actions at other joints if myofascial continuity across these other joints is considered .) So , we think of the joint actions that the target muscle to be stretched can do and we compare that knowledge to the stretch that is offered by the authority . If the knowledge matches , we can trust that the stretch will , in fact , be effective and we can begin employing it in our practice ; if it does not , we can choose to not embrace it .
Figure 1A . Ulnar deviating the hand at the wrist joint has little or no effect at stretching the brachioradialis because it does not cross the wrist joint .
Figure 2A . Stretching the vastus musculature of the quadriceps femoris group is accomplished by flexing the knee joint .
For example , given that the brachioradialis does not cross the wrist joint , why would moving the hand into ulnar deviation at the wrist joint add to its stretch as is often recommended by authorities ( Figure 1A )? Could it be that the increased stretch that is felt by the client is occurring in the nearby extensors carpi radialis longus and brevis , which do cross the wrist joint and are stretched with ulnar deviation of the hand ? And given that the end forearm position when the brachioradialis is maximally contracted and shortened is halfway between full pronation and full supination ( at the radioulnar joints ), why would we want to place the forearm in that position as is often recommended ? Making a muscle longer to stretch it is not accomplished by placing it in the position of its actions , it is accomplished by doing the opposite of its actions . Wouldn ’ t full pronation ( or even full supination ) of the forearm make more sense because this position brings the attachments farther apart , therefore the muscle is lengthened ( Figure 1B )?
Looking at a stretching example in the lower extremity , why is it recommended by many authorities to change the position of the hip joint when stretching the c ? If the vastus muscles do not cross the hip joint , then other than flexing the hip joint to slacken the rectus femoris and knock it out of the stretch ( so it does not limit stretching the vastus musculature ), what are we trying to accomplish by altering the position of the hip joint ( Figure 2 )? If it has to do with myofascial meridian continuity , then a specific position should be determined based on the adjacent muscle / myofascial
Figure 1B . Placing the forearm in full pronation at the radioulnar joints is the most effective forearm position to stretch the brachioradialis .
units that are in the meridian ; does the recommended change in the hip joint make sense when compared with this information ?
Using trigger point ( TrP ) treatment as another example , if a TrP is understood to be due to local ischemia in the tissues , does it make sense to create any further ischemia with prolonged pressure ? And if deep pressure is administered , does it make sense to hold it for a prolonged time ? What are we trying to accomplish and are we accomplishing it as effectively as possible ? Given that ischemia is the problem ( because it causes a decrease in blood supply that then causes a decrease in ATP molecules that are needed to break the actin-myosin cross-bridges that create the contraction ), then wouldn ’ t a stroking technique that increases local blood supply be more efficient ? Therefore , mightn ’ t multiple short deep effleurage strokes be more effective when treating TrPs than holding sustained compression ? These are the kinds of questions that can be asked and answered without benefit of authority , research studies , and months of testing in your practice ( Figure 3 ).
Figure 2B . The thigh is laterally rotated and medially rotated at the high joint respectively . These motions do not stretch the vastus musculature because the vastus
muscles do not cross the hip joint .
Figure 3 . Deep stroking massage functions to increase arterial blood circulation to the trigger point ( TrP ). If done along the direction of the taut band of the TrP , it also helps to stretch and physically break the cross-bridges of the TrP .
Evaluating new knowledge against principles of anatomy and physiology can also improve our assessment skills as well . Continuing with the brachioradialis as the example , if we want to assess it through palpation and we need to make it contract to engage it and locate it , it makes sense that we want to contract the brachioradialis and only the brachioradialis if we want to discern it from the adjacent musculature . This requires an isolated contraction . So we ask the client to place their forearm in a position that is halfway between full
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