Massage Techniques

Question 1

What are the goals of massage therapy

Answer 1

enhance tone and tissue extensibility

increases blood flow (deep)

increases cutaneous temperature (deep)

Question 2

What does massage effects

Answer 2

1. nervous
2. muscular
3. circulatory
4. lymphatic

Question 3

What are GENERAL PRINCIPLES of massages

Answer 3

1. Start superficial, and then go deep… this warms up area/tissue, increase blood flow and extensibility before going deeper
2. start non-specific and then become more specific
3. end with general/broad strokes … this helps relax the patient and increase blood flow

Question 4

What are the Benefits of Effleurage

Answer 4

1. Warms tissues due to mild erythema,
   decreases pain, reduces muscle tension
2. slow technique - no more than 15 strokes
   per minute

Question 5

How to do Petrissage (fancy term for kneading/pinching)

Answer 5

1. Grasp the skin and underlying muscle tissue while applying cross-fibre stroking or stretching
2. Alternating traction, squeezing and relaxing of a localized mass of tissue between thumb and fingers

Question 6

What are the Benefits of Petrissage (hands in a C position or crab hands)

Answer 6

1. Improves tissue fluid exchange and vascularity
2. reduces swelling and fluid accumulation
3. creates hyperemia
4. improves elasticity and contractility of connective tissue
5. Decreases muscle tone via spindle cells and golgi tendon receptors
6. may break adhesions

Question 7

ROULOMONT (aka skin rolling)

Answer 7

1. lifts the skin away from the fascia surfaces underneath
2. similar to petrissage but you are only pulling the skin
3. Warms and softens superficial fascia

Question 8

Tapotement can be done with finger tips, tools, palms etc.

Answer 8

1. tapping or vibration applied rapidly to the soft tissue… hand in knife position and perform the chop chop
   i.e. in movies
2. Applied perpendicular to the muscle fibres, 8-10 sinusoidal vibrations per second
3. Produces reflexive physiologic effects in 2-5 mins
4. Hyperaemia, improved muscle tonicity (the state of tension or contraction in muscles when they are at rest. “Improved muscle tonicity” suggests that the stimulus leads to a positive change in the resting tension of muscles, possibly resulting in enhanced muscle function or readiness),reflex stimulation of cutaneous receptors (Cutaneous receptors are sensory receptors located in the skin that respond to stimuli such as touch, pressure, temperature, and pain. “Reflex stimulation” indicates that the stimulus triggers a quick, automatic response in these receptors, leading to sensory feedback or reactions)

Question 9

Benefits of Transvere Friction

Answer 9

1. side to side or small circular movements
2. moves skin over subcutaneous tissues and muscle
3. Lubricant is usually avoided because you are trying to move the tissue under the skin
4. Performed over ligaments or myofascial lesions
5. Stretches/releases adhesions
6. Reduces edema
7. Reduces fibrosis
8. Disperses pathologic deposits
9. Reduces pain
10. Reduces muscle spasms

Question 10

Benefits of Transverse Friction

Answer 10

1. vigorous friction applied across the
   treated tissue
2. breaks up adhesions, encourages absorption of exudates
3. Creates a controlled inflammatory response, causes heat and redness through histamine release and increased circulation*need to consider pt tolerance as it’s not
   overly comfortable

Question 11

Risk Factors of Mobilization

Answer 11

1. Exacerbation of symptoms with overuse
2. Muscle soreness or fatigue from introducing new movement
3. Joint instability for people with pre-existing joint issues

Rationale:
This involves gradually increasing the intensity of movement or exercise. The rationale behind the risks associated with graded mobilization includes the exacerbation of symptoms with overuse, such as increased pain or discomfort due to pushing the body beyond its current capacity. Muscle soreness or fatigue can also occur when introducing new movements, especially if the muscles are not accustomed to the specific actions.

Question 12

Risk Factors of Stretching

Answer 12

1. Delayed onset muscle soreness
2. Muscle or tendon injury – can cause strain
3. Joint instability for people with pre-existing joint issues
4. Overstretching or strain

Rationale: Stretching aims to improve flexibility and range of motion but can lead to delayed onset muscle soreness (DOMS) due to microscopic damage to muscle fibers. Overstretching or straining during stretching exercises can also cause muscle or tendon injuries, particularly if done improperly or too aggressively. People with pre-existing joint issues may experience joint instability or exacerbation of symptoms with stretching.

Question 13

Risk Factors of Traction/Distraction

Answer 13

1. Joint hypermobility or laxity with overuse
2. Potential muscle strain
3. Exacerbation of symptoms with overuse

Rationale: This technique involves gently pulling or separating joint surfaces to relieve pressure and improve mobility. However, overuse can lead to joint hypermobility or laxity, potentially causing joint strain. Muscle strains may also occur, especially if traction is applied too forcefully.

Question 14

Risk of Strain-counterstrain

Answer 14

1. Exacerbation of symptoms with overuse
2. Temporary soreness or discomfort

Rationale: This technique aims to reduce muscle spasms and pain by positioning the body in a relaxed state. However, overuse can lead to exacerbation of symptoms, such as increased pain or discomfort. Temporary soreness or discomfort may also occur after the procedure.

Question 15

Risk of Myofascial Release

Answer 15

1. Bruising or skin irritation due to pressure
2. Temporary increases in pain
3. Soreness

Rationale: Myofascial release techniques target the fascia (connective tissue) to improve mobility and reduce pain. Risks include bruising or skin irritation from pressure, temporary increases in pain, and exacerbation of symptoms, particularly if the techniques are applied too aggressively.

Question 16

Active Myofascial Release

Answer 16

1. Bruising or skin irritation
2. Temporary increase in pain
3. Exacerbation of symptoms
4. Soreness

Rationale: PNF techniques involve stretching and contracting muscles to improve flexibility and strength. Risks include muscle soreness, joint strain for individuals with hypermobile joints, pain from inappropriate nerve compression, and increased fatigue for those actively training.

Question 17

Risk of PNF Proprioceptive Neuromuscular Facilitation

Answer 17

1. Muscle soreness
2. Joint strain for people with hypermobile joints
3. Pain for inappropriate nerve compression
4. Can increase fatigue for people actively training

Rationale: This technique targets specific points of muscle tension (trigger points) to reduce pain and improve mobility. Risks include soreness, discomfort, bruising, skin irritation from pressure, and increased local pain if the pressure is too intense.

Question 18

What are the Risk of Ischemic Compression

Answer 18

1. Soreness and discomfort
2. Bruising or skin irritation from pressure
3. Risk of injury from over-compression

Rationale: Ischemic compression involves applying pressure to reduce blood flow temporarily. Risks include soreness, discomfort, bruising, and skin irritation from pressure, as well as a risk of injury from over-compression.

Question 19

Risk of Effluerage

Answer 19

1. Allergic reaction to oils and lotions
2. Skin irritation from prolonged application of massage techniques
3. Risk of overstimulation in sensitive people, discomfort, nervousness and anxiety symptom

Rationale: Effleurage may cause allergic reactions or skin irritation from oils and lotions.

Question 20

Risk of Petrissage

Answer 20

1. Temporary muscle soreness
2. Temporary pain from breaking up adhesions
3. Bruising or skin irritation from aggressive or excessive manipulation
4. Risk of increased pain

Not appropriate for acute injuries
Rationale: Petrissage can lead to temporary muscle soreness, pain from breaking up adhesions, bruising, or skin irritation from aggressive manipulation.

Question 21

Risk of Roulomont

Answer 21

1. Bruising or skin irritation from aggressive or excessive manipulation
2. Not directly effective for muscular pain

Rationale: Roulomont may cause bruising or skin irritation from excessive manipulation and may not directly address muscular pain.

Question 22

Risk of Tapotement

Answer 22

1. Risk of temporary increased pain
2. Skin irritation and bruising
3. Not appropriate for acute injuries like fractures or on bony structures

Rationale: Tapotement can temporarily increase pain, cause skin irritation, and is not suitable for acute injuries or bony structures.

Question 23

Risk of Friction

Answer 23

1. Increased pain in connective tissue
2. Skin irritation
3. Not suitable for muscle belly pain/muscular knots
4. Controlled inflammation that may be irritating

Rationale: Friction can increase pain in connective tissue, cause skin irritation, and is not suitable for muscle belly pain or muscular knots.

Question 24

Benefits of trigger point release

Answer 24

How to perform:
it’s generally recommended to hold pressure on a single trigger point for about 30 to 120 seconds during each press. If the point remains tender, you may release the pressure briefly and then repeat if necessary

Benefits of trigger point release:
1. Pain Relief: Trigger points often refer pain to other areas, causing discomfort and muscle tension. Releasing trigger points can alleviate this referred pain and reduce muscle tightness.
2. Increased Range of Motion: Tight muscles with active trigger points can restrict joint movement. By releasing the points, muscle length can improve, allowing for a greater range of motion and flexibility.
3. Improved Circulation: Sustained pressure on a trigger point helps increase blood flow to the area after release. This helps bring oxygen and nutrients to the muscle tissue, which aids in healing and recovery.
4. Reduced Muscle Spasms: Trigger points can cause muscles to contract involuntarily or spasm. Releasing these points helps relax the muscle fibers, which can reduce or stop the spasms.
5. Enhanced Muscle Function: Trigger points can weaken the muscle and decrease its endurance. By treating these points, muscle function can improve, making it easier to perform daily activities or physical exercise.
6. Decreased Stress and Anxiety: Chronic pain from trigger points can contribute to stress and anxiety. Reducing this pain can improve mood and decrease stress, especially for people who experience pain daily.
7. Better Posture: Tight and painful muscles can cause postural imbalances, leading to poor alignment and additional strain on other muscles. Releasing trigger points helps improve muscle balance and supports better posture.
8. Support for Injury Recovery: Trigger point release can help with rehabilitation by reducing pain and muscle tightness in injured areas, allowing for more effective stretching and strengthening exercises as part of the recovery process.
9. Headache and Migraine Relief: Many headaches and migraines are related to tension in the neck, shoulder, and upper back muscles. Releasing trigger points in these areas can alleviate tension headaches and even some types of migraines.
10. Enhanced Athletic Performance: By reducing muscle tightness and improving range of motion, trigger point release can aid athletes in performing better with less discomfort and a reduced risk of injury.

Why not to hold it longer than 2 mins at a time isn’t recommended:
1. Risk of Tissue Damage: Prolonged pressure can reduce blood flow to the area, potentially damaging muscle fibers or surrounding tissue.
2. Nervous System Response: Holding pressure for too long can overstimulate nerve endings, causing discomfort or even increasing muscle guarding (a reflexive tensing), which makes the muscle tighten up rather than relax.
3. Circulation and Oxygen Supply: Trigger points often form due to muscle tension that restricts blood flow. Short bursts of sustained pressure can help release tension, improve blood flow, and encourage oxygenation in the muscle. Prolonged pressure, however, might restrict blood flow too much, which can be counterproductive.
4. Pain Tolerance and Patient Comfort: Holding pressure for too long can be very uncomfortable for the patient, which can make the therapy session less effective or even discourage further treatment.
5. Diminishing Returns: After about 120 seconds, most of the potential therapeutic effect of trigger point release is achieved, so additional time usually doesn’t provide extra benefit.

By limiting the pressure hold to around 30-120 seconds, practitioners can effectively release trigger points while minimizing discomfort and risk to the muscle tissue.