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CERVICAL TRACTION

BY: Lori Mitchell & Sarah Murray

Physiological Effects
  1. Decrease in cervical neuromuscular activity.
  2. Decrease in muscle spasm.
  3. Decrease pain.
  4. Improve blood flow.
  5. Reduction of disc lesion or myofacial adhesions.
Indications
  1. Muscle spasm.
  2. Degenerative disc diseases.
  3. Herniated/protruding intravertebral discs.
  4. Nerve root compression.
  5. Osteoarthritis.
  6. Capsulitis of the vertebral joints.
  7. Pathology of the anterior or posterior longitudinal ligaments.
  8. Management of facet joint impingement or pain.
  9. Jointer hypomobility
Contraindications
  1. Unstable spine.
  2. Vertebral fractures.
  3. Extruded disc fragmentation or rupture.
  4. Spinal cord compression.
  5. Acute strains or sprains.
  6. Joint hypermobility.
  7. Pregnancy.
  8. Conditions in which vertebral flexion is contraindicated.
  9. Conditions which worsen following traction treatments.
  10. Osteoporosis.
Precautions
  1. Cervical traction should never be attempted on conditionsthat have not been evaluated by a physician.
  2. The athlete should be closely monitored.
  3. Treatments should be discontinued if: a) symptoms increase, b) if painor parasthesia is experienced.
Preparation of Athlete
  1. Determine athlete's body weight.
  2. Instruct athlete to remove any earrings, glasses, or anything else thatmay interfere with the halter/harness.
  3. Have athlete lay on the treatment table in the supine position.
  4. Position the unit so that the force of pull runs with the midline ofthe athlete's body.
  5. Secure the halter to the cervical region according to themanufacturer's instructions (note: the athlete should feel the halter snugaround the occipital area, not the chin or any other structure).
  6. Connect the pulley cable to the halter, take up excess slack in pulley.
  7. Align the unit so that the angle of pull places the cervical spine inapproximately 10 - 25 degrees of flexion.
Treatment Setup and Initiation
  1. Adjust all controls to zero.
  2. Choose between intermittent or continuous tension.
  3. Intermittent tension - Adjust ratio of on:off time of treatment. 3:1or 4:1 ration is the most common.
  4. Continuous tension - Tension is constant throughout the treatment.
  5. Adjust tension to 10% of athlete's body weight, not exceed 40 lbs.
  6. Instruct athlete on what to expect and to relax during the treatment.Should be relaxed in both on and off cycles if intermittent traction isapplied.
  7. Set appropriate duration.
  8. Give athlete the emergency off button (panic button). Instruct of useif there is any discomfort or pain.
  9. Treatment time: 1) Can be used for hours at a time, 2) Most commonlygiven for periods between 10 and 20 minutes, 3) Use 5 - 10 minutes forherniated discs, 4) for first time users, start at 5 minutes (want to seehow athlete responds to treatment).
Termination of Treatment
  1. If traction device does not automatically shut off,gradually reduce tension over 3 - 4 duty cycles.
  2. Gain slack in pulley cable and turn unit off.
  3. Instruct athlete to lie still for 5 - 10 minutes. 1) Want the tissuesto approximate gradually, 2) If stand up too quickly, can be detrimental toany benefits received from the traction.
  4. Remove/release halter.
  5. Ask athlete of any perceived benefits or complications derived fromtreatment.
  6. Record information in athlete's file.



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