OSTEOPATHIC. PULATIVE MODALITIES ‘The following is a list of available osteopathic manipulative modalities. This list is not meant to be all-inclusive, ‘These techniques may be used alone or in combination depending on the needs of the patient. A. Myofascial Soft Tissue Treatment - Relaxing This mode of treatment is utilized to achieve relaxation of contracted or contractured muscles. It should relieve pain, restore normal function, and increase arterial, venous, and lymphatic drainage. It is applied specifically and gently (as a gentle stretch,) to the muscles. It should rarely elicit pain, This can be done passively (patient is passive) or actively (patient participates). Progress Note order should read: Myofascial Treatment - Relaxing to area, times daily B. Myofascial Treatment Stimulatory Passive myofascial treatment can also be applied more rapidly with 2 minimum amount of force and should never elicit pain. Its goal is to increase muscle tone and to mildly increase circulation. One should not perform this technique directly on a surgical site, Progress Note order should read: Passive Myofascial Treatment - Stimulatory to area, times daily C. Myofascial Release Treatment This mode of treatment is utilized to release fascial tensions and to increase local circulation and lymphatic flow. The technique entails the application of a gentle force in the direction of free motion or the challenging of barriers which will allow the release of tension and congestion in the tissues. NOTE. This modality requires the operator to have special training in its techniques. Progress Note order should read: Myofascial release treatment to area, times daily. D. Muscle Energy Treatment (M.E.) This mode of treatment is usually used for restrictions of motion between individual vertebrae, It can also be utilized to relax large muscle groups in the neck or elsewhere on the trunk, The technique utilizes the Golgi tendon reflex, reciprocal inhibition, or direct, ‘muscle pull on a specific bony attachment to restore the normal physiological range of motion at the joints, This modality should be applied gently and should rarely elicit pain. Caution should be used when using this technique with acutely spasmed muscles such as with a cervical whiplash injury. If when performing the technique and the affected muscle/muscle groups is/are being engaged in an isometric contraction there is increased Page 7 of 25