The body’s muscles are organized in chains via fascial tissue (myofascial chains) along the body, including the diaphragm, the principal respiratory muscle. Aging, bad postures, muscle spasms, or musculoskeletal disorders may generate imbalances in the body’s myofascial chains generating pain and disability near or far from the problem source. For instance, a knee or hip deviation may cause cervical pain.
Dr. dos Santos offers as physical therapy a combination of techniques that involves Global Postural Re-education joint mobilization and manipulation, myofascial release, and muscle energy. The combination of these techniques restores the balance of the body’s myofascial chains, improving posture and mitigating pain and disability.
Indications:
• Middle, low back, and neck pain.
• Spine and joint deviations.
• Movement restriction.
• Radiculopathies (radiating pain to arms/hands and legs).
• Disk herniations.
• Muscle spasm.
• Rheumatic diseases.
• Prevention of degenerative joint diseases.
• Somatic diseases caused by stress and/or sleep disturbance.
How it works:
Global Postural Re-education, or RPG, is a method based on stretching chains of muscles, which sustain the body against gravity. Simultaneously, the method strengthens the muscles responsible for movement and locomotion. This method uses different static postures (laying down, sitting, and standing) to pull the chain of muscles, like an array of strings, through for approximately 15 to 30 minutes each. The physical therapist uses verbalization and manual contact during the static postures to avoid body compensations, release myofascial tissue, correct spine curvatures, mobilize joints, and reinforce adequate breathing.
Recent scientific studies have confirmed the existence of different types of myofascial chains, their treatments, and the benefits of static postures (RPG) to increase flexibility and strength, improve neck and lumbar pain, and enhance general health perception.
Indications:
• Chronic and Acute muscle pain.
• Spine and joint deviations.
• Movement restriction.
• Reduced mobility.
How it works:
The muscles and visceral organs are linked and sustained through a sheet of connective tissue denominated by fascia. Fascia exists in the body in a continuous tridimensional web of connective tissue from the “head to toe.” Bad posture, trauma, or injuries may tighten or stiffen the fascial tissue and reduce its sliding ability. Over time, this condition causes a malalignment of posture and abnormal movements leading to pain and loss of functional capacity. Myofascial release involves the physical therapist applying gentle and sustained pressure on the restricted area for a couple of minutes to elongate the tissue.
Indications:
• Movement restriction.
• Reduced mobility.
• Joint and spine pain.
How it works:
Spinal mobilization is defined as low-velocity, non-thrust, passive movement within or at the limit of joint range of motion (ROM) while spinal manipulation is defined as high-velocity thrust techniques at the limit of the ROM. In other words, during mobilization, the physical therapist applies oscillatory movements to the target joint.
Physical therapy manipulation uses fast and small movements at the end of ROM, which sometimes generates a ‘crack’ or ‘click’ sound at the joint. Both mobilization and manipulation help to decrease stiffness and muscle spasms, restoring movement and reducing pain. Both techniques take only a few minutes to execute.
Indications:
• Movement restriction.
• Reduced mobility.
• Muscle spasm or shortening.
• Joint and spine pain (low back and neck pain).
How it works:
Muscle Energy consists of positioning any joint at its limited range of movement along with the muscle that controls the joint motion. First, the physical therapist asks the patient to contract the muscle (or move the joint) in a particular direction with proper intensity and time. Simultaneously, the physical therapist applies a counterforce, not allowing the joint to move. After a couple of seconds, the patient is required to relax, and then the joint is positioned to a new enhanced ROM. The goal of Muscle Energy is to increase joint mobility and restore the muscles the muscle function that was inhibited by the nervous system.
