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Modalities > Lecture 6: STM > Flashcards

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
Q

massage intervention allows the PT to treat what 2 things simultaneously

A

fascia and muscle

allows for deep tissue treatment

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26
Q

what is effleurage

A

“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
Q

effleurage helps what

A

pinpoint tightness, trigger points, and muscle spasms

28
Q

purpose of effleurage

A

accustom pt to touch
warm tissues
flush out tissue at end
create length in muscle

beginning and end of every massage

29
Q

what is petrissage

A

“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
Q

purpose of petrissage

A

increase venous/lymphatic return

reduce muscle tension

remove metabolic waste

break adhesions

loosen adherent fibrous tissue

increase skin elasticity

31
Q

how is single hand kneading performed

A

push in and away down medial line and work outward to lateral line

32
Q

how is double hand kneading performed

A

hand over hand

press deep and pull in toward midline with pressure and depth

33
Q

how is deep stripping performed

A

milking skin

apply uniform pressure in single line

34
Q

how is C kneading performed

A

pinch and release

create lift to deeper tissues pull on fascia

35
Q

how is skin rolling performed

A

pinch and release superficially

36
Q

how is finger tip kneading performed

A

pressure lifted through 4 fingers using gravity and weight of pt

used at occiput for nuchal line massage

37
Q

what is tapotement or percussion

A

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
Q

types of strokes for percussion

A

hacking = strike with hypothenar

clapping/cupping = hands create suction; used for postural drainage to mobilize bronchial secretions

beating = closed fist

39
Q

purpose of tapotement

A

increase circulation

stimulate subcutaneous structures

tone/firm muscles

40
Q

what is vibration

A

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
Q

what is a friction massage

A

james Cyriax and Gillean Russell

affects MSK structurs

heavy compression over sift tissues will stretch scars and loosen adhesions

42
Q

technique of friction massage

A

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
Q

purpose of friction massage

A

trigger point release; deep pressure

loosen scar tissue

aid in absorption of local edema

44
Q

what is cross friction massage

A

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
Q

technique for cross friction massage

A

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
Q

purpose of cross friction massage

A

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
Q

what is a myofascial trigger point

A

hyperirritable locus within a taut band of skeletal muscle, tendons, myofascial ligaments, and capsules surrounding joints, periosteum, or skin

48
Q

what is a latent trigger point

A

doesnt cause spontaneous pain but may restrict movement or cause weakness

49
Q

what is an active trigger point

A

causes pain at rest

tender to palpation

characterized by referred pain pattern similar to pts pain complaint

50
Q

trigger points are found most commonly where? these are identified by what?

A

found commonly in postural muscles

identified by a jump sign (pt cries out, winces, etc)

51
Q

what is a trigger point release massage

A

small friction like circular patterns are used on trigger point

like friction massage but pressure held longer

52
Q

what is instrumented assisted soft tissue mobilization

A

friction massage that uses tools

like standard massage but specialized instruments used

allow more direct treatment of involved tissues

53
Q

indications for PT to use IASTM

A

hands cant create needed force

excessive scar tissue
forms of tendonopathy
muscle/ligament strain
plantar fasciitis and ITB syndrome

54
Q

types of IASTM

A

graston = metal stainless steel blades

ASTYM = plastic tools, designed to promote regeneration of tissue

SASTM = sound assisted soft tissue mobilization

55
Q

what is functional massage

A

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
Q

what is strain counterstrain functional massage

A

preposition muscles in relaxed initial position by shortening them, shorten spindle to relax muscle, move origin closer

positional release therapy

57
Q

what is active release technique functional massage

A

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
Q

technique for functional massage

A

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
Q

what is rolfing

A

holistic healing

tissue tension relationship with psychological well being

60
Q

what is trager

A

rocking the body, shaking, or swinging body parts

release tightness to improve mobility

psychophysical integration

61
Q

what is Bindegewebsmassage

A

connective tissue massage similar to reflexology

assists with circulation and blood flow

62
Q

what is acupuncture/reflexology

A

chinese pressure massage to activate meridians

uses hands to reactivate referring parts on the body

corrects vegetative functions of body using ANS

63
Q

what is shiatzu

A

similar to chinese acupressure

Japanese pressure massage

Modalities (7 decks)

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