manual soft hooks extracts
TRANSCRIPT
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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Aponeurotic hooking technique: The Soft Hooks®
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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Aponeurotic hooking technique: The Soft Hooks®
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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Aponeurotic hooking technique: The Soft Hooks®
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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Aponeurotic hooking technique: The Soft Hooks®
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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Aponeurotic hooking technique: The Soft Hooks®
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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Aponeurotic hooking technique: The Soft Hooks®
PRACTICE
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Aponeurotic hooking technique: The Soft Hooks®
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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Aponeurotic hooking technique: The Soft Hooks®
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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Aponeurotic hooking technique: The Soft Hooks®
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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Aponeurotic hooking technique: The Soft Hooks®
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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Aponeurotic hooking technique: The Soft Hooks®
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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Aponeurotic hooking technique: The Soft Hooks®
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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Aponeurotic hooking technique: The Soft Hooks®
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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Aponeurotic hooking technique: The Soft Hooks®
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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