Treatment using these methods is seldom if ever painful and is well received by patients.
Functional methods are suitable for application to the very ill, the extremely acute and the most chronic situations.
Functional Technique Exercises
The exercises which are described are variously derived from the work of Johnston3,5 , Stiles4, Greenman6 , Hoover7, and Bowles1
These experts are definite in their instructions to those attempting to learn to use palpating contacts in ways which will allow the application of functional methods.
- The palpating contact (‘listening hand’) must not move.
- It must not initiate any movement.
- Its presence in contact with the area under assessment/ treatment is simply to derive information from the tissue beneath the skin.
- It needs to be tuned into whatever action is taking place beneath the contact and must temporarily ignore all other sensations such as "superficial tissue texture, skin temperature, skin tension, thickening or doughiness of deep tissues, muscle and fascial tensions, relative positions of bones and range of motion.."
- All these signs should be assessed and evaluated and recorded separately from the functional evaluation which should be focused single-mindedly on tissue response to motion. "It is the deep segmental tissues, the ones that support and position the bones of a segment, and their reaction to normal motion demands that are at the heart of functional technique specificity." (Bowles)
Bowles’ Summary of Functional Methods.
In summary, whatever region, joint or muscle is being evaluated by the listening/palpating hand the following results might occur:
a/ The motive hand (which guides the patients movement) makes a series of motion demands (within normal range) which includes all possible variations. If the response noted in the tissues by the listening hand is ease in all directions then the tissues are functioning normally.
b/ The motive hand makes a series of motion demands which includes all possible variations, however some of the directions of movement produce bind when the demand is within normal physiological ranges. The tissues are responding dysfunctionally.
"Therapy is monitored by the listening hand and fine-tuned information as to what to do next is then fed back to the motive hand. Motion demands are selected which give an increasing response of ease and compliance under the quietly palpating fingers."
The results can be startling, "Once the ease response is elicited it tends to be self-maintaining in response to all normal motion demands. In short,somatic dysfunctions are no longer dysfunctions. there has been a spontaneous release of the holding pattern."
Stiles and Johnston’s Sensitivity Exercise #1
1A.: The time allocation for this exercise is 3 minutes.
Pair up with another person and have them sit as you stand behind them resting your palms and fingers over their upper trapezius muscle, between the base of the neck and shoulder. The object is to evaluate what happens under your hands as your partner takes a deep inhalation. This is not a comparison between inhalation and exhalation, but is meant to help you assess how the areas being palpated respond to inhalation - do they stay easy, or do they bind ? You should specifically not try to define the underlying structures or their status in terms of tone or fibrosity, simply assess the impact, if any, of inhalation on the tissues.