Wat doet men bij manuele fysiotherapie

Wat doet men bij manuele fysiotherapie

Wat doet manuele fysiotherapie ?

Manuele Fysiotherapie

Het doel van manuele therapie na een whiplash-blessure is het herstellen van de beweeglijkheid van elk mobiel segment van de cervicale wervelkolom en de positie van de gewrichtsdelen ten opzichte van elkaar. Dit kan de pijn verminderen en de algehele mobiliteit van de cervicale wervelkolom herstellen. Manuele therapie mag alleen worden uitgevoerd na uitsluiting van een botletsel of na volledig genezen verwondingen.

Ook bij manuele therapie van de cervicale wervelkolom ligt de patiënt meestal op zijn rug en staat of zit de therapeut achter hem. De therapeut kan verlichting en pijnvermindering bereiken door lichte tractie op de cervicale wervelkolom. Bovendien kan hij de wervelgewrichten terug in een fysiologische positie brengen door lichte tegengestelde druk uit te oefenen.

Welke spieren worden versterkt / hoe wordt dit bereikt?

Na een whiplash-blessure is het belangrijk om vooral de diepe nekspieren en de schouder-nekspieren te versterken om de cervicale wervelkolom te stabiliseren en om hernieuwd trauma door schokkerige bewegingen te voorkomen. Daarom moeten de korte nekspieren, de zogenaamde rug strekkers, die direct naast de wervelkolom lopen, en de segmentale spieren, die van wervellichaam naar wervellichaam lopen, worden versterkt. In de meeste gevallen zijn de nekspieren overbelast of beschadigd door de whiplash-blessure, waardoor ze reactief gespannen of steeds meer verzwakt worden door de verlichtende houding.

Manuele fysiotherapie zachte bewegings- en krachtoefeningen

De fysiotherapeut toont tijdens de therapie zachte bewegings- en krachtoefeningen, die ook als huiswerkprogramma tussen de therapiesessies en daarna dienen te worden uitgevoerd. Je eigen hand kan bijvoorbeeld als weerstand dienen door deze op je voorhoofd te plaatsen en je hoofd naar voren te duwen. Vervolgens wordt de oefening herhaald met de hand op de achterkant van het hoofd, het hoofd wordt naar achteren in de hand geduwd.

De volgende oefening is geschikt om de fijn afstemming van de bewegingen te oefenen: De patiënt zit op een stoel voor een witte muur. Aan zijn hoofd is een hoofdband met laserpointer bevestigd.

Nu kan hij worden gevraagd om verschillende activiteiten uit te voeren, zoals letters op de muur schrijven, een lijn / doolhof volgen of een tweede laserpointerpunt dat door de therapeut wordt bewogen. Houdingstraining in het algemeen is ook belangrijk. De houding begint altijd bij de voeten, niet alleen bij de cervicale wervelkolom.

Van onderaf wordt stabiliteit opgebouwd zodat het hoofd eindelijk stevig op de romp kan zitten. Bij het versterken van het spierstelsel zijn het vooral de vasthoudspieren die moeten worden beïnvloed om de spanningen en spanningen van het dagelijks leven te weerstaan. Hiervoor zijn vooral statische oefeningen geschikt.

In eerste instantie kan dit vanuit rugligging worden getraind: 

De voeten zijn ongeveer op heupbreedte uit elkaar geplaatst, de armen zijn naar rechts en links van het lichaam gestrekt, de handpalmen zijn naar het plafond gedraaid om een ​​externe rotatie van de schouders voort te zetten, wat een opening van de borst en dus een rechte houding. De achterkant van het hoofd ligt met een lange nek op een plat kussen.

Nu wordt de patiënt gevraagd om spanning in het lichaam op te bouwen door de hielen, de lumbale wervelkolom en de achterkant van de handen stevig in het kussen te drukken. Vanuit deze uitgangspositie wordt het hoofd lange tijd naar buiten geduwd, de wervelkolom wordt gesuggereerd en gestrekt. Om extra ruimte en lengte in de cervicale wervelkolom te creëren, wordt de kin iets naar beneden gekanteld richting het decolleté en wordt de kin naar achteren geduwd, als een dubbele kin.

Vaak zorgt deze houding alleen voor ontspanning voor de nek en het hoofd. Om de spieren te versterken, wordt de achterkant van het hoofd stevig in de basis gedrukt met behoud van de lange nek. Om de spanning te ondersteunen en te testen, kan de therapeut nu proberen het kussen onder het hoofd vandaan te trekken.

De patiënt probeert dit te voorkomen door de spanning en druk van het hoofd op de pad. Ter verhoging van het spierstelsel wordt het hoofd met gestrekte nek iets van het kussentje opgetild en op zijn plaats gehouden. De volgende stap is om te proberen de nek op dezelfde manier vanuit een zittende positie te strekken.

Ten slotte kan deze oefening in elke dagelijkse situatie worden uitgevoerd. 

Voor een volgende stabiliteitsoefening zit de patiënt weer rechtop.

Torso, nek en hoofd zijn gestrekt en stabiel. Nu geeft de therapeut met zijn handen op verschillende plaatsen op het hoofd en de schouders weerstand, die de patiënt niet uit zijn positie mag laten komen.

Oefeningen tegen hoofdpijn

Vervorming van de cervicale wervelkolom

Fysiotherapie HWS-syndroom

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