Traction

Question 1

Traction

Answer 1

therapeutic use of manual or mechanical tension created by a pulling force to produce a combo of distraction and gliding to relieve pain and increase tissue flexibility

Question 2

mechanical elongation does what?

Answer 2

○ stretches the spine
○ tenses ligaments and facet joint capsules – flattens HNP (“sucks it back in”-Cyriax)
○ widens the IV foramina
○ straightens spinal curves
○ increases movement @ facet joints

Question 3

indications for traction

Answer 3

HNP

DJD/DDD

hypomobility

hard neuro signs

radicular symptoms

+HNP tests

muscle spasms

pain

better with manual distraction and worse with vertical compression tests

postioned by postural preference of pts for comfort

Question 4

contraindications for traction

Answer 4

tumor in spine

infection of spine

vascular compromise

acute traumatic injuries (sprains,strains,fx, immobilizations)

inflammatory issues (RA)

pregnancy/ hiatal hernia (lumbar)

Question 5

precautions of traction

Answer 5

TMJ dysfunction

claustrophobia

inability of pt to relax

Question 6

intensity - weight

Answer 6

50% BW (friction-free table) for separation

25% BW just to initiate traction effect

Question 7

duration

HNP

Answer 7

50% BW

5-10 mins with static, 15 min intermittent (50:10) on/off

if unable to tolerate static, can do longer hold times intermittently

BEWARE OF REBOUND EFFECT

Question 8

duration

hypomobility

Answer 8

30% BW

15-20 min intermittent, shorter cycling time (around 20:20)

note: want lots of reps to improve joint mobility/decrease synovial viscosity

Question 9

what is the rebound effect?

Answer 9

After traction, when the force is released, the spine can recompress suddenly.

This can sometimes worsen symptoms (especially radicular pain) due to sudden reloading.

To prevent this:

Bring traction off slowly.

Have the patient rest in supine for a few minutes before getting up.

Avoid sudden flexion/extension right after traction.

Question 10

HNP

static vs intermittent

Answer 10

static: Constant hold
Static Traction (constant hold)

Best for:

Acute, irritable conditions (esp. HNP/disc herniation).

Severe muscle guarding/spasm.

Patients who peripheralize with movement.

Why:

Constant pull can help “suck in” or centralize disc material (Cyriax).

Reduces motion, which is less irritating to acutely inflamed tissues.

Shorter duration: 5–10 minutes.

Intermittent Traction (on/off cycles)

Best for:

Chronic or subacute conditions.

Facet joint dysfunction (hypomobility, stiffness).

Patients who can tolerate some movement.

Why:

The “on/off” pumping action improves nutrition, reduces stiffness.

Helps mobilize the facet joints.

Longer duration: 15–20 minutes typical.

Cycle example: 50 sec on / 10 sec off (longer holds for disc patients if static isn’t tolerated).

Question 11

positioning

flexion vs extension

Answer 11

flexion:

posterior pull: supine, knees on stool, angled pull

extension:

anterior pull: prone, no pillow, angled pull

neutral pull: prone over pillow, table higher, pull parallel

Question 12

Harness

thoracic / lumbar

Answer 12

bottom of strap is at xiphoid process and hugs ribcage

lumbar:

top of strap is at navel and above iliac crests
should line up below table split once when pt is positioned in prone or supine