Positional Release Technique

•The commonality of all of these approaches is that they move the patient or the affected tissue away from any resistance barriers and towards position of comfort.

• If this method is applied to chronically fibrosed tissue the result produce a reduction in hypertonicity, but would not result in any reduction in fibrosis.

• Pain relief or improved mobility may therefore be only temporary or partial.

1. Exaggeration of distortion: one of the first observations made by Jones was that a position of comfort or ease, commonly was an exaggeration of whatever adaptive distortion pattern were present.

• The tissue which were already shortened were made comfortable by being supported in an even shorter state, so allowing neurological and circulatory mechanisms in resolution of dysfunctional state.

2. Using Jones’ tender points as monitor:• The tender point are usually found in tissue which were

in shortened state at the time of strain rather than those which were at stretch.

• The treatment method usually recommended involves maintaining pressure on the monitor tender point.

1. There is no additional pain in whatever area is symptomatic

2. The monitor point pain has reduced by at least 70%,3. No new or additional pain is created.

• The position of comfort (ease) is held for an appropriate length of time (90 seconds, according to Jones).

• Example: person with acute low back pain who is locked in flexion, the tender point would be located on the anterior surface of abdomen, in the muscle structure which were short at the time of strain.

3. Facilitated positional release (FPR): • The theme of functional methods involves the

positioning of the distressed area into the direction of its greatest freedom of movement, starting from position of neutral in terms of the overall body position.

• Crowding involve compression applied through the long axis of the limb.

• The length of time the position of ease is held is usually suggested at less than 5 sec.

• The mechanisms involved are thought to relate to modifications in neural activity which reduces hypertonicity.

4. Integrated neuromuscular inhibition technique (INIT):

• INIT involves using a position of ease for tissues housing a trigger point as a part of a sequence of its deactivation.

• The sequence commences with location of a tender point/ trigger point, followed by application of ischaemic compression, followed by the introduction of positional release.

• Position of ease is held for appropriate length of time. The patient is asked for introduce isometric contraction into the affected tissue for 7 t0 10 sec, after which the tissue is stretched.

Sports massage

• Friction massage: friction massage is a brisk, often heat producing compressive stroke that may be delivered either superficially to the skin or to deeper tibbue layers of muscles.

• Deep friction techniques such as cross-fiber friction and circular friction.

• Benefits of friction:• Friction generates heat.• It loosens stiffness in joints by relaxing muscles.• Friction reorganizes collagen and facilitates its proper

parallel pattern.• It reduces trigger and tender activity point.

Locating and treating trigger point• During post event and recovery work, the athlete may

encounter hypersensitive tender, ropy and knotted areas.

• If a particular site refers pain when specific pressure is applied, you have located a trigger point.

• The area may feel much cooler to touch due to vasoconstriction, skin also feel dry, tight, thickened, or waxy.

• Avoid treating during acute stage of an injury (24 to 48 hrs)

• Warmup the tissue before treating.• Once an area has been treated, return to relaxing

techniques at least 3-5min before retreating. 1-3 treatment per area is recommended.

• Sorness in the area that has been treated may be present.

• Once or twice weekly session.