To use SHA during muscle guarding, place the patient in which position?

To use SHA during muscle guarding, place the patient in which position?

• A. In a position where the muscle is shortened to reduce stretch
• B. In a position near end range of motion
• C. In a position of maximal stretch
• D. In a position of neutral alignment

Answer: (A)

Muscle guarding is the protective reflex where the muscle contracts to splint an injured area. To use a strategy like SHA during guarding, the goal is to reduce the neural drive and mechanical stretch on the muscle so it can relax. Putting the muscle in a shortened position decreases the stretch on its fibers and lowers muscle spindle activation, which reduces reflexive contraction and pain. This makes it easier to progress therapy without provoking guarding. By contrast, placing the limb near end range or in maximal stretch increases stretch and peripheral input, which can intensify guarding. Neutral alignment doesn’t specifically reduce stretch, so it’s less effective for alleviating the protective spasm.

Muscle guarding is the protective reflex where the muscle contracts to splint an injured area. To use a strategy like SHA during guarding, the goal is to reduce the neural drive and mechanical stretch on the muscle so it can relax. Putting the muscle in a shortened position decreases the stretch on its fibers and lowers muscle spindle activation, which reduces reflexive contraction and pain. This makes it easier to progress therapy without provoking guarding. By contrast, placing the limb near end range or in maximal stretch increases stretch and peripheral input, which can intensify guarding. Neutral alignment doesn’t specifically reduce stretch, so it’s less effective for alleviating the protective spasm.