Manual soft hooks extracts

Aponeurotic hooking technique: The Soft Hooks®

INTRODUCTION

1. Why hooking?

The connective fibrous tissue represents up to 60% of the bodily mass.Of different structures, it mainly features a unique fascia1.

This fascial web must remain absolutely free.Stress at any single point involves the participation of the entire fascia.

Either in case of a muscular contracture, tissue adhesions or fibrous corpuscles, the release by means of a simple mechanical effect will bring relief.

Soft hooks allow to painlessly remove those biomechanical troubles and to re-establish the natural configuration.

2. With what tools?

1 Léopold Busquet, Les chaînes musculaires tome 1,2000.

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The fingertip approach of underlying skin and tissue structures is limited by the thickness of the finger.

A simple and precise tool can put that right.

The soft hook: the real lengthening of the finger.

The soft hook is made of a stainless steel wire of a chosen diameter which ensures the sharpness at tissue level.

First and foremost it is painless.

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3. How?

A few precisions:

1. The hook does not replace the therapist’s hand but will be its perfect auxiliary.2. Any action starts distant from pain and then gets closer to it.3. The palpating anatomy constantly guides the therapist.

The ideal way to hold the tool is summed up in three points: - lay the tool in the commissure between thumb and forefinger-fold the forefinger on the handle- put the thumb in the opposite side

Simple exercise: go over an uneven surface to feel the vibration2.

2 The flexion of the inox wire is limited by the resistance if the welding and by the handle

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Look at the picture showing the best way to hold the tool as well as the typical manoeuvre

Standard movement:

1. The free hand palpates and judges the tissue wave which defines the curve of the hook to be used.

2. The forefinger will identify the place to hook.3. The soft hook comes closer to that forefinger and receives

the tissue wave for the patient’s maximum comfort.

Palpating hand and soft hook both make some exploratory motions over the painful spot.

A brisk pulling of the soft hook will free (the tendon) from adhesions or separate the fibrositis

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4. When?

To free the adhesions resulting from shock during a sports practice or from surgery or to remove inflammatory or neuralgic pains in the locomotive system.

The obvious relaxation of the muscles due to the transverse mobilisation of the fibres and the effect of the inhibition of reflex points already represent a non-negligible treatment.

The main counter-indications are clearly related to the skin and circulatory condition of the patient.

An excitable patient seems very sensitive to hooking.

Suggested indications for hooking (non restrictive):

Epicondylitis, medial epicondylitis, Achilles tendinitis, pubalgia, periostitis, muscle contracture, strain, tenosynovitis, keloids, Dupuytren postoperative, carpal tunnel, ulnar canal syndrome, occipitalgy, sciatica, lumbago, torticollis, PSH, ganglion cysts, algodystrophy

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5. Origin of the method

This technique was developed by Kurt EKMAN, a Swede kinesiotherapist contributor of CIRIAX in London.

He revealed the deficiencies and limits of palpation and manual treatment of soft tissues.

The adhesions and small deposits are difficult to palpate on the deep myo-aponevrotic levels.

He had the idea of creating tools which offered a better access to the pathogenic structures.

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PRACTICE

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A – INFERIOR LIMB

1.- TIGH

ANATOMIC REMINDER

The tigh consists of three areas

Anterior region Posterior region Lateral region

Each area is joined by muscle groups with similar actions and is crossed by a vascular-nervous pedicle.

The whole member is covered by skin, a superficial and a deep fascia.

It surrounds the muscles forming the intramuscular septa.

Anterior region of the tigh

Quadriceps femoris muscle Sartorius muscle

Femoris vessels Artery Vein Nerve

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Medial region of the tigh

(from inside to outside)

Sartorius muscle Iliopsoas Pectineus muscle Adductor longus muscle Gracilis muscle

Deeper Adductor brevis muscle (between ALM and GM)

Buttocks area Gluteus maximus Gluteus medius Gluteus minimus

Tensor fasciæ latæ

Deeper Piriformis muscle Sacrospinous ligament

Posterior region of the tigh

Long rear muscles Semimembranosus muscle Semitendinosus muscle Biceps femoris muscle

Nerves Sciatic nerve Posterior cutaneous nerve

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Popliteal fossa (Knee pit)

BoundariesInside

Semimembranosus muscle Semitendinosus muscle

Outside Biceps femoris muscle

Inferior (with the plantaris muscle) Medial and lateral heads of the gastrocnemius muscle

Contents Popliteal vein and artery Tibial nerve

Floor Popliteal muscle

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HOOKING

Separation of the anterior gracilis muscleInternal: the Sartorius muscleExternal: to the fasciæ latæ

Separation of the Sartorius muscleVastus medialis muscle (teardrop muscle)

Area of concentrationSartorius muscle – vastus medialis muscle – anterior gracilis muscle

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Edge of the vastus lateralis muscle in contact with the anterior gracilis muscle

ReminderThe vastus lateralis (side and rear) is covered by the FLT

Separation of the vastus lateralisfrom the short head of the biceps femoris muscle down the tigh

Separation if the vastus lateralisfrom the long head of the biceps femoris muscle to the upper area

of the tigh

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Key pointVastus lateralis – biceps femoris – gluteus maximus

Gluteus maximus, linked up with long head of the biceps femoris muscle semitendinous muscle

Afterwards, separation of semitendinous / semimembranous muscles

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Separation of the gracilis muscle with Semimembranous muscle (popliteal area) Sartorius muscle (just ahead it)

Separation of the adductor magnus muscle (posterior side) semitendinous, semimembranous gracilis muscle (just ahead it)

Key pointAdductor longus – semimembranous – gracilis muscle

Adductor longus gracilis muscle adductor brevis

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PATHOLOGIES

STRUCTURES TO BE TREATED

Patellar hyperpressure Buttocks Tensor Adductor Patte d’Oie

Pubalgia Adductor longus Adductor magnus Gracilis Gluteus maximus Abdominal muscles (periosteum) Hamstring Piriformis Psoas Quadratus lumborum muscle

Muscular strainHooking the periphery of the injure relaxes the contracture emphasizing this way the drainage with this defibrosing effect.

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Health & Medicine

Manual soft hooks extracts