Massage

Question 1

What is massage?

Answer 1

Mechanical stimulation of tissues by applying pressure and stretching in a rhythmic pattern.

Question 2

What physiological changes can massage cause?

Answer 2

• Reduce anxiety and stress
• Elevate mood
• Stimulate sensory receptors in the skin/superficial tissues
• Stretch muscles, tendons, and other soft tissues
• Increase local circulation via arterial dilation
• Increase release of histamines/prostoglandins
• Reduce pain
• Increase lymphatics flow/drainage
• Increase pulmonary function (break up mucus)

Question 3

Massage Indications

Answer 3

• Edema/poor venous or lymph drainage
• Decrease/prevention of adhesions
• Increase skin tone
• Pulmonary congestion
• Promote wound healing
• Promote relaxation

Question 4

What benefit from massage do PTs focus on?

Answer 4

• Breakup and prevention of adhesion formation (scar tissue)

- Loosening of trigger points

Question 5

Massage Contraindications

Answer 5

• Edema caused by total renal failure
• Acute inflammation
• Suspected clot in the area
• Suspected aneurysm
• Tumors
• Over open lesions, infections
• Abnormal abdominal mass
• Non-union fractures
• Graft sites (very sensitive, do not want to damage)

Question 6

When would massage be indicated for a cancer patient?

Answer 6

• Only when the cancer is terminal, might help patient relax and feel better temporarily

Question 7

Massage Precautions

Answer 7

• Chronic fatigue syndrome
• Fracture sites
• Osteoporosis
• Touch hypersensitivity
• Diabetes
• Complicated pregnancy
• High BP
• Asthma
• Alcoholism
• Open lesions
• Children w/ shunts
• Psychiatric illness

Question 8

What are the components of massage?

Answer 8

• Lubricant
• Draping of patient
• Patient position
• Therapist’s behavior
• Preparation
• Application of massage techniques

Question 9

What is effleurage?

Answer 9

• Long strokes, gliding movements that follow length of the muscle
• Done at the beginning and end of massage

Question 10

What are the benefits of effleurage?

Answer 10

• Massages superficial structures
• Gets patient used to touch and progression to deeper tissue work
• Can increase venous return

Question 11

What is petrissage?

Answer 11

• Kneading, compression and release movements

- Lifts the subcutaneous tissue up and away from the underlying structures (muscle)

Question 12

What are the main Swedish Massage principles?

Answer 12

• All pressure strokes are towards the heart
• Begin and end w/ effleurage
• Force of strokes should follow the muscle fiber direction
• Goal is to return body to an uninhibited flow of energy

Question 13

What is friction?

Answer 13

• ]Technique that uses thumb, finger tips, back/heel of hand to create deep pressure
• Used to loosen tight muscle tissue
• Includes X-fiber, rolling and wringing

Question 14

What is tapotement?

Answer 14

• Technique that uses tapping, percussion, and rhythmic motions
• Includes tapping, hacking, cupping and pinching

Question 15

What is vibration?

Answer 15

• Technique used to transmit trembling motion for hands of the PT to the patient’s tissue.
• Used after massage of trigger points and deep pressure to tissues/joints

Question 16

What is connective tissue massage?

Answer 16

• The skin is pulled away in a perpendicular direction to the muscle.
• Includes pinching technique
• Can be uncomfortable

Question 17

What is trigger point massage?

Answer 17

• Massage focuses on finding tender areas of tightness.
• Pressure is applied w/ finger and thumb w/out lubricant
• Duration is 1-5 minutes per trigger point
• Often painful

Question 18

What are the functions of the lymphatic system?

Answer 18

• Removal of wastes and excess fluids
• Production of immune cells
• Absorption of fatty acids

Question 19

T/F: Lymphatic massage uses the same techniques as Swedish massage.

Answer 19

False

Question 20

Why would a patient need to have lymphatic massage?

Answer 20

• Patient has some sort of lymphatic failure in their system that causes the system to not drain properly

Question 21

What are the types of lymphatic failure? (x4)

Answer 21

• Dynamic
• Mechanical
• Combination
• Hemodynamic

Question 22

Dynamic Lymphatic Failure

Answer 22

• Transport capacity is normal
• Lymphatic load is increased
• Example: edema

Question 23

Mechanical Lymphatic Failure

Answer 23

• Transport capacity is decreased
• Lymphatic load is normal
• Example: lymphedema

Question 24

Combination Lymphatic Failure

Answer 24

• Transport capacity is decreased
• Lymphatic load is increased
• Example: lymphedema

Question 25

Hemodynamic Lymphatic Failure

Answer 25

• Transport capacity is normal or decreased
• Lymphatic load is increased due to right ventricular failure
• Example: cardiac edema

Question 26

Lymphatic Massage Precautions

Answer 26

• Bronchial asthma
• Hyperthyroidism
• Ongoing menstrual cycle
• TB
• Toxoplasmosis
• Nevus
• First trimester of pregnancy
• Cancer (treated)
• Low or high BP

Question 27

Lymphatic Massage Contraindications

Answer 27

• Malignant cancer
• Acute infection
• DVT
• Cardiac edema
• Renal failure
• Radiation fibrosis
• PAD

Question 28

What is manual lymphatic drainage?

Answer 28

• Massage technique that manually manipulates the lymphatic vessels in increase lymphangion contraction

Question 29

What are the goals of manual lymphatic drainage?

Answer 29

• Increase lymphatic vasomotoricity
• Mobilization of fluid
• Softening indurated tissues

Question 30

Steps of manual lymph drainage

Answer 30

1. Teach patient self massage
2. Deep breathing
3. Clear the venous angle
4. Stimulate the lymph node beds that will receive fluid
5. Move fluid from proximal segment to open lymph bed, then move to next segment
6. Perform on anterior and posterior surfaces
7. Close treatment with deep breathing