Exam Review - Massage theory Flashcards
What is massage therapy ?
A therapeutic, integral healing relationship where the therapist assists client in restoring, maintaining and enhancing the wellbeing.
What is massage therapy SOP?
SOP
- The assessment of the soft tissue & joints of the body.
- The Treatment & Prevention of physical dysfunction and pain of soft tissues and joints by manipulation to develop maintain, rehabilitate or augment physical function or relieve pain.
Physiological Effects of Massage?
- Calms the mind
- Unblocks energy flow
- Decreased effects of depression/anxiety/stress
List some Reflex Effects from massage.
- Vasodilation of arteries
- Stimulation of peristalsis
- Inc/Dec muscle tone
- Triggers relaxation response
- Soothing/Stimulating effects on muscles
List some mechanical effects.
- Increased Venous Return
- Increased Lymphatic Flow
- Loosening of mucous
- Increased muscle temperature
- Increased ROM
What are some indications for massage?
- Stress reductions
- Postural dysfunctions (Hyperlordosis, Hyperkyphosis, Scoliosis)
- Muscle Spasms
- Trigger points
- Headaches
- Pes Planus (Flat Foot)
What are some injuries you might see as a RMT?
- Wounds/Burns/Scars
- Frozen Shoulder
- Inflammation
- Whiplash
- Contusions (Bruise)
- Strains/Sprains/Dislocations
- Shin splints
What are types of Inflammation a RMT might see?
- IT band syndrome
- Tendonitis
- Plantar Fascitis
- Bursitis
- Carpal Tunnel Syndrome
- Piriformis syndrome
- Thoracic Outlet Syndrome
- TMJ syndrome
What are some Degenerative diseases a RMT might see?
- Degenerative Disc Disorders
- Asthma
- Emphysema
- Bronchitis
What is the Aim for Massage therapy ?
Decrease Sympathetic Nervous System activity (Flight or Fight) to allow relaxation
What are examples of Self-Care recommendations to patients?
- Stretching
- Deep Diaphragmtic Breeathing
Explain what a ContraIndication is ?
Conditions when massage cannot be performed due to high risk of worsening the clients condition.
It is divided:
- General (No Massage at all)
- Local (No massage in the area, affected by this condition)
What is a Precaution?
Conditions where massage is performed but must be modified to the clients condition.
Divided into
- General (Any massage area requires modifying of the techniques)
- Local (Modification of the techniques is required in the area, affected by this condition)
Describe the history of massage and where/when it started.
References started with Hippocrates but the current philosophy derived from Peter H. Ling of Sweden (1776-1839) who developed a systemic form of massage that integrated ancient techniques with anatomy & physiology. That is why it is referred as Swedish Massage
What are the Components of Massage?
- Rate : Pace of massage technique. Faster Rate = Stimulation / Slower Rate = Soothing
- Rhythm : Flow of delivery. Smooth, Even & Consistent
- Direction : Towards the Heart. Each technique follows this except for Stroking
- Duration : How Long a technique, routine or massage is spent (1 hour)
- Pressure: Amount of Force applied to a technique
- Contact: Maintaining Full Contact and what part of the body is used.
What is Consent ?
- A Verbal/Written agreement between two parties to explain what is going to take place.
- Must be obtained voluntary
- Recorded within 24 hours
- Client is given an opportunity to ask questions, if there is a finding of incapacity there must be substitute decision maker
What needs to be discussed in consent ?
Informed Consent must discuss
- Goals/Benefits/Risks
- Duration/Costs/Removal of clothing
- Allergies to oil/lotion or any preferences
- Draping/Pillowing/Comfort Level/Pain Scale/Areas of Body
- Assessment/Re-Assessment & Treatment Plan
- Empowerment: Stopping @ anytime, Change treatment plan
- Questions
- Future massage & hydrotherapy
- Referral to other health care/alternatives
What are the four principle of massage?
- General - Specific - General
- Work in large areas to a number of smaller localized areas and resort back to the larger one
- Start with broader strokes and progress to specific techniques and finish with broader strokes
- Whole hand contact at the beginning and end of routine then perform more precise techniques. Broad full contact at the end and direct towards the heart to ensure venous return and lymphatic drainage
- Superficial - Deep - Superficial
* Depth of pressure should be light and progress to deeper/firmer manipulations once the soft tissues is relaxed and circulation increases and return to light techniques - Proximal - Distal - Proximal
- Heart is the point of reference for direction. Once soothing/opening techniques are completed. Specific deeper massage begins at proximal and progress to distal.
- Then general techniques is applied back towards the heart to reduce congestion and keep the circulatory pathway open
- Peripheral - Central - Peripheral
- Used for treating Acute/Sub-Acute injuries, Scar tissues and pain.
- Aids in removal of toxins and waste from inflammatory process
- Working around affected area and working into the area to promote drainage, healing proccess and manage scar tissue to prevent “Kick Back”
What are the 4 T’s of Palpation ?
- Tone
- Temperature
- Texture
- Tenderness
What are the three causes of Massage-related injuries ?
- The physical results of repetitive motion
- Predisposing characteristics of each therapists body
- Innapropriate practice settings, equipment and expectations
What is Tixotropism?
Starting with light tehcniques and progressing to deeper ones by giving the tissue additional energy.
Explain the Effleurage Techinque
- Gliding manipulation to affect circulation of blood & lymph
- Direction is twards the heart and lymph nodes
- Hands should be relaxed and moulded to body part with pressure no more than 32 mm/HG
- Rate (Soothing or stimulating)
- Be cautious with too much radial or ulnar deviation
Explain the effects of Effleurage
- The Circulatory
- Inc Venous return & stroke volume
- Assistance of arterial blood flow, cellullar nutrition and removal of waste products
- Reflex effects of vasodilation & inc. capillary permeability
- Lymphatics
* Mechanical drainage of lymphatic vessels - Muscles
- Effects on efficiency and recovery
- Reflex effect of soothing or stimulating
- Nerves
- Increasing circulation to nerves
- Reflex soothing or stimulation effect, depend on rate & rhythm.
Explain what Petrissage is and its characteristics
- Means to “knead”
- Tissues are compressed and released in rhythmical fashion so the layers are kneaded and and stretched relative to each other.
- Direction is towards the centre
- Rate depends on desired effects (Soothing/stimulating, rate, pressure and degree of stretch)
Explain the different types of petrissage?
Box Kneading
- Performed on the limbs only (calves) with the hands placed on internal and exteneral side of the limb while they are producing circulatory motions and pressing one towards other.
Broading
- Performed on the same area but the circulatory motions are pulling the tissues apart
Muscle Squeezing
- Milking Action with pressure exerted between heel of hand and fingers.
- Static technique - No movement applied
Picking up
- Tissues are lifted away from underlying strcutures
- Applied with movement along the muscles and pressure is maintained
Wringing
- Transverse motion with hands beginnning on opposite sides of the part, hands glide past one another compressing the tissues
Sking rolling
- Skin and subcutatneous tissues rolled between thumbs and fingers
Muscle Stripping
- Slow steady stroke following the direction of the muscle fibres
Effects of Petrissage Techniques
- Circulatory and Lymphatics
* Stimulates active muscle pump thus increases circulation in any tissues - Muscular
- Loosening and stretching muscle fibres and fascias
- Inc/Dec muscle tone
- Skin
* Decrease adhesions between cutaneous and subcutaneous layers - Nerves
* Reflex soothing or stimulating effect depends on rate
*** Prepare tissues for specific advanced techniques (Trigger Points therapy, Frictions and joint mobilizations)
Explain the Effects/ Uses & CI of Stroking techniques
Effects
- Excite or soothe nervous system
- Incr/Decr muscle tone
Uses
- Desired changes of nerve firing
- Conditions when mechanical pressure is CI
- To soothe after mechanical manipulation
CI
- Skin Infections or open Lesion
Explain the Technique, Effects, Uses and CI of Rocking or Shaking
Technique
- Rocking to create movement around the joint
- Shaking to move the soft tissue
Effects
- Soothing effect
- Nervous system: Stimulate vestibular reflexes, producing soothing/stress reduction
- Digestion: Stimulation of digestive process
Uses
- Stress reducing technique
- Sluggish Digestive, Absorptive or Eliminatroy function (Of constipation)
- Evaluation of muscle spasticity
CI & Precaution
- Precaution for clients having joint subluxation/dislocation/joint disease
- Inflammation or effusion or compromised integrity of the adjoining soft tissue.
Explain the Effects, Techniques and Contraindications of Shaking
Effects
- Stimulation effect (Sympathetic)
- Stimulates nerves, muscles, excitatory effects
- Loosen joints/Stretches periarticular structures
- Loosen Adherent Mucous in the lungs, bronchi and sinuses
- Stimulates venous return and lymphatic drainage
Uses
- Conditions require increase muscle tone and motion response
- Respiratory conditions
- Making the nerves system alert
CI
- All general and local apply
Explain the Techniques, effects, types and CI of Vibration massage
Techniques
- Static vibrations - whole hand is continuous contact with the clients body without sliding over the clients skin
- Running vibrations - whole hand is continuous contact with the clients body but with a slight glide over the skin
Effects
- Fine : Soothing effect, temporary decrease of the muscle tone, pain management effect. Useful to facilitate digestive and elimination process
- Coarse : Stimulating effects , temporarily increase of the muscle tone, increasing somating perception, faciliation of the regeneration of the injured nerve/lower motor neurons, loosing up the mucous in the nasal sinuses.
What are the different type of Tapotement ?
Light Tapotement
- Pincement
Pinching between thumb and forefingers
- Tapping
Alternative application of fingertips
- Point hacking
Simultaneous applications of fingertips
- Light Hacking
Ulnar border of hand, dorsal or ulnar surfaces of third, fourth and fifth fingers
Heavy Tapotement
- Clapping (slapping)
Slapping with full palmar surface
- Cupping
Fingers flexed to create slgiht vacuum in palm (Dippiest Tapotement technique)
- Heavy Hacking
Ulnar border of hand, fingers are held rigidly
- Beating
Soft fist, Dorsal surface of fingers and heel of hand
- Pounding
Soft fist, ulnar border of fist
What are the effects of Tapotement ?
- Circulatory
Local Hyperaemia (Increasing local circulation
- Muscularly
Temporarily increase of muscle tone (Stretch reflex)
Decrease tone, if application is prolonged and deep
Loosening and softening fibrosed tissue
- Nerves
Stimulation of nerves conductivity
Facilitate nerve (Neurons) regeneration after injruy (Severe nerve, polio)
- Respiratory
Loosens adherent mucus in lungs and promotes drainage
Improves gaseous exchange
What are the Uses & CI’s for Tapotement ?
Uses
- Condition requiring stimulation
- Respiratory conditions
- Where local increase of circulation is desired
- Stimulate peristalsis
CI
- Fractured bones & Frail Chest (Osteoporosis, Bone Cancer)
- Insomnia
- Neuritis and Neuralgia
- Hemmorhage conditions & Unstable cardiac conditions
- Skin lesions and spastic paralyses
DO NOT perform over Kidneys, Abdomen, Bony prominence, Atrophied muscles or pregnancy.
What is the Alimentary Canal?
The group of organs that start from the mouth to the rectum and take part of digestion.
What are some key benefits of abdominal massage ?
- General improvement in blood circulation benefits the blood vessels in the abdominal cavity
- The vein transport the blood depleted of oxygen to the heart more quickly and the arteries respond by supplying the body cells with fresh oxygen blood.
- Liver, Gall-Bladder and pancreas receive large oxygen & nutrients & release metabolic waste products like carbonic acid in the blood stream
Explain how to perform abdominal massage ?
- Person is supine, knees supported, abdomen is exposed with chest and pelvis draped
- Warm the Fascia, employ strokes from descending colon, around the transverse and ascending colon
- Use softer strokes and light pressure on the abdominal walls and and intensify the massage strokes with gentle vibrations during exhalation
*
What are some precautions and contraindications for abdominal massage?
- Should be avoided after meals (No longer 2-3 hours before)
- Bladder should not be full (Empty bladder)
- Avoided if bleeding stomach, brain or lungs
- Never during menstruation
- Inflammation of uterus, bladder, ovaries and fallopian tubes
- Modified in case of hernia
- Avoided on patients with high blood pressure
What is acute constipation ?
- Constipation lasting no more than a few hours to a few days.
- Change from normal bowel habits that is due to stres, changes in schedule, before or after menstruation, side effects of medications and bowel obstructions
What is Chronic Constipation
- An on going problem for the lcient which may be constant or recurring
- Due to irregular schedule or resisting the urger
What is spastic constipation ?
- Hypertonicity of the colon that results in loose/stringy feces
- Due to sympathetic stress response decreasing intestinal blood flow and motility resulting in build up of toxins causing irritation (Spastic colon)
What is Atonic Constipation ?
- Lack of tone in the colon causing hard, lumpy feces
- Common in elderly/bedridden people who resist to defecate
- Carthartic Colon/Lazy Bowel can occur from proplonged reliance on laxatives or enemas (Rectal injections) that lead to thickening/fibrosis of muscle wall and electrolyte imbalance causing seepage of fecal liquid
- BOTH Spastic and Atonic Constipation can occur in one person.
What is Obstructive Constipation ?
Blockage of the colon - considered MEDICAL EMERGENCY
What are the 2 categories of a healthy function of the colon?
- Recycling of Nutrients
- Formation and elimination of stool
Explain how the body recycles nutrients in the colon
- High metabolic activty of the gut flora and absorption of water & solutes - dehydrating colonic contents to form stool
- During digestions, food mixes with bile salts, enzymes, gastrointestinal and hepatobiliary-pancreatic secretions
- Small Intestine absorbs 95% of bile salts, nutrients and fluid
- The Ileum (Last part of SI) is rich in water, nutrients, proteins and Carbs
- Strongest absorptive activty occurs in the ascending colon
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Explain the second category “Formation and Elimination of Stool”.
- Formation of stool is dependent on (Dietary Fibre) through the GI tract. Fibre is a major factor of bacterial fermentation in the colon.
- Poorly fermented/indigestible fibers increase bulk and speed up transit time through the colon
- Easy digested fibres is completely fermented little bulk and slows down transit time of feces through bowel.
- A diet high in water, insoluble, poorly fermented/indigestible fibers can decrease the likelihood of diseases (Constipation, Colon cancer and Diverticulosis) from happening.
What is the difference between the ascending colon and the descending colon?
- The Ascending colon has strong absorptive capacity - The cecum and Ascending colon is known the “Fermentation Chamber” where the bacteria is most metabolically active
- The Descending Colon Site of storage and remaining dehydration of the stool
What is the difference between Autonomic-NS , PS-NS and S-NS
- A-NS : Storage and Excretion of stool
- P-NS : Increase Peristaltic activity in the colon and inhibit rectum from releasing contents
- S-NS : Decrease Peristaltic activty in the colon and stimulate rectume to release contents.
*
Explain Peristalsis
- Involuntary wavelike movement of smooth muscle
- The Ascending colon goes through antiperistalsis back towards the cecum
- Descending colon undergo Tonic Contraction propelled toward the rectum to separate the contents in globular masses.
- Mass Peristalsis produces propulsvie/retropulsive contractions with frequent activity after meals.
What is the Rebound test ?
- Client is supine with knee and hips flexed, palpate 1/3 from ASIS in line with umbilicus and apply slow deep pressure with every breath.
- A positive rebound test indicated by sharp, sever pain upon the pressure release requires immediate medical attention
What are CI for Abdominal massage ?
- Inflammatory Bowel disease
- Crohns disease
- Ulcerative Colitis
What are the short term & long terms AIMS for Abdominal massage?
Short term
- Decrease SNS response, pain, discomfort and abdominal congestion
- Increase Peristalsis and full diaphragmatic breathing
Long Term
- Reduce headaches
- Educate client stress reduction, diet and activity
- Address posture, antacid and laxative use
How would you perform a massage with someone who has Spastic constipation ?
- Aim is to decrease sympathetic nervous system so should be slow, deep and soothing
- Spend more time on back and other relaxing areas
- Encourage deep breathing
How you apply a massage for Atonic Constipation ?
- Requires mechanical movement of feces
- Encourage diaphragmatic breathing, use vibrations from cecum to sigmoid colon.
- Overhand effleurage in direction of peristalsis
- Fingertip kneading begin at sigmoid colon and move along colon and in direction of peristalsis
- Tapotement light and ulnar border wringing.
What is Irritable Bowel Syndrome (IBS) ?
- A disorder of motility (Rhythmic peristalsis) in small/large intestines resulting from the digestive tracts reaction to daily stressors and dietary patterns.
- Rapid changes in speed/coordination of intestines&colons normal peristaltic action causes obstructions of flow of stool and gas. As a result it causes pain, bloating and cramping
- A BENIGN G.I disorder (Unline Crohns and Ulcerative Colitis)
- Does NOT affect life span, nutrient absorption, or intestinal tract.
- Food is a aggravating factor causing flare up and remissions
- Most common, Affects woman more and occurs early adulthood and may onset at 45
Explain the technique for Pre-Event sport massage
- Stimulating, superficial, fast-placed and rhythmic massage lasting only 10-15 minutes.
- Emphasis is on the muscles used in the sport and prepare is perfect physically
- Massage techniques that require recovery time or painful is strictly CI.
- Focus on circulation enhancement without overworking the muscle
- Should be general, non-specific, light and warming. Avoid friction/Deep heavy strokes
Explain the techniques for Inter-competition massage
- Given during the breaks in the event, concentrates on muscles that are about to be used on the event.
- Short, light, relaxing and decrease acute muscle soreness (DOMS) and lactic acid that develop 12-24 hours after activity.
- DOMS can be prevented with a relaxation massage with a lot of long effleurage strokes and be performed 1-2 hours after activity.
Explain the technique of Post-event massage
- Treatment massage to reduce muscle tensions, minimize swelling and soreness, encourage relaxation and reduce recovery time
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Explain the common course of the inflammatory process
Acute (24-72 Hours)
- Restricted motion inflammatory stage
- Seen before the resistance
Subacute (3-21 days)
- Controlled motion stage
- Pain is seen together with resistance
Early Chronic (21-60 days)
- Remodelling stage
- Pain is seen after resistance
Late Chronic (60-360 days)
- Maturation stage
- Pain is seen after resistance
What is the function of the lymph nodes ?
- Act as filters with reticular connective tissue filled with lymphocytes that collect and destroy bacteria and viruses
- Throughout an infection lymphocytes multiply rapidly and produce characteristics swlling of lymph nodes.
