Massage Flashcards
General Effects of Massage: Cardiovascular System
Circulation
- Dilation of superficial vessels via local reflexes
- Increase in stroke volume via promotion of venous return (for some pt’s. this may not be good because the heart would be able to handle the increased blood volume).
- Decrease incidence of DVT via decrease in blood viscosity and hematocrit.
Edema
- Increases lymph flow via mechanical pressure.
Massage has 3 effects
- Psychological
- Physiological
- Mechanical
General Effects of Massage: Connective Tissue
Decreases pain and improves tissue mobility (Mechanical)
Cyriax Friction (for injury only)
- Traumatic hyperemia
- Prevents/Disrupts adhesion
- Temporary analgesia
General Effects of Massage: Muscle Tissue & Nervous System
Muscle Tissue
- Decreases muscle spasm
- Decreases muscle hypertension
- Increases muscle extensibility
Nervous System
- Decreases pain, possibly via the Gate Theory of Pain and via an increase an opiate production.
Indication for Massage
Pain Edema Muscle Spasms Trigger Points Inefficiencies of Circulation Contracted Tissue Specific or General Tension
Contraindication for Massage
For this course:
Severe Distress (severe pain, febrile state) Systemic Edema Acute Conditions (0-48 hrs, minimum) Over Recent Surgery Increased Circulation is not Desired Contagious Skin Conditions Over Foreign Bodies or Sharp Bony Prominence Over Areas of Active Bone Growth Over Areas of Decreased Sensation Tuberculosis Diagnosis Over the Pregnant Abdomen
What is the Role of Touch (How Does Touch Effect)
Interaction is both physical and physiological (gets the pt. used to you and visa versa)
Helps you identify the pt’s. state
Touch can communicate your state of being
How are your hands? (how do they feel)
How are your hands?
Always wash your hands before and after a treatment (H2O and Soap).
Hot Water, 15+ seconds.
Hands warm and dry prior to touching the pt.
Always consider short finger nails and rings.
Positioning of the Patient
Support should be given to natural joint curvatures.
Pt. Limbs should be elevated to allow gravity to assist (when possible) with circulation.
Patient should not be holding /supporting any part of themselves
Above all else, the pt. should be comfortable.
Draping
You want to expose the area that you will be treating.
Parts not treated should be covered by a towel or a sheet.
Draping should be tight.
The Drape Line - The line of the drape you DO NOT cross.
Massage Media (lotion/creams)
The purpose for massage media is to avoid uncomfortable friction between the clinicians hands and the pt’s skin.
It is best if it is unscented, hypo allergenic.
Avoid lotions: Many absorb too quickly into the skin requiring repeated pauses/interruptions to the massage.
Positioning the Therapist
Always monitor your own body mechanics.
Shift your weight.
When possible, face the pt. when performing massage (this allows you to monitor non-verbal cues, and gives them more assurance if they can see you and what you are doing).
Where should the table be for the Therapist?
The table height is usually between the therapist’s wrist and the ends of the fingers.
This may vary though; therapist may need to use a step.
Effleurage Massage
A rhythmic, consistent, stroking
This can be superficial or deep.
Superficial effects - reflex effect and is calming.
Deep effects - reflex and mechanical effect
Effleurage also helps with:
Information gathering
Calming/Focusing
Warming of superficial tissues (skin and fascia).
Petrissage and Compression
This is intermittent Kneading
This can be done unilaterally, bilaterally, or digitally (by the therapist)
Petrissage helps to:
Increase circulation
Softens and lengthens tissue
Friction Massage
This type of massage is sustained pressure with movement.
Friction massage may be done linear, cross fiber and circular.
Cyriax Cross Fiber is a particular technique.
Jostling
Is a rhythmic shaking of tissue or a limb.
This helps to:
Decrease muscle guarding.
Helps the pt. to relax.
Percussion/Tapotement
This includes: Hacking* Slapping* Cupping* Gorilla Punching* Beating Punching
Direct Pressure (Type of Massage)
This is a sustained pressure without movement. (One point)
Myofacial Release
Look Up
Trigger Point Technique
Look Up
Principles Regarding Massage Strokes (Consider?)
Direction - linear, cross fibers, digital, proximal (Always distal to proximal or end that way, towards the direction of the heart).
Duration - Take adequate time to achieve goal
Pressure - this varies based on intent, body region, pathology and pt. tolerance.
Rate & Rhythm - This should be purposeful and consistent (like massage should)
Principles regarding Stokes
Work broad and light - specific and deep
Mold your hands to the pt’s body.
Deep pressure: always distal to proximal
Address the entire length of the muscle of interest.
Minimize interruptions (lifting hands, stopping abruptly, taking phone calls etc)
Pain
Massage helps painful musculoskeletal conditions
Massage may be potentially beneficial for:
Back pain
General orthopedic conditions
Post-operative conditions
Fibromyalgia
Degenerative joint conditions
Edema
Edema is swelling caused by an increase in fluid in the interstitial, intra-articular, or intracellular space.
Massage is proposed as a treatment for helping to reduce edema caused by injury, illness or surgery.
Types of Edema
Local: Edema is confined to an area ex. ligament sprain
Systemic Edema: Occurs throughout the body ex. Congestive Heart Failure
Lymphedema: Edema resulting from compromise of lymphatic system ex. Removal of cancerous lymph nodes
The Lymphatic System
The lymph system is comprised of: Lymph fluid/Interstitial fluid Lymph Nodes Lymph Ducts Associated lymph tissues, capillaries and vessels that produce and transport lymph fluid
Tissues –> Circulatory system
Functions of the Lymphatic System
- Remove excess fluids from tissues
- Absorption of fatty acids and subsequent transport of fat to the circulatory system.
- Production of immune cells
Side note: There are no pumps in the lymphatic system. Lymphatic fluid is moved by muscular contraction (body movements) through one way valves.
