Issue link: https://www.massageandbodyworkdigital.com/i/1256819
technique MYOSKELETAL ALIGNMENT TECHNIQUES 88 m a s s a g e & b o d y w o r k j u l y / a u g u s t 2 0 2 0 Using Bones as Levers to Restore Muscle Function Reduce Friction and Enhance Movement Through Joint Play By Erik Dalton, PhD 1 2 Joint play between the femoral head and acetabulum helps reduce friction. Joint play provides roll, glide, and spin to aid in smooth joint motion. In nature, friction exists wherever there is movement, and it affects objects in all sorts of ways. By briskly rubbing our hands together, we create thermal energy to warm them up. When we press the brakes on a car, we generate friction to reduce speed. To counter the negative effects of friction, everything made to move has a built-in factor of "play" that lessens friction and promotes efficient movement (Image 1). The wheel on a car axle, the piston in the cylinder, and even the simple door hinge all have calculated play between their moving parts. Such play is critical to the function of human joints as well. In his classic book Joint Pain, John Mennell, MD, explores the role of joint play in the human body. His research pinpoints three available movements in every synovial joint: active, passive, and joint play. Mennell described joint play as "small movements within the joint that are independent of voluntary muscle contraction." 1 Although these movements measure less than one-eighth of an inch in any plane, they provide combinations of roll, glide, and spin to aid in smooth joint motion and better muscular control (Image 2). Mennell stressed that it is the integrity of these movements, not their range, that is important, and that it is the summation • When a joint is not free to move, the muscles intended to move the joint are not free to move it. • Muscles cannot be restored to normal tone if the joints they control are not free to move. • Impaired muscle function may, in turn, lead to greater derangement of motion-restricted joints. ASSESSMENT AND CORRECTION One of the goals of myoskeletal therapy is to help reduce joint friction due to tension, trauma, and weak posture. To accomplish this, we often use bones as levers to relieve muscle spasm or atrophy. During assessment, if joint play restrictions appear to be causing reactive muscle spasm, various low-force compact/ distract and oscillating techniques are used. There may be individual variations in the degree of joint play at any specific synovial joint, but there is no variation of technique for eliciting each movement. In the examination of all synovial joints and their associated connective tissues, the client must be relaxed, with the therapist applying a grasp that is firm and protective but not restrictive. In Images 3 and 4, for example, I demonstrate a myoskeletal joint play assessment and treatment routine for restrictions at the femoroacetabular joint. Loss of joint play at the hip is a common finding, and left untreated this loss can lead to muscular imbalances that adversely affect strength, flexibility, and performance. When dealing with joint play issues in smaller joints, such as the cervical spine, I often use the fingers of both hands to of joint play and voluntary movement that helps reduce friction, enrich sensory input, and boost motor output. Through decades of collecting anecdotal research, Mennell developed the following four basic joint play concepts: • Normal muscle function is dependent on normal joint movement.