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Lecture 6: STM Flashcards

1
Q

MT and massage billing code for STM

A

MT: 97140

massage: 97124

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2
Q

purposes of STM

A

local muscle relaxation

increase mobility of different tissues

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3
Q

specific massage techniques we will utilize

A

Hoffa technique

STM

functional massage

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4
Q

pathologies that can restrict motion

A

contracture

edema

adhesion

mechanical block
tone
spinal disc herniation
weakness
adverse neural tension
pain
psychosomatic or psychological factors

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5
Q

explain a contracture and how it restricts motion

A

soft tissue shortening due to immobilization/disuse

pathological cross links occur that cause shortening/adhesions that prevent normal alignment of collagen

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6
Q

difference between scar tissue and muscle contractures

A

ST = over proliferation during this phase of healing causing too many cross links

MC = permanent shortening of muscles that produce deformity; caused by prolonged spasm, guarding, imbalance, or immobilization

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7
Q

compare/contrast intraarticular edema and extraarticular edema

A

intra = excess fluid forming inside joint capsule; restrict motion in a capsular pattern

extra = outside joint capsule; restricts motion in noncapsular pattern

both restrict AROM and PROM

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8
Q

what are adhesions

A

abnormal joining of different types of tissue

fibrofatty tissue may proliferate inside joints and it may adhere between structures as it turns into scar tissue

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9
Q

types of treatment approaches for movement restriction

A

stretch

motion

surgery

physical agents

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10
Q

what is plastic deformation

A

elomgation that produced under loading that remains after load is removed

low load prolonged stretch for 30-60s

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11
Q

how can A/PROM address motion restrictions

A

inhibits contracture formation by physically disrupting the adhesions between gross structures and/or by limiting intermolecular cross linking

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12
Q

how does massage treat motion restriction

A

can increase tissue extensibility, control inflammation, control pain, and facilitate motion

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13
Q

thermotherapy can address motion restriction by

A

increasing soft tissue extensibility

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14
Q

how might sx be used to improve motion restriction

A

surgical release of adhesions, contractures, or tissue limited by spasticity limits

if motion is restricted by bony block

in cases stretching can’t lengthen a contracture

hypertonicity due to spasticity

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15
Q

physical agents help reduce motion restrictions by…

A

increasing soft tissue extensibility (thermo and cryo)

control pain/inflammation (cryo, thermo, US, light)

facilitate motion (tx, massage)

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16
Q

why is touch important

A

sensory receptors in skin

accustomed to relief with touch from utero

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17
Q

swedish massage originally developed where

A

stockholm, Sweden in 1847

1900 = Albert Hoffa published book “technik de massage” in Germany and is credited by many

underlies all modern techniques

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18
Q

modern massage techniques

A

Effleurage (stroking)

Petrissage (Kneading)

Tapotement (percussion)

Vibration

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19
Q

physiological effects of massage

A

stretch/loosened adhesions

increased venous/lymphatic flow/stimulated circulation that reduces edema and lactic acid

decreased neuromuscular excitability

sedation (muscle relaxation)

modulate pain

restore joint mobility

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20
Q

2 categories of physiologic effects are

A

mechanical and reflexive

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21
Q

psychological effects of massage

A

sedative
lowers tension and anxiety
feeling of being helped

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22
Q

what are mechanical effects

A

effects exerted through mechanical technique

stretching of muscle
elongating fascia
mobilizing adhesions

effects on muscle/skin

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23
Q

what are reflexive effects

A

exerts effects through skin an superficial connective tissue

believed to be an autonomic nervous system effect

effects of pain/circulation

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24
Q

indications for massage

A

swelling
decreased ROM
muscle spasm
pain
tightness in tissue
HA
trigger point

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25
massage intervention allows the PT to treat what 2 things simultaneously
fascia and muscle allows for deep tissue treatment
26
what is effleurage
"to skim over" gliding stroke; doesnt move deep tissue starts light and becomes heavier deep effleurage stimulates capillary circulation begins at peripheral areas and moves to heart
27
effleurage helps what
pinpoint tightness, trigger points, and muscle spasms
28
purpose of effleurage
accustom pt to touch warm tissues flush out tissue at end create length in muscle beginning and end of every massage
29
what is petrissage
"to knead" kneading/press/toll muscles break up areas of muscle tension metabolic waste "wringed out" of muscles and pit back into circulation to be filtered milking effect to increase venous return
30
purpose of petrissage
increase venous/lymphatic return reduce muscle tension remove metabolic waste break adhesions loosen adherent fibrous tissue increase skin elasticity
31
how is single hand kneading performed
push in and away down medial line and work outward to lateral line
32
how is double hand kneading performed
hand over hand press deep and pull in toward midline with pressure and depth
33
how is deep stripping performed
milking skin apply uniform pressure in single line
34
how is C kneading performed
pinch and release create lift to deeper tissues pull on fascia
35
how is skin rolling performed
pinch and release superficially
36
how is finger tip kneading performed
pressure lifted through 4 fingers using gravity and weight of pt used at occiput for nuchal line massage
37
what is tapotement or percussion
brisk bouncy firm contact used to tone the muscles, firm sagging skin, and increase circulation brisk blows administered with relaxed hands not good for kids or elderly
38
types of strokes for percussion
hacking = strike with hypothenar clapping/cupping = hands create suction; used for postural drainage to mobilize bronchial secretions beating = closed fist
39
purpose of tapotement
increase circulation stimulate subcutaneous structures tone/firm muscles
40
what is vibration
fine/tremulous movement to assist secretion removal from airways applied during exhalation hands remain in contact with pt rhythmic trembling from whole forearm used in conjunction with postural drainage and cupping to loosen secretion
41
what is a friction massage
james Cyriax and Gillean Russell affects MSK structurs heavy compression over sift tissues will stretch scars and loosen adhesions
42
technique of friction massage
tips of fingers or thumb or heel of hand should move in small circles across the muscle fiber rather than alonf the longitudinal axis of fibers pressure gradually increases with pt tolerance pressure never abruptly released
43
purpose of friction massage
trigger point release; deep pressure loosen scar tissue aid in absorption of local edema
44
what is cross friction massage
used for chronic tendon inflammation used with chronic inflammation when process gets "stuck" increases tendon stiffness used most often with chronic overuse problems like epicondylitis, tendonitis, etc
45
technique for cross friction massage
tendon in slight stretch deep circular or cross fiber massage to break up adhesions perpendicular to fiber orientation 7-10 min every other day very painful and noxious = warn pt
46
purpose of cross friction massage
increase inflamamtion to a point where inflammatory process is complete and injury can progress into the later stages of the healing process assist to appropriate proliferation break up adhesions or minimize rough surfaces between tendons and their synovial sheath
47
what is a myofascial trigger point
hyperirritable locus within a taut band of skeletal muscle, tendons, myofascial ligaments, and capsules surrounding joints, periosteum, or skin
48
what is a latent trigger point
doesnt cause spontaneous pain but may restrict movement or cause weakness
49
what is an active trigger point
causes pain at rest tender to palpation characterized by referred pain pattern similar to pts pain complaint
50
trigger points are found most commonly where? these are identified by what?
found commonly in postural muscles identified by a jump sign (pt cries out, winces, etc)
51
what is a trigger point release massage
small friction like circular patterns are used on trigger point like friction massage but pressure held longer
52
what is instrumented assisted soft tissue mobilization
friction massage that uses tools like standard massage but specialized instruments used allow more direct treatment of involved tissues
53
indications for PT to use IASTM
hands cant create needed force excessive scar tissue forms of tendonopathy muscle/ligament strain plantar fasciitis and ITB syndrome
54
types of IASTM
graston = metal stainless steel blades ASTYM = plastic tools, designed to promote regeneration of tissue SASTM = sound assisted soft tissue mobilization
55
what is functional massage
combines passive and active mobilization of joints and massage technique similar to friction good for stretch and collagen alignment muscle compression and stretch assists in reducing motion restriction from soft tissue
56
what is strain counterstrain functional massage
preposition muscles in relaxed initial position by shortening them, shorten spindle to relax muscle, move origin closer positional release therapy
57
what is active release technique functional massage
affected tissues cam be treated by using combo of specific muscle movements as well as applying specific and direct pressures AROM or PROM assisted by PT
58
technique for functional massage
combine synchronized repeated joint movements in rhythmic manner direction of force in line with muscle fibers release force when resetting the position of jt pressure dependent on pt reactivity
59
what is rolfing
holistic healing tissue tension relationship with psychological well being
60
what is trager
rocking the body, shaking, or swinging body parts release tightness to improve mobility psychophysical integration
61
what is Bindegewebsmassage
connective tissue massage similar to reflexology assists with circulation and blood flow
62
what is acupuncture/reflexology
chinese pressure massage to activate meridians uses hands to reactivate referring parts on the body corrects vegetative functions of body using ANS
63
what is shiatzu
similar to chinese acupressure Japanese pressure massage

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