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Treatment of ‘Neurological Tightness’ in the posterior deltoid using motor point acupuncture

September 14, 2010

As I have discussed in the past, a large focus in my soft tissueexaminations is to distinguish between tissues that have ‘mechanical tension,’ vs. ‘neurological tightness.’  This is important as the preferred treatment approach differ’s greatly between the two.  The video below demonstrates a treatment protocol utilizing motor point acupuncture stimulation to attempt to decrease motor-neuron pool excitability in the posterior deltoid….a structure which I often find to contain an increased neural drive with various shoulder conditions.  Following the video I have taken a section directly out of the Functional Range Release™ seminar manual which helps to define how I differentiate these two distinct soft tissue findings.

Taken from the F.R.™ manual…

“NEUROLOGICAL TIGHTNESS” VS. MECHANICAL TENSION – copyright 2010 Functional Anatomy Seminars™ , all rights reserved

“Any musculoskeletal condition can be viewed as having two basic components – neurological and mechanical:

The Neurological component refers to changes in nervous system functioning that leads to, or is caused by injury.  These alterations effectively lead to changes in neural drive (a measure of the number and amplitude of nervous system impulses to a muscle).  This can included a decreased neural drive (causing muscular inhibition), or an increased neural drive (leading to contraction).  I refer to the latter as “Neurological tightness.”

The Mechanical component refers to physical changes in structure including fascial contraction and adhesion formation.  These changes lead to alteration in tissue mechanics and motion by physically restricting normal lengthening and/or relative motion between tissues (the ability of tissues to slide past one another).  I refer to this as “Mechanical tension.”

In order to select the proper intervention procedures, assessment techniques must distinguish between these two components.  For example, simple range of motion testing does not provide any information as to the cause of normal or abnormal results.  Restriction can be due to adhesion and scarring, or an increased neural drive.  Thus it does not help the practitioner select the appropriate treatment techniques to effectively correct the problem.

Tissue palpation is the most effective way to distinguish between neurological tightness and mechanical tension.   The distinguishing features are as follows:

Neurological tightness:

  • Tension is felt along the entire muscle group
  • Muscle tension is felt in the muscle with both static and dynamic (i.e. motion) palpation
  • No changes in relative motion (tissue sliding) other than a decreased available range of motion
  • Responds less effectively to application of soft tissue release protocols

Mechanical tension:

  • Tension is felt in distinct areas within the muscle group
  • Dysfunction can only be found with dynamic palpation.
  • Changes in relative motion (tissue sliding) between structures
  • Responds effectively to application of soft tissue release protocols

Simply using static palpation to feel the muscles is insufficient.  In order to properly assess tissues using palpation, one must utilize both static, and dynamic procedures (Tissue Tension Technique™) in order to distinguish between neurological tightness and mechanical tension.  Also note that these two components are often occurring simultaneously.

Once a proper palpation assessment is complete the practitioner can then select the appropriate interventions to correct the finding.  Such interventions for Neurological tightness include Electro-acupuncture or modality currents.   For Mechanical tension, the Functional Range Release™ soft tissue management system provides effective results.”

FUNCTIONAL ANATOMY SEMINARS.com

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