Still technique: passive or active; indirect or direct
passive, mixed (indirect then direct; like articulatory)
in Still technique, an axial force is directed where
toward the dysfunction
mechanism of indirect aspect of Still technique
inhibits neurological protective mechanisms, relaxes myofascial components
mechanism of direct aspect of Still technique
re-pattern the neuro-fascial-vascular complex
indications of Still technique
articular or myofascial SD
absolute contraindictions of Still technique
spinal or joint instability, severe loss of intersegmental motion (from spondylosis, osteoarthritis, or rheumatoid arthritis), positive vertebral artery test, exacerbation of life-threatening sympatomatology in monitored pt
principles of Still technique
1) indirect: move restricted joint/tissue into position of ease
2) vector of force (compression or traction; <5 lbs)
3) direct: take the joint/tissue where it doesn’t want to go with the vector of force
4) palpable release (sometimes a click)
5) release force vector and passively return tissue to neutral
what does FPR stand for
facilitated positional release
facilitated positional release (FPR): passive or active; indirect or direct
passive, indirect
in FPR, a force is directed where
toward muscles (superficial –> deep)
mechanism of FPR
sudden muscle contraction/stretch –> proprioceptive/nociceptive dysregulation –> muscle hypertonicity –> restriction motion
increased gamma motor neuron activity –> stimulated muscle spindles –> muscle hypertonicity
mechanism of neutral position of FPR
mechanical unloading
mechanism of facilitated force of FPR
shortens muscles –> immediate effect on muscle spindles
indications of FPR
muscle hypertonicity, articular SD
absolute contraindictions of FPR
acute/unstable fracture, positive vertebral artery test, exacerbation of life-threatening sympatomatology in monitored pt
principles of FPR
1) place joint in neutral position
2) facilitating force (compression or torsion)
3) move into position of ease
4) hold for 3-5 sec
5) release the position (does not require slow return to neutral)
mechanism of FPR is similar to what other treatment modality
counterstrain
what does LAS stand for
ligamentous articular strain
ligamentous articular strain (LAS): passive or active; indirect or direct
passive, indirect
LAS was developed and taught by who
Dallas Osteopathic Study Group
what does BLT stand for
balanced ligamentous tension
BLT was developed who and where
Still/Sutherland Study Group (ASSSG); New England
LAS and BLT is based on the work of who
Dr. William Garner Sutherland
mechanism of LAS/BLT
healthy joint: tensions on a ligament are balanced
unhealthy joint: disrupted balance in ligament tension –> strained and weaker ligaments (dysfunction!) –> unable to return to healthy balanced tension
