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. The contraction of the heart creates this.
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 the 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.
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.