. TECHNIQUE Locate the trigger points
Inhibitory pressure
SCS
20 -30 second hold
Isometric contraction and
hold for 7-10 seconds
Post isometric relaxation
Gently stretch
4. Back to Agenda
Integrated Neuromuscular
Inhibitory Technique
Integrated Neuromuscular Inhibitory Technique
(INIT) is a therapeutic approach used in physical
therapy and sports medicine to alleviate pain and
improve muscular function. The technique
combines various elements from different
therapeutic modalities to achieve muscle
relaxation, reduce tension, and improve overall
neuromuscular efficiency.
5. ISCHEMIC
COMPRESSION
Ischemic compression is a manual therapy technique used to alleviate pain and muscle tension
by applying sustained pressure to specific points in the muscle, known as trigger points. This
technique aims to temporarily reduce blood flow (ischemia) to the targeted area, which can help
in releasing the muscle knot and reducing pain.
POSITION
RELEASE
TECHNIQUE
The Positional Release Technique (PRT), also known as Strain-Counterstrain, is a manual
therapy technique used to alleviate pain and muscle tension by placing the body in a position of
comfort to release tension in the affected tissues. This method was developed by Dr. Lawrence
Jones in the 1950s and has since become a widely used technique in physical therapy and
osteopathic medicine.
MUSCLE
ENERGY
TECHNIQUE
Muscle Energy Technique (MET) is a form of manual therapy used to treat musculoskeletal
dysfunction by using the patient's own muscle contractions against a controlled counterforce
applied by the therapist. This technique is aimed at improving joint mobility, lengthening
shortened muscles, and reducing pain. MET was first developed by osteopathic physician Fred
Mitchell in the mid-20th century and has since become a widely utilized method in physical
therapy and osteopathy.
Here’s a breakdown of the key components
and principles involved in INIT:
6. BENIFITS OF INIT
Pain Relief: Helps in reducing acute and chronic
pain by addressing underlying muscular and fascial
restrictions.
Improved Flexibility and Range of Motion:
Techniques like PNF and myofascial release enhance
muscle extensibility and joint mobility.
Enhanced Muscle Function: By addressing
neuromuscular imbalances and improving muscle
activation patterns.
Holistic Approach: Integrates multiple therapeutic
approaches for a comprehensive treatment plan.
7. SPORTS INJURIES
Chronic pain conditions like fibromyalgia
POST-SURGICAL REHABILITATION
Musculoskeletal disorders such as tendinitis or
bursitis
GENERAL MUSCLE STIFFNESS
AND TENSION
INIT is commonly used in the treatment of:
INDICATION: Back to Agenda
8. IC 2. PRT/SCS 3. MET
INTEGRATED NEUROMUSCULAR INHIBITION TECHNIQUE
INIT
ischemic compression position release
technique
/ strain/counterstrain
muscle energy technique
10. Back to Agenda
applying sustained pressure to specific points in the muscle, known as trigger points
ISCHEMIC COMPRESSION
Principles of Ischemic Compression
Identification of Trigger Points: Trigger points are hyperirritable spots within a taut band of skeletal muscle that are
painful upon compression and can refer pain to other areas. These are identified through palpation and patient
feedback.
Application of Pressure: Once the trigger point is located, the therapist applies firm, sustained pressure directly onto
the point. The pressure should be enough to elicit a mild to moderate discomfort but should not cause excessive
pain.
Duration: The pressure is maintained typically for 30 seconds to 2 minutes. The goal is to hold the pressure until a
decrease in pain or a softening of the muscle knot is felt.
Release and Reassessment: After the pressure is released, the therapist reassesses the trigger point and surrounding
tissues to evaluate the reduction in tension and pain.
11. ASSESSMENT: A practitioner identifies the trigger point or tight area in the muscle. Trigger points
are hyperirritable spots within a taut band of skeletal muscle that can cause
referred pain and discomfort.
PREPARATION: Using fingers, knuckles, or an appropriate tool, the practitioner applies firm pressure
directly on the trigger point. The pressure is typically maintained for 30 seconds to 2
minutes.
APPLICATION: Use your thumb, fingers, knuckles, or a specialized tool to apply direct pressure to the trigger
point.
Increase the pressure gradually until the patient feels mild to moderate discomfort.
Hold this pressure steady, ensuring that it remains within the patient’s pain tolerance..
The aim is to reach a point where the muscle begins to relax.
RESTORATION
OF BLOOD
After releasing the pressure, blood flow returns to the area, bringing oxygen and nutrients that help
in the healing process and in reducing muscle tightness.
Steps in Ischemic
Compression
12. Benefits of Ischemic Compression
PAIN RELIEF: Helps reduce pain associated with trigger points by disrupting the pain
cycle.
DECREASED
MUSCLE TENSION
Aims to relax tight muscles and reduce spasms.
IMPROVED RANGE
OF MOTION:
Alleviating trigger points can enhance flexibility and joint mobility.
ENHANCED
BLOOD FLOW
Once the pressure is released, there is often an increase in blood flow to the
area, promoting healing.
https://drive.google.com/file/d/15sefJe_qDAPva4sIPA-
-2YT25uN2nHwd/view?usp=drive_link
13. Ischemic compression is commonly used to
treat various conditions, including:
INDICATION:
Myofascial pain syndrome
Chronic muscle tension
Headaches related to
muscle tension
Neck and back pain
Sports injuries
Fibromyalgia
14. Ischemic compression is not used to treat
various conditions, including:
CONTRAINDICATIONS:
open wounds,
infections,
severe vascular diseases.
It is also contraindicated
in patients with certain
circulatory conditions,
such as deep vein
thrombosis.
15. Patient
Comfort
Always ensure the
pressure applied is
within the patient’s
tolerance to avoid
causing excessive
pain.
Considerations
Gradual
Increase of
Pressure:
Start with light pressure
and gradually increase to
the desired level.
17. Back to Agenda
used to alleviate pain and muscle tension by placing the body in a position of comfort to release tension in the
affected tissues.
POSITIONAL RELEASE TECHNIQUE
Principles of Positional Release Technique:
Finding the Tender Point: The therapist identifies specific tender points or areas of hypertonicity in
the muscle. These points are typically associated with discomfort or pain.
1.
Position of Ease: The therapist then moves the patient's body or limb into a position where the tender
point is least painful or the muscle feels most relaxed. This position is known as the position of ease.
2.
Holding the Position: The position of ease is held for a specific duration, usually between 90 seconds
to 3 minutes. During this time, the muscle and associated tissues are allowed to relax and release
tension.
3.
Gentle Return: After holding the position, the therapist gently and slowly returns the body part to a
neutral position. This is done carefully to avoid reactivating the muscle tension.
4.
Reassessment: The therapist reassesses the tender point to determine if there has been a reduction in
pain and tension. If necessary, the technique can be repeated or adjusted.
5.
18. Steps in Positional
Release Technique:
ASSESSMENT: Conduct a thorough assessment to identify the tender points and areas of
discomfort.
POSITIONING
:
Move the patient's body part to find the position of greatest comfort and
minimal pain at the tender point.
MONITORING
:
Continuously monitor the patient's response to ensure the position
remains comfortable.
19. Steps in Positional Release Technique:
HOLDING: Maintain the position of ease for 90 seconds to 3 minutes,
allowing the muscle fibers to relax and reset.
RELEASE: Slowly and gently return the body part to its neutral position.
REASSESSMENT
:
Check the tender point and overall muscle tension to evaluate
the effectiveness of the technique.
https://drive.google.com/file/d/15EPDzQMVucZxPovPHrfXFNky-
wrOAjbD/view?usp=drive_link
20. Benefits of Positional Release
Technique:
PAIN RELIEF: Reduces acute and chronic pain by decreasing muscle tension and spasm.
INCREASED
RANGE OF
MOTION:
Enhances flexibility and joint mobility by relieving muscle tightness.
IMPROVED
CIRCULATION:
Promotes better blood flow to the affected area, aiding in healing.
NON-INVASIVE: A gentle and non-invasive technique suitable for a wide range of patients,
including those with acute pain.
21. PRT is effective for treating various
conditions, including:
INDICATION:
Muscle strains and sprains
Fibromyalgia
Tendinitis
Back and neck pain
Post-surgical rehabilitation
Chronic pain syndromes
22. PRT is not used to treat various conditions,
including:
CONTRAINDICATIONS:
Fracture
Severe Osteoporosis
Malignancy
Acute Infection
Severe Rheumatiod
Arthritis
Severe Vascular
Disorders
24. Back to Agenda
to treat musculoskeletal dysfunction by using the patient's own muscle contractions against a controlled
counterforce applied by the therapist post isometric relaxation technique is used.
MUSCLE ENERGY TECHNIQUE (MET)
Principles of Post isometric relaxation
Voluntary Muscle Contraction: The patient actively contracts their muscle or muscle group against a
resistance provided by the therapist.
Controlled Counterforce: The therapist applies a specific counterforce that matches the patient’s effort,
ensuring the contraction is isometric (meaning the muscle length doesn’t change).
Gentle Stretching: Following the muscle contraction, the muscle is gently stretched to a new length.
Repetition and Relaxation: The technique typically involves several repetitions, with brief periods of
relaxation between each contraction and stretch.
26. Isometric contraction- using PIR(with and
without stretch):
Indications
- Relaxing acute muscular spasm or contraction
- Mobilizing restricted joints
- Preparing joints for manipulation
Contraction Starting Point
- At easy restriction barrier
Mode
- Agonist used in isometric contraction to treat affected muscle via Post-Isometric
Relaxation (PIR), allowing for easier stretching.
Force
- Subject's effort; initially 20%
Duration of Contraction
- Initially 7-10 seconds, gradually increasing to 20 seconds
27. Isometric contraction- using PIR(with and
without stretch):
Action Following Contraction
- Rest interval of 5 seconds
- Stretch held for 10-30 seconds (painless)
Stretching
- For chronic or subacute restricted, fibrotic, contracted soft tissues (fascia, muscle)
or tissues with active myofascial trigger points
Repetitions
- 3-5 times until no further gain in Range of Motion (ROM)
28. Isometric contraction- using RI(with and without
stretch):
Indications
- Stretching chronic or subacute restricted, fibrotic, contracted soft tissues (fascia,
muscle) or tissues with active myofascial trigger points
- Chosen when agonist contraction is contraindicated due to pain
Contraction Starting Point
- Slightly short of restriction barrier
Mode
- Antagonist is used in isometric contraction, treating muscle via Reciprocal Inhibition
(RI) for easier stretch
29. Isometric contraction- using RI(with and without
stretch):
Force
- Subject's effort; initially 30%, gradually increasing to 50%
Duration of Contraction
- Initially 7-10 seconds
Action Following Contraction
- Rest for 5 seconds
- Stretch held for 10-30 seconds (painless)
- Repeat without stretch and relaxation
Repetitions
- 3-5 times until no further gain in Range of Motion (ROM)
31. ASSESSMENT
:
he therapist assesses the patient to identify the dysfunction, such as reduced
range of motion or muscle tightness.
POSITIONIN
G:
The patient is positioned comfortably, and the affected muscle or joint is taken
to the initial point of restriction (the barrier).
PATIENT
CONTRACTIO
N:
The patient is instructed to gently contract the targeted muscle against the
therapist's resistance, typically at 20-30% of their maximum effort. The contraction
is held for 5-10 seconds
Steps in Muscle Energy
Technique
32. Steps in Muscle Energy Technique
RELEASE AND
RELAXATION:
The patient is asked to relax the muscle completely. After relaxation,
the therapist gently stretches the muscle to a new barrier.
REPETITION: This process is repeated 3-5 times, each time stretching a bit further,
until optimal lengthening or range of motion is achieved.
https://drive.google.com/file/d/17BGLqMKHeHSGYhY7Fw3Cl_
eUV85pcaQv/view?usp=drive_link
33. Benefits of Muscle Energy Technique
IMPROVED JOINT
MOBILITY:
Helps restore normal joint function by increasing the range of motion.
DECREASED
MUSCLE TENSION:
Reduces hypertonicity and muscle spasm.
PAIN REDUCTION: Alleviates pain by addressing the underlying muscle imbalances and joint
restrictions.
ENHANCED
CIRCULATION:
Promotes better blood flow and nutrient delivery to the affected areas.
INCREASED
STRENGTH:
Helps in strengthening muscles through controlled isometric contractions.
34. MET can be used to treat a variety of conditions,
including:
INDICATION:
Back and Neck Pain: Helps to relieve tension in the paraspinal muscles and
improve spinal mobility.
Joint Dysfunctions: Particularly effective for sacroiliac joint dysfunctions and rib
dysfunctions.
Muscle Strains and Sprains: Aids in the recovery by gently stretching and
strengthening the affected muscles.
Postural Imbalances: Corrects muscle imbalances that contribute to poor
posture.
Sports Injuries: Assists in the rehabilitation of injuries by improving flexibility and
muscle function.
35. Muscle energy technique is not used to
treat various conditions, including:
CONTRAINDICATIONS:
acute injuries,
severe osteoporosis,
other conditions where
muscle contractions may
be contraindicated.
36. Patient
Comfort
Ensure the patient is
comfortable and that
contractions are within
their pain tolerance.
Considerations
Gradual
Increase of
Pressure:
Increase the stretch
gradually to avoid
overstretching and causing
discomfort.
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