Procedures

The following procedures can best be described as ongoing orthopedic and/or neurological tests. They should not be attempted unless you are a certified and licensed practitioner. They may cause injury. Only a few assessment procedures are demonstrated here.

In these video clips we are assessing the clients’ symptoms to determine if their cause is a lack of blood flow and oxygen supply.

Fluids and gases only flow if a pressure gradient exists. In the body, contraction of the heart and diaphragm are the major forces producing pressure differences. Because of these two actions, blood circulates and air flows into and out of the lungs.

At the capillary/tissue level the pressure difference is only a few millimeters Hg. Therefore, any increase in tissue pressure will compromise the flow.

The goals of therapy are to identify and treat these areas. Once this pathology is identified effective outcomes would be due to the lowering of tissue pressure to normal values.

Lowering elevated interstitial fluid pressure is accomplished in 2 basic ways: directly and indirectly.

Direct methods are used when stenoses exist in the spine. By applying traction (usually with flexion) the volume in the lateral and central canal will increase. Increased volume leads to decreased pressure.

Most presentations will not involve stenosis and so indirect methods will have to be performed. In these cases the increased pressure is due to too much fluid (edema).  In order to decrease the pressure this fluid has to be removed. As mentioned earlier, fluid only moves through a pressure gradient. These indirect procedures therefore actually increase the tissue pressure to even a higher level during the treatment. A key factor for success is to apply the pressure long enough to give the edema enough time to move out of the area.

Therapeutic pressure results from torsion, compression and traction. Any viscoelastic tissue is amenable to these forces. These include bone, cartilage, entheses, ligaments, joint capsules, nerves, fascia, muscles, tendons, skin and blood vessels.¬†Just a note. We assume that traction decreases pressure but that is not the case. When viscoelastic structures are stretched their transverse volume is decreased and the pressure therefore rises. Imagine ‘ringing out’ a wet rag.

You’re using similar procedures in your practice now without realizing their mechanism of action. In understanding these concepts, you will improve your outcomes by merely fine tuning your present techniques. The videos below are only a sample.

Mechanical properties of peripheral nerves

Structure and biomechanics of peripheral nerves

Canalicular fluid flow induced by bending of a long bone

Modeling deformation-induced fluid flow in cortical bone’s canalicular-lacunar system

A finite difference model of load-induced fluid displacements within bone under mechanical loading

Videos

Professor Ludwig Von Drake’s Biophysics Lab

Distal Tibea

Proximal Tibea

Calcaneus

Scaphoid

Professor Ludwig Von Drake’s Four Myths

When a Myth is Not a Myth

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