Massage Flashcards
What is the rationale behind using this treatment (Pain/Increase ROM/Strengthen etc)?
reduce pain
muscle relaxation
stimulate circulation
What are the physiological effects of the treatment?
muscle relaxation by increasing blood flow
pain relief by stimulating the release of endorphins
improved circulation by promoting vasodilation
stimulate lymphatic drainage, especially through effleurage and through stimulating the lymphatic system
What structures are affected by the technique?
skin-increasing circulation to skin
muscles, ligaments and tendons (increase in o2 delivery)
CV system-in aiding venous flow
What principles are used in carrying out the technique?
use talcom powder, but not directly on the clients leg, instead on your hand
Precautions and contraindications?
cuts or open wounds
cancer
blood clots
broken bones
uncontrolled hypertension (as massage increases blood flow)
fever (massage increase circulation that can increase the severity)
How to prepare the room for massage?
wash hands
find talc
make sure brakes are on plinth
adjust bed height to suit you and the patient
make sure space is clear (shoes and socks out the way)
wash, dry and clean plinth at the end of the session
How to carry out effluerage?
rub it in and then perform stroking with both hands looking for abnormalities
put hands together, create a V, starting at the bottom and working way upwards towards lymph node and give a gentle squeeze at the end
then change the hand so the pisiform is doing the work, with fingers facing outwards, starting at bottom and up into node
then flat hand, one hand on top the other, leading with fingers, least pressure
How to prepare the client for lower limb massage?
lying position to make sure there is no bend at top of leg, to make sure no vessels impeded
patient cant see what’s on, so keep telling them what you are doing
knee bent slightly over pillow so no hyperextension
heel needs to either be off the plinth or have a towel underneath
drape the model to protect the modesty but can still access lymph nodes
raise the plinth so back can be straight and instead use knees to move
if the massage is for an increase in circulation of a reduce in swelling you may want gravity to help, so could face backwards of the plinth and elevate legs with head rest
How to prepare a patient for upper limb massage?
draped with a pillow under the arm, increase more pillows to allow gravity to help
can also be sitting with the arm on the desk to support
if limb needs to be elevated or needs to be higher use more pillows
draped in a ‘toga’
How to apply effleurage for lower limb?
start by stroking and then running hands from the feet up to the lymph nodes at the top of the leg with a V shape
apply to all areas of the leg, including underneath, always moving distal to proximal but maintaining contact with the patient at all times
What is kneading used for?
to mobilise the muscles
How to apply effleurage for upper limb?
hold at hand, but not tights as we don’t want sweating
start at fingers, then wrist, then arm, up the axillary node
holding hands throughout
using v shape, going round all sides of the arm
then go along the deltoid muscles and into the axillary node
How to carry out kneading for the upper limb?
move proximal to distal on deltoid as it wont effect circulation
right hand in a clockwise motion and left hand anticlockwise, lifting the muscle up in the upwards motion
then go to biceps and triceps doing the same motion and moving down the arm
however, when you get to the extensor muscles, they are much smaller so use the fingers or thumb, still lifting and stretching on the upwards stroke
How to carry out kneading for the lower limb?
when kneading hamstrings you can either start proximal of distal
pick up the muscle with the mid part of the hand, making sure to keep the whole hand in contact
right hand clockwise and left hand anticlockwise always
if there is a really part of muscle you can use the hell of hand to make it deeper
for a specific area you can use fingers or thumb, reinforcing with the other hand for deep massage
then move down the leg
How to carry out picking up and ringing?
push down into muscle , squeeze muscle towards bone at 90 degrees with thumb towards hand, using the other hand as counterpart
move proximal to distal
don’t actually ‘pick up’ the muscle as it will pinch, make sure the muscle is in the thenar eminence
then once the muscle is relaxed you can move onto ringing
do this by pushing down into the muscle, squeezing the muscle off the bone, then take right thumb to left index finger and vice versa to carry out the ringing
if you lose the picking up of the muscle just start again, but make sure that hands stay in contact with the patient throughout
then walk slowly down the muscle
HOWEVER! -this technique should only be done when the muscle is relaxed enough
How to prepare the client for neck and back massage?
fold towel in half so its equidistant around the client
hold this folded towel whilst the client lays down and roll the towels to the side
then tuck a new towel into their shorts
for the neck, wrap the towel around the patient and ask them to sit forward, with female patients remove the bra straps and tuck into the towel
if the head rest isn’t available, then keep the client upright with pillows
What is the procedure/treatment for massaging the neck?
start by stroking, not crossing the spine
with effleurage, we don’t have to be too concerned with lymphatic flow because of gravity
start with SCM, coming round the middle fibres of traps into the supraclavicular node, then the paravertebrals round into axillar
then move onto kneading, starting proximal and moving distal to the upper fibres of trapezius
in between use effleurage to remove built up fluid
then go to the other side, making sure not to massage over the bone.
then do heeling
can use fingers/thumb to massage some specific tight areas when most of it is relaxed
the can do some ringing
then come down the edge of the scapula, can ask them to retract to get in the really deep spots of tightness
however, the area around the clavicle shouldn’t be pushed down and instead go 45 degrees
What is the procedure/treatment for massage of the back (stroking part of the treatment)?
stroke the back avoiding crossing over spine
start on the sacrum, pushing over the top of the gluteal muscles
then up to waist and down back to nodes
then up to the bottom of ribs and down
then straight up the axillar
then paravertebral muscles, around scapula into axillar
then paravertebral muscles all the way up into supraclavicular nodes
all of the things above are stroking methods don after one another
How to carry out kneading for the back and scapula?
use strokes of kneading with heel of hand on the glutei muscles, doing one side then another if you find it too hard to do both sides together
then do this on the paravertebral muscles as well and move up the muscle as you do so.
you would adjust the rate depth and rhythm to the effect that you want on the muscle
the lumbar area can have reinforced kneading
if you come across an area that’s sore you can do reinforced finger kneading
then do stroking around the scapula, flat hand kneading/effleurage, and edge of ribs into supraclavicular nodes
can then do glides of heel of hands, forming inverted V shapes, and finger kneading-as may often feel tension point here with lumps in muscles
What should massage look like when the scapula is relaxed?
can get them to put arm into small of back, which lifts the scapula off
then repeat the process as you can now get at the deep muscles under the scapula
can use fingers/thumb to find the tense muscles following the scapula all the way round
When should you use tapotement?
cup hands and and relax wrists, making sure air is underneath so that you don’t slap them, also stops your wrists getting tired
can use both hands at the same time, a towel is placed over the model
can vary through depth and speed depending on effect needed
if quadriceps, went don’t have to cover as we want to be stimulating, whilst stroking the quads ask the pt to tense quadriceps
What technique to you need to make sure you know the pt for and why?
pinching and brushing because it’s designed to promote aggression on the skin
the pt may be a boxer so pinch over the back of clothes for stimulation
then brush hands over client, slightly pushing, note it will seem aggressive
