Orthopaedic Manual Therapy according to the concept Kaltenborn – Evjenth
Orthopaedic Manual Therapy is a narrow specialization within physiotherapy oriented manual examination and treatment of patients with so-called. locomotor dysfunctions, and thus pain, contraction and instability in the joints of the upper limbs, lower limbs, temporomandibular joints, and within individual segments of the spine.
Due to the fact that examination and treatment is performed by therapist hands, this type of work has been called manual therapy. Precise examination enables application of proper treatment which is different for pinched nerve, deformed joint and extensively tight or shortened muscle. The type of pathologically deformed tissue determines application of specific for this type manipulative techniques such as post-isometric relaxation, stretching, fast activation of blocked spine joints (called ‘manipulations’), long maintained stretching of joint capsule (called ‘mobilization’) or restoration of nerve structures mobility. The main purpose of the therapist is as fast as possible restoration of painless positions of patient’s body movements and prevention of symptoms recurrence.
Soft Tissues Therapy
Muscle Energy Techniques
Group of techniques using muscle tension aimed at liquidation of existing damages of soft tissues. Indications: muscular hypertonus, muscular or connective tissue contracture, muscle impairment, movement limitations resulting from soft tissues restriction
Fascia is a flat fibrous tissue which surrounds human body underneath the skin and separates muscles and muscle groups dividing it into layers. Fascia creates integral and continuous net reaching all human organs. Myofascial system restrictions may cause hypertonia even in separate areas of our body leading to joint compressions, fluid flow limitations and pressure on nerve structures and, as a result, pain. Therapist finds limitation in fascia laxity and by relaxation eliminates restrictions.
Active relaxation techniques
Involve maintenance of constant pressure or tissues blocking with simultaneous tissue stretching. Highly effective, especially after sport injuries and long term immobilizations.
Trigger points therapy
Trigger point is a sensitive spot within hypertonic tissues which is characterized by tenderness. It may cause radiating pain and other symptoms in areas far from the place of stimulation. Liquidation of trigger points leads to significant decrease of tissue tension in particular disordered area. Liquidation of trigger point may include among others, pressure, positional release, strain–counterstrain.
Involves arrangement of particular joint in position leading to maximum relaxation of tissues and maintaining this position for 20-120 sec. It results in radical improvement of movement range and decrease of pain. This technique is totally painless ad has wide application in acute cases.
The aim of this method is to eliminate neuromechanics disorders. It involves examination and elimination of disorders in laxity or disorders of elasticity of nerve structures. Nerve tissue moves around surrounding tissues both, along and across of its course. Problems with mobility or elasticity of nerve structure may manifest in pain in the course of nerve or in the area of sensory neuration.