Myofascial Manipulation: Theory and Clinical Application

352 Pages·2011·11.5 MB·English

by  Robert I. Cantu

Myofascial Manipulation

Myofascial Manipulation
Theory and Clinical Application
THIRD EDITION
Robert I. Cantu
Alan J. Grodin
Robert W. Stanborough
8700 Shoal Creek Boulevard
Austin, Texas 78757-6897
800/897-3202 Fax [phone]
www.proedinc.com
© 2012, 2001, 1992 by PRO-ED, Inc.
8700 Shoal Creek Boulevard
Austin, Texas 78757-6897
800/897-3202 Fax [phone]
www.proedinc.com
All rights reserved. No part of the material protected by this copyright notice may be reproduced
or used in any form or by any means, electronic or mechanical, including photocopying,
recording, or by any information storage and retrieval system, without prior written permission of
the copyright owner.
The author has made every effort to ensure the accuracy of the information herein. However,
appropriate information sources should be consulted, especially for new or unfamiliar
procedures. It is the responsibility of every practitioner to evaluate the appropriateness of a
particular opinion in the context of actual clinical situations and with due considerations to new
developments. The author, editors, and publisher cannot be held responsible for any typographical
or other errors found in this book.
Photo used in design on opener pages reprinted from Histology (p. 212) by A. W. Ham and D. H.
Cormack with permission of J.B. Lippincott Co.,© 1979.
Library of Congress Cataloging-in-Publication Data
Cantu, Robert I.
Myofascial manipulation : theory and clinical application/ Robert I. Cantu, Alan J. Grodin,
Robert W. Stanborough. - 3rd ed.
p. cm.
Includes bibliographical references and index.
ISBN 978-1-4164-0498-9 (Print) ISBN 978-1-4164-0600-6 (e-book PDF)
1. Myofascial pain syndromes-Physical therapy. 2. Manipulation (Therapeutics)
I. Grodin, Alan J. II. Stanborough, Robert W. III. Title.
RC925.5.C26 2012
616.794-dc22
Art Director: Jason Crosier
Designer: Jan Mullis
This book is designed in Minion Pro and Univers.
Printed in the United States of America
1 2 3 4 5 6 7 8 9 10 20 19 18 17 16 15 14 13 12 11
To the Good Shepherd ... who restores my soul.
R.I.C.
To my wife, Carol,
and my children,
Jason, Evan, Seth, and Lisa,
for their support and tolerance
of my personal and professional life.
A.J.G.
To my wife, Becky,
for her never-ending patience and support,
and to my children,
Abby and Jake,
whose inquisitive nature is ever-inspiring.
R.W.S.

Contents
Contributor s . ................................................................ xi
Fore,vord .................................................................. .
x 111
. ..
Pfre ace .................................................................... xv11
Ackno,vledgments .. ........................................................ . xxi
PART I
Historical Development and Current Theories
of Myofascial Manipulation ................................ 1
CHAPTER 1
Hi stori cal Basis for Myofasc ial Ma nipul ation ......................... 3
Robert I. Cantu and Robert W. Stanborough
Ancient Times . ........................................................ .4
Modern Times: The Trend Toward Mobility and Diagnosis of Pathology ...... 10
Futur e Considerations .................................................. 13
CHAPTER 2
Mod ern Theori es and Systems of Myofasc ial Ma nipul ation . . . . . . . . . . . 17
Robert I. Cantu, Alan J. Grodin, and Robert W. Stanborough
Autonomic Approaches ................................................. 17
Mechanical Approaches ................................................. 21
Movement Approaches ................................................. 25
Conc lusion . .......................................................... .2 8
PART II
Scientific Basis for Myofascial Manipulation .................. 31
CHAPTER 3
Hi stolo gy and Biom ech anics of Myofasc ia .......................... 33
Robert I. Cantu and Robert W. Stanborough
VII
v111 Contents
Histology and Biomechanics of Connective Tissue ......................... 33
Histolog y and Biomechanics of Muscle ................................... 54
Histology and Biomechanics of Junctional Zones ........................... 58
Conclusion . .......................................................... .6 3
CHAPTER 4
Histopathology of Myofascia and Physiology
of Myofascial Manipulation .................................. 69
Robert I. Cantu, Alan J. Grodin, and Robert W Stanborough
Histopathology of Myofascia ............................................ 69
Physiology of Myofascial Manipulation ................................... 80
Conclusion . .......................................................... .8 6
CHAPTER 5
Neuromechanical Aspects of Myofascial Pathology
and Manipulation .......................................... 91
Clayton D. Gable
Basic Afferent Neurology of Connective Tissue ............................ 92
Receptor Influence on Movement ....................................... 105
Muscle Tone .......................................................... 111
Application to Specific Therapeutic Techniques ........................... 117
Conclusion . ......................................................... . 121
CHAPTER 6
Muscle Pain Syndromes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Jan Dommerholt and Robert W Stanborough
Soft Tissue Lesion and Mechanical Dysfunction ........................... 126
Myofascial Pain Syndrome ............................................. 128
Fibromyalgia ........................................................ . 149
PART Ill
Evaluation and Treatment of the Myofascial System .......... 181
CHAPTER 7
Basic Evaluation of the Myofascial System. . . . . . . . . . . . . . . . . . . . . . . . . 183
Robert I. Cantu, Alan J. Grodin, and Robert W Stanborough
History ............................................................. . 184
Postural and Structural Evaluation ...................................... 185
Contents
IX
Active Movement Analysis ............................................. 193
Compressive Testing of the Spine ........................................ 195
Palpatory Examination ................................................ 195
CHAPTER 8
Atlas of Therapeutic Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
Robert I. Cantu, Alan J. Grodin, and Robert W Stanborough
Techniques for the Lumbar Spine ...................................... 205
Techniques for the Lumbopelvic/Lower Quarter Area ..................... 248
Techniques for the Thoracic/Upper Thoracic Spine and Upper Extremity ..... 279
Techniques for the Cervical Spine ...................................... 305
Index .. .................................................................... . 317
About the Authors .......................................................... 327