How to Perform a Lower Extremity Massage - Class 6 Flashcards
what is an edema massage performed for
edematous tissues of mechanical origin
how should we position the pt
LE elevated above the heart
supine
prone
supine –> positioning
preferred position
w/ entire extremity elevated
what should we do with supine positioning
fill in the gaps
spine in neutral
drape every area not being massaged
when is prone positioning utilized
when deemed necessary to massage posterior LE muscles
what should we do in prone position
ankles should be kept in neutral DF/PF
entire LE cannot be elevated
drape every area not being massaged
why cant the entire LE be elevated
secondary to protecting lumbar spine/pelvis from increased lordosis/anterior tilt
what should we do before the massage
take dorsalis pedis pulse to determine blood flow patency
what should we do first
clear proximal joints with effleurage (clearing) and petrissage (kneading)
what joints do we clear
hip joint
knee
what strokes do we use to clear proximal joints
long clearing strokes
kneading petrissage
long superficial clearing strokes
long clearing strokes –> hip
from below hip to above hip
distal to proximal directions
kneading petrissage strokes –> hips
along the quads, hamstrings, hip ADD/ABD muscles
long superficial clearing strokes –> hip
to push everything into circulation
long clearing strokes –> knee
from below the knee to above the knee
distal to proximal
kneading petrissage strokes –> knee
along the proximal anterior and posterior lower leg
long superficial clearing strokes –> knee
to push everything into circulation
how do we open our massage
w/ long effleurage/clearing strokes
opening can be..
1 part
2 parts
1 part opening
from toes to hip
2 part opening
from toes to knee
then
below knee to hip
what should we make sure at opening
covered all aspects of the LE
how do we start our opening
superficial strokes (effleurage strokes) along anterior tibails and gastroc regions
distally to proximally
what strokes should we use during our opening
clearing
bilateral tree
shingling
horizonal strokes
what is the 2nd step in our opening
MFR skin strokes
where do we do the MFR skin strokes
along anterior tibial and posterior gastroc regions/scar mobilization
what strokes do we use in the MFR skin portion
skin glides
finger slides
direct and indirect techniques
how do we continue our massage after opening the massage
continue along anterior and posterior lower leg
move deeper to muscular strokes and NM techniques
muscular strokes/NM techniques are done along the
anterior lower leg
posterior lower leg
muscular strokes/NM techniques –> anterior lower leg
stripping
specific contact compressions
circular frictions
stripping –> anterior lower leg
along tibialis anterior and tibialis posterior and fibularis longus
specific contract compressions/circular frictions
along medial and lateral sides of the tibia
muscular strokes/NM techniques –> posterior lower leg
stripping
specific contact compressions/circular frictions
petrissage/kneading
stripping –> posterior lower leg
along gastroc, soleus
specific contract compression/circular frictions
along gastroc and soleus and b/w them
petrissage/kneading –> posterior lower leg
1 or 2 handed
along gastroc
what comes after the muscular strokes and NM techniques
MFR muscle strokes along the gastroc
MFR muscle strokes along the gastroc
muscle play
strumming
perpendicular mobilizations
after finishing the lower leg where do we do
foot and ankle
how do we start the foot/ankle massage
circular frictions around the medial and lateral malleolus
and in b/w the malleoli
opening the foot and ankle
effleurage from toes to malleoli
dorsal and planta aspects
after effleurage of the foot and ankle
MFR skin glides along dorsum of foot
direct/indirect technique is restricted
where do we begin on the feet
distally along the toes
what do we do distally to proximally on the toes
stripping and circular frictions
stripping and circular frictions –> feet
along flexor and extensor digitorum tendons
b/w web spaces
stretch the web spaces
where else do we strip/circular frictions –> feet
b/w the metatarsals (dorsal aspect)
plantar fascia and met heads (plantar aspect)
calcaneus and achilles insertion
what else do we do to the feet
ROM of toes
intermetatarsal mobilizations
stretch the arches of the foot
manual gastroc stretches
stretching the arches of the feet
medial longitudinal
lateral longitudinal
anterior transverse
close stretches by placing foot back into its fxnal position
closing the massage
one part or two part
deep to superficial
long clearing strokes along all parts of the leg
what could we do before the entire massage
cross friction massage over a tendon or ligament
scar mobilization
what does cross frictioning do
realigns connective tissue fibers
how should we perform cross frictioning
place ligament on slight stretch
third digit over the second digit
move in direction perpendicular to the fibers
