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high velocity manipulation literature
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high velocity manipulation literature - April 14, 2002 2:45:00 AM
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henryryry
Posts: 100
Joined: September 6, 2000
From: Brisbane, Australia.
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hi all:
I will be doing a seminar on the mechanisms of action and indications in using high velocity manipulation. Does anybody have any hypothesis on what happens during a manipulation, and why manipulations may be more effective than other joint mobilization techniques?? References would be helpful. I just want to see if anyone else has a different theory compared to what I have read so far.
Thank you.
Henry***
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Re: high velocity manipulation literature - April 14, 2002 8:22:00 AM
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Diane
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From: Vancouver, B.C., Canada
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Hi Henry,
One theory I heard was that high-velocity manipulation shuts off the type 3 mechanoreceptors. Which takes away pain, for awhile, then it comes back, after the joint receptors begin to fire again. (Which means three-times-a-week visits...OK, I won't go there. [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG] ) Sorry, I don't have a reference for you...
Good luck with your seminar.
Diane
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Re: high velocity manipulation literature - April 14, 2002 12:08:00 PM
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henryryry
Posts: 100
Joined: September 6, 2000
From: Brisbane, Australia.
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Diane,
haha.... I think that is a good theory. I spoke to a DC in California, who says that type IV receptors are stretched with manipulation and not mobilizations or other techniques, but didn't really explain the significance of type IV receptors in pain relief or restoration of joint movement.
Henry***
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Re: high velocity manipulation literature - April 14, 2002 1:07:00 PM
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Diane
Posts: 1510
Joined: March 9, 2001
From: Vancouver, B.C., Canada
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Hi Henry,
Couple questions...
1. Would you mind clarifying the difference between type 3 and type 4 mechanoreceptors? I thought type threes were the joint nocioceptors. What do fours do? (please pardon my ignorance..)
2. My understanding was that manipulation (high vel.) actually "shocked" the type threes into submission, i.e. *not* firing, at least temporarily. By overloading them? Then theoretically they switch back on, little by little. I also assumed (probably need some more input here also...) that they could actually be sensitized by high-vel manips, that they would not only resume firing but at a decreased threshold, leading to addiction to manipulation/quick fix. (Three-times-a-week--->"maintainance" phenomenon, til forever...)
(As you can probably tell I'm not the biggest fan of this technique, having experienced the "joy" of having to extricate myself from its longterm effects at my mid-thoracics...)
Diane
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Re: high velocity manipulation literature - April 14, 2002 1:13:00 PM
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henryryry
Posts: 100
Joined: September 6, 2000
From: Brisbane, Australia.
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Diane,
From what I understand, there are 4 types of joint receptors - type 3 are located within the joint capsule whereas type 4 are nociceptors situated inside the joint itself. What they say is that type 4 nociceptors are usually silent and are only stretched beyond normal range (I would think to warn the person of pain). You are right, the manipulation is suppose to silence or dampen type 4 receptors (maybe type 3 as well?).
There is an article on the topic if you are interested:
Pickar, Mclain et al., "Responses of mechanosensitive afferents to manipulation of the lumbar facet in the cat" Spine 20 (1995) 2379-85
Henry***
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Re: high velocity manipulation literature - April 14, 2002 3:18:00 PM
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Diane
Posts: 1510
Joined: March 9, 2001
From: Vancouver, B.C., Canada
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Hi Henry,
Thanks for the clarification. You don't happen to have a link to that article, do you? I couldn't seem to get through to it.
Are the type 4s inside the synovial membrane of the joint? And type 3s in the ligaments? Are 1s and 2s involved in any way, I wonder?
Diane
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Re: high velocity manipulation literature - April 16, 2002 3:39:00 AM
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henryryry
Posts: 100
Joined: September 6, 2000
From: Brisbane, Australia.
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Diane,
I will review the articles and let you know what I find. I think then I can be more confident in my facts.
Henry***
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Re: high velocity manipulation literature - April 16, 2002 6:37:00 PM
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chipomalley
Posts: 156
Joined: January 7, 2002
From: Baltimore, MD
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I am thinking the Type 1,2 and 3 are mechanoreceptors and the type 4 is the true nociceptor. It is a free ending found in the joint capsule, ligaments and periarticular tissues. The Type 1 is found in capsule and ligaments. Type 2 is found between the capsule and synovial membrane. Type 3 is in the ligaments.
Type 1 low threshold, slow adapt for position and movement
Type 2 low threshold, rapid adapt for movement
Type 3 high threshold, slow adapt for endrange tension, position and movement
Type 4 high threshold, slow adapt for noxious chemical/mechanical stim
From: Warmerdam, A: Manual Therapy, Wantagh, NY, Pine Publications, 1999, pp29-38.
------------------
George E. O'Malley, Jr., PT, OCS
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Re: high velocity manipulation literature - April 16, 2002 7:09:00 PM
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Diane
Posts: 1510
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From: Vancouver, B.C., Canada
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Thank you for that info, George.
Diane
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