Creep Phenomenon By Firu

Phenomenon Of Creep In Clinical Application

1. PHENOMENON OF CREEP IN
CLINICAL APPLICATION
ByFirdous Hussain F
BPT FINAL YEAR

2. THECONCEPT OFTHE“CREEPPHENOMENON ”
•THE“CREEPEFFECT” ISTHENATURALTENDENCYOFASOLIDSTRUCTURETO
MOULDITSSHAPEACCORDINGTOTHESTRESSPLACEDONIT.
•ANANALOGYISPULLINGONARUBBERBAND. IFYOUSTRETCHTHERUBBER
BANDANDRELEASEITIMMEDIATELY, ITRETAINSITSORIGINALLENGTH
•IFYOUSTRETCHITFORANHOURANDRELEASEIT, THERUBBERBANDWILL
HAVELOSTITSORIGINALLENGTH; ITWOULDHAVESTRETCHEDANDBECAME
LONGER.
•THISISVERYSIMILARTOWHATHAPPENSTOTHETISSUESTRUCTURESIN
OURBODY.

3. THECONCEPT OFTHE“CREEPPHENOMENON ”
•CONNECTIVETISSUESWILLGRADUALLYELONGATE(CREEP) AFTERANINITIAL
ELASTICRESPONSETOACONSTANTTENSILELOADANDTHENGRADUALLY
RETURNSTOTHEIRORIGINALLENGTH(RECOVERY) AFTERTHELOADIS
REMOVED.
•INACLINICALSETTING, THISMIGHTAPPLYTOASTRETCHINGSHORTENED
TISSUE: A CLINICIANAPPLIESCONSTANTFORCEANDTHETISSUE
GRADUALLYELONGATES.
•FORCARTILAGEANDBONE, COMPRESSIVEFORCEISUSEDTOTESTTHE
CREEP, ANDSODEPTHOFINDENTATIONREPRESENTSCREEPANDRECOVERY

4. THECONCEPT OFTHE“CREEPPHENOMENON ”
•WHENYOUSITINASLOUCHED(“BAD”) POSTURE, YOUMAYNOT
FEELANYEFFECTINITIALLY. HOWEVER, AFTERAPERIODOF
STAYINGINTHATPOSTURE, YOURMUSCLES, LIGAMENTS,
CONNECTIVETISSUEBECOMESTRETCHED

5. THECONCEPT OFTHE“CREEPPHENOMENON ”
•THEPOSITIONALORMOVEMENTRECEPTORSINTHESE
STRUCTURESARETRIGGEREDANDTHEYSENDSIGNALSUPTO
YOURBRAIN, WHICHPROCESSESTHEMANDSENDSPAINSIGNALS
BACKTOTHEAREATOALERTYOURBODY.
•NOTALLISLOSTBECAUSEOFTHE“CREEPEFFECT” THOUGH; IT
CANBENEGATEDBYFREQUENTCHANGESINPOSTUREAND
SPECIFICSTRENGTHENINGANDSTRETCHINGEXERCISES.

6. BASICDEFINITIONS
•STRESS :
-INTENSITY OF AN INTERNAL FORCE/
EXTERNAL FORCE
CALCULATION : FORCE / AREA
•STRAIN :
-RELATIVE MEASURE OF THE DEFORMATION
OF AN OBJECT.
CALCULATION:CHANGE INLENGTH /
ORIGINAL LENGTH

7. MECHANICAL PROPERTY DEFINITIONS
•DEFORMATION CANBECLASSIFIEDINTO:
1.ELASTICDEFORMATION.
2.PLASTICDEFORMATION.

8. •ELASTICDEFORMATION
•REVERSIBLECHANGESINSHAPETOAMATERIALDUETOALOAD.
•MATERIALRETURNSTOORIGINALSHAPEWHENLOADIS
REMOVED..
MECHANICAL PROPERTY DEFINITIONS

9. MECHANICAL PROPERTY DEFINITIONS
•PLASTIC DEFORMATION
•IRREVERSIBLE CHANGES IN SHAPE TO A MATERIAL
DUE TO A LOAD.
•MATERIAL DOES NOT RETURN TO ORIGINAL SHAPE
WHEN LOAD IS REMOVED.

10. MECHANICAL PROPERTY DEFINITIONS
CREEP :
•Increased load deformation
with time under constant load.
•IN A CLINICAL SETTING,
THIS MIGHT APPLY TO A
STRETCHING
SHORTENED TISSUE: A
CLINICIAN APPLIES
CONSTANT FORCE AND
THE TISSUE GRADUALLY
ELONGATES.

11. MECHANICAL PROPERTY DEFINITIONS
LOAD RELAXATION ( STRESS –RELAXATION) :
•Decrease in applied stress under conditions of constant strain.
•In a Clinical Setting, A Therapist May Perceive this as a Reduced
Resistance to Stretch ( less force is Required to maintain tissue length)

12. Material Strength: Stress vs Strain
Curve
•Stress strain curve is derived from axially loading an object and
plotting the stress verses strain curve.

13. Material Strength: Stress vs Strain
Curve
•ELASTIC ZONE :
o The zone where a material will return to its original
shape for a given amount of stress.

14. Material Strength: Stress vs Strain
Curve
•PLASTIC ZONE :
o The zone where a material will not return to its
original shape for a given amount of stress.

15. Material Strength: Stress vs Strain
Curve
•BREAKINGPOINT:
oThe object fails and
breaks.

16. Material Strength: Stress vs Strain
Curve
•Yield point :
othetransition
pointbetween
elasticand
plastic
deformation

17. Material Strength: Stress vs Strain
Curve
•YIELD STRENGTH :
o the amount of stress necessary to produce a
specific amount of permanent deformation .

18. CREEP IN CLINICAL APPLICATION
•In 1940’s & Early 1950’s, the Physician JAMES CYRIAX Contributed
much to the development of a system of PHYSICAL EXAMINATION
•He Originated A Concept Of ‘’END FEEL”
•The end of Each Motion at each Joint Is Limited From Further
Movement by Particular Anatomical Structures. Which Can Be
Detected By the Examiner Performing Passive ROM, Thus the
Feeling Experienced By the Examiner is Called “ENDFEEL”
•HARD ENDFEEL ( BONETOBONE)
•FIRM ENDFEEL (MUSCLE,CAPSULE, LIGAMENT)
•SOFT END FEEL ( SOFTTISSUE)

19. FIRM ENDFEEL
•With this type of end feel, there is an abrupt increase in the
resistance ( soft tissue stretching ) that stops further movement
with slight give
•Firm end feels include varying amount of CREEPdepending on
whether the barrier to the end of the motion is the stretching
of
•A ) Muscle
•B ) Capsule
•C ) Ligament

20. FIRM ENDFEEL
•A ) Firm End feel with the MOST CREEP would be Provided by The
Stretch of Muscle Tissue
•Ex: SLR–Hip Flexion With Knee Extension ( Passive Elastic Stretching of
Hamstring Muscles

21. FIRM ENDFEEL
•B) Firm end feel with the MODERATE CREEP would be Provided by The
Stretch of Joint Capsule.
•Ex: Extension Of MCP Joints ( Stretching Of the Anterior Capsule of MCP
Joint

22. FIRM ENDFEEL
•C ) Firm End feel with the LEAST AMOUNT OF CREEP would be Provided
by The Stretch of Ligament
•Ex : Foot Inversion ( Stretching of the Lateral Ligament of the Ankle)

23. CYRIAXCONCEPT
•According To Him,
•A) Deep Transverse Frictions
restore the mobility of the Muscles
•B ) Manipulation Frees a Joint

24. •‘’Mechanical Disturbances of the articular systems
leads to mechanical joint pain & are Best treated by
mechanical means’’
•He classified the Pain Of Mechanical Origin to Three
Syndromes:
•Postural Syndrome
•Dysfunction Syndrome
•Derangement Syndrome
ROBINA. MCKENZIE’SCONCEPT

25. ROBINA. MCKENZIE’SCONCEPT
Postural Syndrome:
•End Range stress of normal structures
•Mechanical Deformations Due To
Stress Eventually Produces Pain
Dysfunction Syndrome:
1.End range stress of shortened structures
2. mechanical deformation when attempting full
movement immediately produce pain
3. may be discogenic,apophyseal,ligamentous,
muscular,aponeurosis,etc

26. ROBINA. MCKENZIE’SCONCEPT
Derangement Syndrome:
1. Anatomical Disruption And/OrDisplacement of structures
2. altered tension in structures within and around disc
3. some structures under increased mechanical defomation
immediately or eventually produce pain

27. CONCLUSIONS: CLINICALAPPLICATIONS
Treatment : Pain Must be Reproduced by Sustaining the Causative
Factor in Order to Confirm the Presence of the syndrome (
Postural Syndrome)
1. Correction of Posture in Sitting
2. Correction of Posture in Standing
3. Correction of Posture in lying
Treatment : Explaining the Imporenceof postural correction and
the goal of stretching in shortened structures
1. Reduction of Derangement
2. Maintenance of Reduction
3. Recovery Of Function
4. Prevention of Recurrence/ Prophylaxis