Postisometric Relaxation (Pir)

Manual therapy should begin with a massage of the patient's soft tissues. The massage is performed with force, but without causing pain. It is necessary to take into account the condition of the patient's muscles (hypo- or hypertonicity), as well as his general condition.

The main task of the massage therapist is to prepare the motor segment for treatment, relaxing the surrounding muscles as much as possible. Therefore, muscle massage precedes manual therapy techniques such as mobilization and manipulation.

Massage techniques must be performed carefully, otherwise muscle spasms may occur, worsening the patient's condition. Shock vibration techniques that increase blood flow to soft tissues and cause compression of nerves are not recommended.

Before manual therapy, pain and spasm should be eliminated and the muscle should be stretched. For this purpose, post-isometric relaxation (PIR) with massage is used.

PIR occurs after muscle contraction. To do this, apply a slight resistance to it. It can be created with the palm, the second hand fixes the patient.

The patient moves against resistance while inhaling for 5-10 seconds. Then, as you exhale, the specialist makes a passive movement in the opposite direction. PIR is repeated 2-7 times.

PIR on the neck is performed carefully so as not to injure this mobile part of the spine. In a sitting position, the head is pulled up with the elbows together or with one hand, holding the chin on the elbow. In a lying position, the head is pulled back by the chin and the back of the head.

On the thoracic region, PIR of the respiratory muscles is performed in a lateral position, and on the middle and lower thoracic regions in a sitting position.

On the lumbosacral region, in a lying position, pull your legs towards you or move your body and legs back. Separate stretching of the legs with emphasis on the pelvis is also used. Before manipulation, use flexion at the lower back with tension on the shins.

PIR prepares the motor segment for manual therapy and is used for acute pain and in weakened patients.