LIVING CHIROPRACTIC
MYOTHERAPY
Myotherapy is a client-centred healthcare profession focussing on the assessment, treatment and management of the whole person, applying a range of modalities and evidence informed knowledge to support client outcomes. Myotherapy Association Australia.
Previously, Myotherapy had been isolated to a very biomechanical and purely muscle-focussed approach. However, we are not mechanical beings, we are human beings with our own thoughts, belief systems, pain perceptions, stress levels and lifestyles that all contribute to our entire self. Therefore, in order to treat effectively, it is important to consider the biological, psychological and social aspects of pain presentation.
A typical Myotherapy consult will include a subjective examination to help understand the presentation and story behind the individuals pain, followed by an objective examination which involves the individual performing particular movements so the therapist can observe movement patterns and identify where there may be any dysfunction/muscular discrepancies. The therapist will then form and discuss an individualised treatment plan and clarify any confusion prior to proceeding with the treatment.
The treatment modalities vary greatly between practitioners as they do in all disciples on health care professionals, but what you can often expect from a Myotherapy treatment is client education and communication, soft and deep tissue work, digital ischaemic pressure (previously known as trigger point work), Myofascial Dry Needling, Dermatome Needling, Cupping, Joint Mobilisations, exercises and a constructed plan to help you achieve optimal results with your presentation.
What Are the Principles and Aims behind the Main Modalities of Myotherapy Care?
a) Soft Tissue Therapy
Soft Tissue treatment/Myofascial release can result in decreased pain, better posture, reduced symptoms, increased range of motion and improved quality of life. Myofascial release is often used to manage scar tissue and the adhesions that may accompany scar tissue.
The technique involves using the hands to massage the skin and underlying tissues around the scar. Motions are slow and the amount of force used is usually light. Myofascial release, also called “trigger point method,†is a massage technique in which the therapist uses gentle, sustained pressure on the problem areas to release adhesions and smooth out the fascia.
b) Myofascial Stretching
Myofascial Stretching differs from traditional stretching. All Myofascial Stretches must be held continuously for a minimum of 1 to 2 minutes before the fascia even begins to let go. Traditional 30 seconds stretching only affects the elastic and muscular portions, providing temporary results.
Myofascial Stretching differs from traditional passive stretching is the concept of active elongation. Active elongation is what allows one to engage the fascial barrier. The fascial barrier is the point at which you feel resistance to the stretch.
During active elongation, muscle groups opposing the tight fascia have to contact in a sustained manner. This prolonged isometric contraction of muscles against the resistance of the fascial barrier strengthens, them, helping to maintain the elongated state of the tissue you have just released. Myofascial stretching is applied during treatment to length muscles. PNF, MET, Static stretching all assist in rehabilitating from an injury or improving the treatment.
c) Electro Therapy
Transcutaneous Electrical Nerve Stimulation(TENS) is the use of electric current produced by a device to stimulate the nerves for therapeutic purposes. It works by stimulating peripheral motor or sensory nerves.
In a Myotherapy clinic, we can use it to provide gate control for pain relief and oedema reduction. It can be used for many pathologies such as sports injuries, general muscular pain, arthritic pain, sciatic pain and also during labor/childbirth outside a Myotherapy clinic.
TENS is usually connected to the skin using two or more electrodes. A battery-operated TENS unit is able to modulate pulse width, frequency and intensity. Generally TENS is applied at high frequency with an intensity below motor contraction (sensory intensity) or low frequency with an intensity that produces motor contraction.
http://en.wikipedia.org/wiki/Transcutaneous_electrical_nerve_stimulation
MIMT Electro Modality notes 2014
d) Myofascial Dry-Needling
Myofascial Dry Needling refers to the use of a fine solid sterile needle to penetrate through skin and directly enter an identified myo fascial trigger point (MTrP), to treat muscle pain and dysfunction. The technique has gained popularity as an effective pain management technique to deactivate MTrP.
Myofascial dry needling is performed on the basis of an assessment of signs and symptoms. An understanding of pain referral patterns is essential and a detailed palpatory evaluation of muscles is undertaken to elicit the pain referral response from symptomatic muscles. MTrP is most effective when used in conjunction with soft tissue work
However, dry needling is often interchanged or confused with acupuncture. It is the therapists responsibility to be able to outline the difference between the two and educate the patient. Acupuncture is based on Chinese medicine and the traditional Chinese acupoints along lines of energy/meridians or Qi.
In Victoria, one can only use the term Acupuncturist if they have completed the 4years of study associated with it and are registered with the Chinese Medicine Registration Board. A Myotherapist cannot. Dry Needling is based on myofascial trigger point therapy, MTrP. AMTrP is there is a hyper-irritable spot which is usually found in taut band muscles or its fascia.
(Referance: MIMT Dry Needling Course notes. Page 5)
e) Therapeutic and Rehabilitative Exercise
At a certain stage of recovery to an injury, it is safe to start implementing an Exercise Prescription and Rehabilitation program. Exercise therapy can be used as a complementary modality to your current manual treatment or as a treatment on its own for the patient to exercise at home.
Therapeutic and Rehabilitation exercises are to help the patient regain strengthen and to restore mobility.
The uses of equipment clients can use are:
f) Corrective and Lifestyle Advice
Myotherapists aim with this modality is to improve your patients awareness of their body and to encourage them to take responsibility for their health. Myotherapists can refer clients to a dietician for expert nutrition advice. We can give postural advice by include teaching core stability exercises to improve daily activities.
All of the above modalities are to use at any one time during treatment to restore the well-being of your patient. It also comes down to the patients lifestyle and how much the wish to help themselves.
Lifestyle plays a huge part in our everyday well-being. So taking a look at our home life, nutrition, work load and stress levels is a great place to start.