Ankle pulling is traditionally a manual traction technique performed by physical therapists to decompress the spine and relieve nerve and vertebrae pressure. Vincent Zarcone, a physical therapist at the Veterans Affairs Medical Center in Batvia, New York, devised an efficient mechanical way to perform the ankle-pulling technique without overexerting himself in the process. Patients lie both prone and supine on a traction table with padded ankle harnesses secured around their ankles. The harnesses are attached to a traction unit that pulls against the body weight of the patient. Patient comfort is facilitated by pillows placed under the ankles, lower legs or feet.
Lumbar traction stretches the lower back in an attempt to increase patient mobility and alleviate pain. Mechanical traction employs halters, harnesses and hand grips to support stability on motorized split-traction tables. As traction tables are extended, spinal vertebrae slowly pull apart and disc positions readjust. On the whole, mechanical traction tables apply motorized pulling to many of the same techniques that are strenuous for physical therapists and osteopathic clinicians when done manually.
A second form of mechanical lumbar traction involves the patient's assuming the Fowler's position on a motorized split-traction table. The Fowler's position is executed when a patient is lying flat on his back with his legs supported on a stool. The knees and hips stay flexed the entire time. The therapist drapes a harness around the upper body to force a stable position. The stool supports the weight of the patient's calves and thighs to prevent spinal bending while another harness goes around the pelvis. The table is slowly extended to enable traction.
Hand Grip Use
The use of hand grips during traction places upper body stabilization control in the hands of the patient and are used in lieu of a chest harness. Patients lie face down on a traction table wearing a pelvic harness. As with other mechanical lumbar traction techniques, the traction table is extended until the desired level of tension is reached. The difference with hand grips is that patients hold onto them to support the positioning of their torsos during the process.
Adjunct TENS Therapy
A mechanical device known as a transcutaneous nerve stimulation, or TENS, device is often used in conjunction with traction tables. Transcutaneous nerve stimulation machines require that lead wires and electrodes be attached to the patient's body during traction. Electrical stimulation delivered by TENS machines stimulates myelinated nerve fibers in the back while pressure is relieved from nerves by traction. According to Care Rehab, a physical therapy and rehabilitation product vendor, the combination of electrical and tension mechanics helps alleviate pain during traction treatment.
- The Spinal Columns Network: Lumbar Traction
- Advance for Physical Therapy and Rehab Medicine: A New Look at Lumbar Traction; Vincent Zarcone; April 3, 2000
- "Australian Journal of Physiotherapy"; Loads in the Lumbar Spine During Traction Therapy; Raymond Y.W. Lee and John H. Evans; 2001
- Excellus Health Plan Inc.; Medical Policy; Subject: Lumbar Traction: Vertebral Axial Decompression and Home Lumbar Traction Devices
- Care Rehab: Clinical Resource Series -- TENS Protocols
- Photo Credit Comstock/Comstock/Getty Images