Facilitated positional release

Facilitated positional release was developed by the author of this chapter. He first presented it to the profession in an article in the Journal of the... 

American Osteopathic Association, "Facilitated Positional Release," in 1990. 

This treatment is directed toward the normalization of hypertonic muscles, both superficial and deep. It is probable that most of the vertebral joint motion restrictions diagnosed as somatic dysfunctions are caused and/or maintained by hypertonicity of the small, deep, intervertebral muscles. These hypertonic muscles respond well to facilitated positional release, thus immediately restoring normal joint function. 

Sehiowitz S. Facilitated positional release. J Am Osteopath Assoc 1990 901 145-155. 

Facilitated positional release involves positioning a region or joint into neutral, luiloading the joint, adding a facihtating force (compression and/or torsion), adding motion in all three planes of freedom, and monitoring for release. The time interval is a few seconds. 

All facilitated positional release techniques for treating cervical region dysfunctions are begun with a slight flattening of the cervical lordosis. 

FIG. 29-1 Facilitated positional release treatment of superficial muscle hypertonicity of cervical region application of axial compression. 

FIQ. 29-2 Facilitated positional release treatment of muscle hypertonioity in the oen/ical region with extension and right side-bending added. 

FIG. 29-3 Facilitated positional release treatment for C4 flexion dysfunotion with right side-bending and rotation. 

Once the acute inflammation has subsided, some tissue tension will still remain. Range of motion will improve but may still be limited. The patient may now be treated with appropriate osteopathic manipulative techniques to the injured area or wherever somatic dysfunction is found. Muscle energy, counterstrain, lymphatic drainage techniques, cranial, and facilitated positional release techniques may be used judiciously. Thrusting techniques should not be used until the soft tissues are no longer boggy and warm. If necessary, they may be used to correct stubborn somatic dysfunctions with firm barriers to motion. 

Facilitated Positional Release in the thoracic region may be performed with the patient in either a seated position or in a prone position. If the patient is treated in a prone position, use of a pillow will be necessary. The pillow is placed under the patient s abdomen or head and neck to assist in flattening the thoracic kyphosis. 

FIG. 40-1 Facilitated positional release treatment for thoracic superficial muscle hypertonicity application of compression at the left cervico-thoracic junction. 

FIG, 40-3 Facilitated positional release treatment for T3 extension somatic dysfunction, patient prone. The physician applies a caudad and parallel pull, creating compression and side-bending. 

At the next visit, 1 week later, she was having less discomfort in the thoracic spine. The dysfunction at T4 had not returned. The one at T8 was present but responded easily to a facilitated positional release technique. The left muscles were less hypertonic. She was instructed to continue the exercise program and to return for a follow-up x-ray in 6 months, unless the pain and discomfort recurred. 

FIG. 51-2 Facilitated positional release treatment for a lumbar extension somatic dysfunction. 

FIG. 51-5 Facilitated positional release alternate treatment fior a lumbar flexion somatic dysfunction. 

FIG. 51-6 Facilitated positional release treatment for sciatic radiation of pain caused by herniated lumbar disc. 

The patient was treated using facilitated positional release techniques for the hypertonic muscles as well as the somatic dysfunctions that were... 

The patient was treated using facilitated positional release techniques for relief of the muscle hypertonicity as well as the restrictions and somatic dysfunctions found. Special attention was given to the treatment of the piriformis and tensor fascia lata muscles. A prescription was given for nonsteroidal antiinflammatory (NSAID) medication. 

Facilitated Positional Release Techniques for the Sacrum and Pelvis... 

This chapter describes facilitated positional release (FPR) techniques for the sacrum and pelvis. The principles of FPR apply the lumbosacral spine is flattened by placing a pillow under the abdomen of the prone patient, the involved area is placed into the freedoms of motion of the involved joint or the muscles being treated are shortened, and a facilitating force is added, either compresson or torsion. 

There are no muscles that directly insert into both the sacrum and the ilium exclusively. Therefore, the usual facilitated positional release techniques do not apply. What will be described is a method for diagnosing sacral motion restriction on the ilium and a biomechanical technique to normalize the joint motion, if needed. 

Counterstrain and facilitated positional release techniques are most useful. Each of the three tender points must be treated, if they are present, to be effective. Any dysfunction of sacral motion should also be corrected. A piriformis stretching exercise should be prescribed for use at home. 

This chapter contains the methods for treating rib somatic dysfunctions with facilitated positional release techniques. 

FIG. 73-1 Facilitated positional release treatment for first rib dysfunction application of compression with internal rotation of the shoulder. 

FIG. 73-4 Facilitated positional release treatment for anterior rib cage somatic dysfunction with forward bending, side-bending, and rotation added. 

R.T. was treated with osteopathic manipulation. He received soft tissue myofascial techniques to the neck and upper back. The somatic dysfunctions were treated with facilitated positional release techniques, as was the first rib. The T3-4 somatic dysfunction was also treated with high-velocity, low-amplitude thrusting technique. 

CHAPTERS FACILITATED POSITIONAL RELEASE OF THE UPPER EXTREMETIES 443... 

FIG. 87-1 Facilitated positional release treatment for hypertonicity at the medial aspect of the right shoulder. 

He was treated with a variety of osteopathic techniques. The cervical spine was treated with muscle energy and normal motion was restored. The first rib was treated with facilitated positional release. The pronator teres and the wrist were treated with counterstrain. The wrist was treated with articulatory techniques. 

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