Chapter 10 Test Carries Class Flashcards
What is soft tissue deformation
Change in shape of soft tissue through external or internal forces
Examples of external forces used to create soft tissue deformations
•compressive forces/ compression
•tensile forces/ tension
•twisting forces/ torsion
•shearing forces
Examples of internal soft tissue deformation
•gravity
•poor body mechanics
What happens when you have internal soft tissue deformation
Internal forces may result in muscle tension from the force of gravity pulling on the tissues
Poor body mechanics may cause soft tissue to tighten, shorten, weaken or lengthen resulting in possible nerve compression, pain or dysfunction
What happens when you apply external forces to deform soft tissue
External forces may be applied therapeutically to positively affect soft tissue structures
What soft tissues are affected by applying therapeutic forces
•skin
•subcutaneous fascia
•deep fascia
•myofascia
•muscle
•as well as nerves, nerve endings, blood vessels, and lymph associated with those soft tissues
What can therapist use to apply compression forces?
Fingers
Palms
Entire hand
Fist
Forearm
How can compression be used as an assessment tool?
May be used as an assessment tool to examine…
Repetivity
Resistance
Tension
Tissue density
Or mobility of tissue
Compression forces can be used to?
Enhance local circulation
May sedate/stimulate tissue
Override nerve impulses
Separate fascia
Initial effect of compression forces?
Press/reduce space between structures
Secondary effect of compression forces?
Rebound/opening/expanding tissue
Can passively shorten or compress a muscle
What is Tensile force/tension
Opposite of compression used to elongate tissue by pulling layers of tissue apart from each other
How to apply tension forces?
Engaging tissue with two hand + moving hands away from each other
Using little to no lubricant
This can be applied by..
Tractioning
Pulling
Stretching
Or lengthening the targeted tissues
What happens to the tissues and muscles when therapist applies tension forces?
Elongate or stretch tissue between hands
Can be used to separate or stretch muscle fibers or to enhance the elasticity of facia and other soft tissue
Tension forces helps?
Elongate shortened tissues
Reduce adhesions
Improve ROM
Improves elasticity of fascia
What is muscle tension?
The result of increased motor nerve activity, causing the muscle to contract or increase its tone
Extreme or sudden tensile force on soft tissues?
•Is a common cause of injuries such as
•Ligament sprains
•Muscle strains
•Nerve traction injuries
What does Twisting forces/Torsion/torque do to the tissues? How?
Deforms tissues by shifting structures against each other
(Compressing and twisting one end of structure in one for while other end is help or compressed twisting in opposite direction)
Twisting forces/torsion or torque techniques include?
Kneading and wringing movements
Twisting/ torsion methods help?
Break up adhesive bonds between tissues
Enhance local circulation
Make muscle more pliable
What does Shearing forces do to tissue
Deforms tissue by shifting different structures agains each other
How to apply shearing forces?
Frictioning techniques
By using fingers pushed deeply and moving back/forth or circular movements
Shearing forces help?
•Generate heat
•Create therapeutic inflammation that warms the connective tissue, thus helping increase its pliability
•Helps reduce adhesions
Reorganize collagen and fiber alignment
What are the 7 common massage methods
• static
• gliding
• torsion
• shearing
• oscillating
• percussive
• joint movement
How to apply Static method?
•Hands are positioned + held for a fixed length of time
•Can gently rest hand on body or pressing into trigger point or supporting body
Static method helps?
•Helps establish trust (good opener)
•Helps create stillness
•Sedate or stimulate nervous system
4 Types of static methods?
•Stationary touch
•Ishemic compression
•Holding
•METS
How to apply gliding methods
Applied with a smooth continuous motion that do not lose contact with clients skin (except for energy or aura strokes)
Lighter gliding methods help?
•Apply Lubricant evenly
•Warm the tissues
•Introduce the client to deeper techniques
•Feel pleasurable
•Stimulates the parasympathetic nervous system response, which promotes relaxation
Deeper gliding methods help?
Deform tissue with tensile, shearing + compressive forces
Therapist uses gliding methods to distinguish?
One type of tissue from another
Detect texture, density and tension
Types of gliding methods?
Aura stroking
Feather stroking
Effleurage
Light, medium, or Deep gliding
Torsion methods
Deforms tissue by compressing/twisting
Torsion methods are used to?
Loosen/soften superficial tissue
Broadens + stretches fascia
Torsion methods help?
Enhance local circulation
Making tissue more pliable by loosening adhered fibers
Types of torsion methods?
Skin rolling
Fulling
Wringing
Petrissage (kneading)
Shearing methods
Pulling/moving perpendicular against each other
Shearing methods helps?
Producing heat
Increase blood flow
Stretch/broaden tissue
Reduce adhesions
Types of shearing methods
Circular
Cross fiber
Linear friction
Oscillating methods
Deform soft tissue with momentum created by back and forth vibrating or rocking movements
Benefits of oscillating methods?
Stimulating/relaxing nervous system
Loosening muscles
Stimulating peristalsis
Release emotion holding
Lower tension in muscles
Create movement/ open joints
Reduce tension on attachments
Revealing holding patterns
Moving stagnant energy
Types of oscillating methods?
Vibrating
Shaking
Rocking
Jostling
Percussive methods
Rapid rhythmic contact
Percussive methods help
Initially stimulate
Prolonged will relax tissue (sedate)
Warm the muscles
Stimulate nervous system
Types of percussive methods
Tapping
Slapping
Cupping
Hacking
Beating
Joint movements includes
Passive joint movements
Passive stretching
Active joint movements
Active resisted
Active assisted
ROM techniques
Types of joint movements
MET- muscle energy techniques
PNF- proprioceptive neuromuscular facilitation techniques
Joint movement methods encourage
•More freedom of movement by stretching muscle and fascia
•Renewing bodies awareness of movement potential
•Stimulating production of synovial fluid
•Stimulate lymph and blood flow in area
Factors that influence massage strokes
Intention
Direction
Speed
Length
Duration
Rhythm
Pressure
Therapeutic intention
•Having a desired goal when performing a certain technique
•Mindfulness of treatment options that are chosen will affect outcome of massage
• intent of massage is determined pre assessment + interview + influenced by wishes/needs of client
Engaging the tissues
Working with and Into various layers of soft tissue
Touch is noninvasive + evokes sensitivity + communication with the tissue
Direction of strokes toward the heart help
•Centripal- strokes towards the heart
•Enhance blood and lymph circulation
•Reduce edema
•Relaxing + soothing
Direction of stokes away from the heart helps
Centri fugal- strokes away from heart
Stimulating + energizing
Direction of strokes across the fiber
Stretch + soften adhesions
What is edema
Excess fluid in the interstitial spaces
Quicker strokes help
Stimulate
Slower stokes help?
Relax
Rhythm of massage
Steady + slightly slower then clients breathing pace - relaxation massage
More upbeat rhythm - sport massage
What is Adhesions
A bond of scar tissue that joins two surfaces of the body that are usually separate (stuck together)
What is scar tissue
An area of fibrous tissue that replace normal skin after injury
Superficial touch helps
Reducing pain
Lower blood pressure
Controlling nervous irritability
Main goal of superficial touch?
Provide comfort + calming connection
Static touch with deep pressure helps?
Sooth muscle spasms
Relaxing pain and reflex areas
Stress points
Trigger points in muscles
Feather stroking (nerve stroking) helps
2/3 strokes Slightly stimulate the nerves
More repetitions have more of a sedating response
Superficial gliding helps?
Overcome fatigue/restlessness
Soothing to nervous or irritated people
Benefits of deep gliding
Shearing/elongating effect on muscles and fascia
Enhance local fluid movement
Increase relaxation
Palpating deeper tissue
Kneading/petrissage
Deforms tissue by compressing + twisting
Kneading/petrissage helps
Enhance fluid movement
Soften + broaden superficial tissue
Reduce adhesions
Stretch muscle and fascia
Reduce atrophy
Enhance muscle tone
What is atrophy?
Muscle shrinks from not using it
Skin rolling helps?
Warms
Stretches underlaying fascia
Begins to separate adhesions between fascial sheaths
Superficial shearing friction helps?
Warm superficial tissues
Stimulate superficial circulation
Deep shearing friction helps?
•Flatten/broaden/stretch/separate tissue
•Produce heat
•Soften adhesions
•Aids in absorption of fluid around the joint
•Increase metabolic activity
•Adding heat + energy also affects the connective tissues surrounding muscle making it more pliable
What is hyperemia
Hyper-increase or excessive
emia-blood
Increased blood in area of the body
What’s fibrosis
Thickening or scarring of the tissue
Circular shearing friction helps
Produce heat
Stretch and loosen fascia
Can also palpate an area when assessing underlying tissues
What are the two types of Directional friction?
Cross fiber
Longitudinal friction
Cross fiber friction helps
Broaden, separate and align fibrous tissues
Break up adhesions
Soften scar tissue
Rehabilitation of fibrous tissue injuries
Ways to apply cross fiber friction?
•Usually applied with finger tips or thumbs
•Stroke is broad enough +deep enough to reach targeted tissue
•When massaging fibrous band stroke is short so it just snaps across the fiber
•Another way to apply is to compress and move the limb (good for joints)
Cross fiber friction also known as?
Transverse friction
Using cross fiber friction while fibrous tissue Injury is healing helps?
Promotes formation of elastic fibrous tissue
Reduces the formation of fibrosis and scar tissue
This helps so that the healed Injury retains its original strength and pliability
Using cross fiber friction on old injury sites help?
Break down some adhesion’s and fibrosis
Increasing pliability and mobility
Reducing chance to re-injury
Longitudinal friction is intended to?
Stretch tissue
Align collagen fibrils within fascia
Effects and benefits of Torsion methods
•Superficial friction causes superficial hyperemia
•Produces heat in the skin and superficial tissues
•Stretches, broadens and loosens tissues
•Break down connective tissue adhesions
•Increase pliability of tissue
•Cause mild therapeutic inflammation
•Promotes more pliable scar formation
How is Rolling accomplish?
Rapid back and forth movement with hands where flesh is rolled around axis (imaginary centre line of a body part)
Intention of rolling?
Warm tissue
Relax tissue
Encourages deep muscle relaxation
How is Chucking accomplished?
Grasping flesh firmly + moving it up and down along the bone
How is Compression accomplished
Rhythmic pressing movements directed into muscle (rhythmic pumping)
Compression helps?
Bring more blood and fluid to tissue
Cause enhance circulation and lasting hyperemia in the tissue
(Popular pre-event sports massages)
Shaking methods help?
Help client release tension
Can help therapist tell where client is storing tension
If an area is ridged it indicates?
Tension
How to apply jostling
Most effective after muscles have been exerted (workout/competition)
Muscles are shortened + relaxed, grasp across entire muscle, lift slightly away * shake quickly
How to apply rocking
Body part is pushed away and slightly allowed to roll back
Rocking helps
Sooth and relax tense muscles
How to apply Vibration
Continuous shaking or trembling movement
Vibration is used to?
•When applied for long periods of time with pressure can anesthetize/numb or Desensitize an area
•When applied lightly it’s relaxing and releases tension
How to apply Percussive methods/ tapotment
Quick striking manipulations such as tapping, beating, slapping
Percussive methods help?
Highly stimulating
Tone muscle
Impart a healthy glow
Muscle first contracts then relaxes
How to apply Tapping?
With finger tips
Most superficial percussive method
Used over delicate or sensitive areas
How to apply Cupping?
With cupped palm of hand
Usually over posterior rib cage
What does cupping help?
Help bring up lung congestion
How to apply slapping
Flattened palm or fingers
Slapping methods help?
Very stimulating
Enhances circulation
Gives “glow” to area
How to apply hacking
A rapid striking movement using the side of hand
Hacking helps?
Encourage relaxation
Encourage local circulation
Help stimulate nerve responses in muscles Helping firm them
How to apply Beating
This is the heaviest and deepest form of percussion (but force is never heavy or hard)
Hands are held in lose fists + striking movement
Initial Effects and benefits of percussion
Stimulating
Prolonged effects and benefits of percussion methods?
Encourages relaxation
Have an anesthetic effect on some nerve endings
Deeper application of percussion effects and benefits
Cause vasodilation
Increase circulation
What is vasodilation?
The widening of blood vessels as a result of the relaxation of the blood vessels muscular walls
How to apply passive joint movements? (PJM)
•Client remains relaxed + allows practitioner to stretch + move the part of the body
•Always support the limb + move it in a normal moving pattern
•If it is to asses only move to the point of resistance (note the extent and quality of movement)
Passive joint movements help
Help practitioner asses the ROM of body part
Gently stretches the fibrous connective tissue
Improve joint mobility
If the passive joint movement is therapeutic you should?
Challenge the ROM by slightly extending or pushing into the end of the movement
How to apply Active joint movement
•Client moves the joints without any intervention from therapist
•Can be used as an assessment tool if any limitations exist
How to apply Active assistive joint movement
Done by moving limb passively through the desired movement, therapist assisted and repeated several times
Active assistive helps?
Restore mobility to an injured limb
Used when client cannot move a limb to its full ROM
How to apply Active resisted joint movement?
Movement made by client + resisted by therapist
What does active resisted movements help?
mobility
flexibility
strength
What are Anatomical barriers
Limit movement (ROM) because of a physical structure of the joint. Can result in damage if go beyond this barrier
What are physiological barriers?
•Can be the anatomic barrier
Due to bone to bone (elbow)
•Can be due to soft tissue approximation (flexion of elbow, biceps press agains forearm restricting further movement)
•Sometimes due to pull on ligaments (hypertension of hips)
What are Pathological barriers?
Same as physiological but occurs either before end of ROM or is accompanied by pain or discomfort that will restrict movement
(Tense muscle, injury, scar tissue, inflammation can restrict ROM)
What are End feels
•The change in the quality of movement from the first sense of resistance to the extent of the physiologic or anatomic barrier
•Good assessment tool
What is Hard end feel
Bone to bone (extension on elbow)
What is soft end feel
The soft tissue prevents further movement (knee flexion)
What is empty end feel
The restriction of the joint movement doesn’t meet its full ROM due to pain
Hard, soft end feel without pain indicates?
Normal healthy tissue
Encountering a hard end feel before the normal physiological barrier indicates?
Abnormal function or empty end feel
A soft end feel before normal physiological barrier could indicate?
Restriction in muscle, fascia or neuromuscular guarding
Ankle joint play flexion
Out and pointed
Ankle joint play dorsiflexion
Up and towards self
Ankle joint play inflexion
Twist inward
Ankle joint play efflexion
Twist outward
Hip joint play
Lateral + medial rotation
Shoulder joint play horizontal abduction
Flexion /up
Shoulder joint play horizontal aduction
Extension/ back
Scapula stretches laying prone
Pulling back / pushing in
Medial + lateral rotation Scapula stretches laying prone
Rotate arm up and out
Rotate arm up and back
Scapula stretched abduction + aduction
Out and up and down
Neck joint play in prone
Flexion
Chin down pushing head upward
Neck joint play in prone
Extension
Chin back + arm supporting neck
Neck joint play in prone
Lateral rotations?
?
Neck joint play in prone
Lateral extensions
Cross arms 1 on head other on shoulder and push slightly
Neck joint play in prone
Lateral extensions
Cross arms 1 on head other on shoulder and push slightly
Static methods
What is stationary touch
Lightly touching the skin so that no pressure or movement is applied to the underlying soft tissue
Static methods
Ischemic compression
Deliberately increase the blockage of blood to an area so that upon release there will be a resurgence of blood
Static touch
MET
Uses muscles energy in the form of gentle isometric contractions to relax and lengthen the muscle
