Muscle Activation Techniques (MAT)

• Normal muscle function
• Stretch
• the muscle (extrafusal fibers) are placed under stretch
• the muscle spindle (infrafusal fibers) sense tension under stretch
• relays it back to the CNS
• CNS stimulates the alpha motor neurons
• stimulates the muscle to contract and resist the tension
• Contraction
• the muscle (extrafusal fibers) shorten in contraction
• the muscle spindle (infrafusal fibers) slacken
• lack of contractile force regulation
• CNS stimulates gamma motor neurons 
• gamma motor neurons stimulates the muscle spindle to contract
• infrafusal fiber contraction stimulates alpha motor neurons
• stimulates the muscle to contract and resist tension
• Traumatized muscles decrease the sensitivity of the muscle spindle
• muscle becomes less capable of regulating tension relative to stretch or load
• decreased gamma motor neuron stimulation during contraction
• more contraction, greater slack, less responsive spindle
• actin and myosin crossbridges overlap excessively = inefficient 
• biomechanically inefficent as well 
• Reciprocal Inhibition and MAT
• If proper neurological input is not being sent to an agonist muscle, proper inhibition is not occurring of the antagonist muscle as well
• the antagonist muscle is more active consistently becoming hypertonic
• becoming tight
• thus muscle tightness caused by traumatized weakened muscles

PT Volunteer 6/29/12

• articulations and joints of TUB test
• glenohumeral joint
• acromial clavicular joint
• sternoclavicular joint
• scapular thoracic joint (not synovial capsular joint)
• scapular thoracic - anterior tip (when inferior angle of scapula wings out and away from ribcage)

PT Volunteer 6/14/12

• unilateral vs symetrical pain
• palpating the spine?
• upper traps on fire with shoulder injuries, protects the shoulder
• stretch muscles along scapula to loosen the shoulder joint in order to manipulate humerus head and manipulate the deep labrum
• joint mobilization - physically pushes the humerus head inside the glenoid fossa to stretch labrum and muscles
• muscle grade system
• 5 strong perfect uninjured
• 4 + motion w/ resistance
• 4 motion with some resistance
• 4- motion but breaks under resistance
• 3 motion w/out resistance
• creative ways to exercise quad w/out leg extension?
• dry needling - trigger point therapy
• laxity? - loose ligaments

PT Volunteer 6/13/12

• Biomechanics of throwing a boxing punch
• muscles utilized - posterior leg, hip internal rotation, elevation of scapula, contraction of pectoralis min/maj and anterior serratus and latissimus dorsi, extension at shoulder, internal rotation of shoulder,
• hook - over use of shoulder? 
• hyperextension of knee normal range for general population?
• orthotics
• arch height
• heel height
• heel depth
• Premod is for muscle contraction
• interferential is for swelling/inflamation
• traction is used with gapping 
• 0-18 kg of pressure - muscle stretch
• 18-20 kg of pressure - cervical pulling apart
• helps w/ degenerative disc diseases and neurological diseases
• Lunge technique form? (most people over lunge and place excessive force on their knee)
• 3 partial squat
• combines eccentric, concentric, and isometric exercises in one
• plica - appendage of knee, normal tissue not scar
• correcting airplane form 
• hips and pelvis  forward 
• avoid external rotation of pelvis
• add stability 
• bend support knee
• use pole for support
• decrease rear leg raise height
• hold (isometric) vs higher leg raise height

Physical Therapy Volunteer 6/22/12

• Neck strain testing
• restricted motion on one side during lateral neck flexion + restricted motion on opposite side during neck rotation
• unstuck shoulder - unstable shoulder joint
• reinforce neuromuscular with isometric exercises 
• passive ROM isn't enough on its own
• muscle function reverses when joint axis is crossed
• MAT (Muscle activation technique) - targets weak muscles, range of motion
• injury caused by muscle tightness caused by weak stabilizing muscles, strengthen the weak muscles and the tightness will resolve itself
• reciprocal inhibition
• ART (activation release technique) - targets scar tissue (soft tissue adhesion)
• applies tension to scar tissue while moving limb/joint through range of motion
• Tommy Johns surgery - ulnar collateral ligament replacement
• palmaris longus (not everyone has one)
• trauma vs long term straining
• volume and rotation
• different pitches - different ROM angles, wrist flexion and rotation, finger contraction
• http://www.orthonurse.org/portals/0/youth%20pitching.pdf
• 
  

PT Volunteer 6/20/12

• Ar - different stride walks
• purpose
• patient has tendency to externally rotate femur (decreased quad contraction, uses hip adducters instead) and vault over leg (decreased knee flexion)
• retrain gait biomechanics - stride w/ increased knee flexion with hips in line
• Ek - high intensity low duration exercises
• * limitations of strength tests - variability? functional sports testing?
• Joint mobilization - ankle 
• biomechanics of ankle dorsiflexion - talus slides back and anterior rotates superiorly
• spine alignment exercises 
• lower trunk (lumbar spine) rotations (LTR) - supine, knees flexed at 90, lower body rotates left and right
• thoracic rotations (book openings) - supine, knees flexed at 90 laying on one side of floor, rotates upper body from hands together twisting the upper body and reaching the other side of the body. 
• FMS (Function movement screen) - whole body movement exercises that looks at big picture of a patient's function/rom/strength
• Florence Kendall 
• manual muscle tests 
• isolate 1 muscle
• id nerve problems, strains, specific
• not designed for what is commonly used for today
• tests motion not muscle strength

Physical Therapy Volunteer 6/27/12

• Florence Kendall - developed the modern strength tests. 
• ? Sick Scapula - 
• S- Scapular malposition, I- Inferior medial scapular winging, C - Coracoid tenderness K- scapular dysKinesis
• Scapular malposition - When arms are at side, one scapula (usually the throwing side) is significantly lower, rises higher when arms are elevated to the side or overhead
• often misdiagnosed as rotator cuff injury
• increased tightness of the posterior shoulder capsule changes the axis of the shoulder causing decreased ROM w/ internal rotation and increased ROM w/ external rotation
• often leads to a SLAP (Superior Labrum Anterior Posterior) lesion due to increased ROM in external rotation causing the long head of biceps brachii to peal the cartilage off the bone
• Inferior medial scapular winging - Inferior tip sticks out from rib cage caused by
• weak mid, low traps, serratus anterior
• tight pectoralis minor
• Scapular DysKinesis - the inferior tip gets stuck in the lower position
• Treatment 
• stretch the posterior glenohumeral capsule
• stretch relax tight anterior muscles (pect minor)
• strengthen the posterior weak muscles (blackburn exercises)
• Passive stability - can't control
• bone, capsule, ligament, labrum,
• Active stability - control
• muscles
• anterior flexors of the shoulder
• anterior deltoid
• subscapularis
• biceps brachii
• coracobrachialis
• supraspinatus