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Key Skills in Physiotherapy - BPT05 > Massage - Theory > Flashcards

Massage - Theory Flashcards

1
Q

Touch

A

Type of communication.
More ambiguous, influenced by culture, personal and family context. Can be interpreted differently.
Tool for massage. Mechanical touch.

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2
Q

Massage

A

Systemic and scientific manipulation of soft tissue for remedial or restorative purposes.
Affects various systems of the body through its influence on reflex processes.

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3
Q

Types of Massage

A

Swedish massage: classic therapeutic massage technique.
Depp tissue massage: works more deeply into tissue.
Relaxation massage: for stress and anxiety relief.
Sports massage
Lymphatic massage
shiatsu

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4
Q

Epidermis

A

Most superficial, avascular.

90% keratinocytes.

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5
Q

Dermis

A

Forms most of skins thickness.
Contains blood/lymph vessels, nerves.
Made by connective tissue, provides strength and elasticity.

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6
Q

Hypodermis

A

Connects skin to the underlying fascia of bones and muscles.

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7
Q

Physiological Effects of Massage

A 
Blood flow increased (vasodilation).
Promotes venous return.
Increases local skin temperature.
Increased parasympathetic activity:
- decreased heart rate
- decreased blood pressure 
- decreased cortisol levels
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8
Q

What is the purpose of massage?

A

Stretching and breaking down adhesions.
Improving tissue mobility (ligaments, tendons and muscles).
ROM changes.

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9
Q

Nervous system effects of massage

A

Facilitates release of endorphins.
Increases serotonin/dopamine.
Neuromuscular excitability decreases (decreased muscle tension).
Combination of decreased pain and muscle spasm.

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10
Q

Biopsychological effects of massage

A

Relaxation

Reduction of anxiety

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11
Q

What does touch stimulate?

A

Analgesic Modulation
Affective Responses
Somatoperceptual Reorganization

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12
Q

Which questions should we consider prior to massage?

A

What is the state of the condition? (acute, subacute, chronic)
What’s the purpose of the massage?
Which region needs to be addressed?
Which massage techniques are safe to be applied?

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13
Q

When do we do Therapeutic Massage?

A

For pain relief, anxiety/stress release, muscle tightness.

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14
Q

Is massage therapy considered evidence based practice?

A

No. Not enough high quality research.

It is used to treat a symptom not a condition.

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15
Q

4 Main Goals of Massage

A

Stress management.
Pain management.
Relaxation.
Maintaining functional mobility.

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16
Q

Can massage be used for recovery of a muscle strain?

A

Yes, for enhancing muscle fiber realignment.

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17
Q

Can massage be used for patellofemoral joint pain syndrome?

A

Yes, for muscle relaxation/tissue extensibility.

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18
Q

Can massage be used for recovery of an ankle sprain?

A

Yes, to break adhesions of ligaments.

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19
Q

Absolute Contradictions for Massage

A 
Acute Injury (24-48h)
Fever
Undiagnosed cancer (consider red flags)
Deep vein thrombosis
Thrombophlebitis
Active infectious disease
Open wound
Active cancer
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20
Q

Relative Contradictions to Massage

A 
Caution must be applied!
Fragile skin: only light pressure
- long term steroid use
- diabetes
- inflammatory disease
- cardiac problems (vulnerable to blood clot)
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21
Q

Preparation for Massage

A

Patients skin clean
Lubricant can be used
Therapists hands should be clean, warm, trimmed nails, no jewelry or watches.
Always get consent!

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22
Q

Postural Awareness

A

Bed in appropriate height.
Use body weight as much as possible to apply pressure.
Least amount of mechanical stress, least amount of energy expenditure.

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23
Q

Body Awareness

A

Stay close to treated area to avoid unsafe trunk movements.
Keep bed at GT to avoid excessive elevation of the arms.
Keep joints and thumbs in neutral position.
Use your body weight to create pressure and avoid muscle fatigue. Shoulders arms and hands should be free of tension.

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24
Q

What can we do to reduce Edema?

A

Elevate the segment (above heart) to enhance lymphatic flow.

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25
Q

Classical Massage Techniques

A

Effleurage or stroking techniques
Petrissage: wringing, kneading, rolling.
Friction movements
Percussion movements: cupping, hacking.

26
Q

Effleurage - Types and subtypes

A

Light: Palm effleurage
Deep: Forearm, thumb, effleurage du poing, fingertip.

27
Q

Petrissage - Types and Description

A

Wringing (petrissage): fingers of one hand copress tissue against opposite thumb.
Kneading: compression with thenar or palm of hand. Small circular movements with fingers. No glide.
Rolling: Diamond. Fingers pulled towards thumbs, thumbs push forward.

28
Q

Friction - Types

A

Circular friction
Horizontal friction
Fingertips or elbow.

29
Q

Percussion Movements - Types and Description

A

Clapping (cupping): fingers and thumbs adducted, hands form a cup shape.
Hacking: Relaxed wrist, fingers adducted. Alternating pronation and supination of the forearm.
Vibration: finger adducted, tissue compressed and released.

30
Q

Effleurage - Technique

A

Hands glide over skin with hands flat and fingers togerher.

31
Q

Effleurage - Application

A

Start and end of massage. From distal to proximal towards the heart. Uniform pressure in each stroke, subsequently increased or decreased. Elevating segment aids in edema reduction.

32
Q

Effleurage - Purpose

A

Relax muscle, reduce pain, relieve edema, relax patient.

33
Q

Wringing/petrissage - Application

A

Skin and underlying tissue kneaded and lifted. One hand moves clockwise and the other counterclockwise, passing by each other to lift tissue. Mid massage treatment session.

34
Q

Wringing/petrissage - Purpose

A

Mobilize deeper tissue to improve tissue mobility, relax muscle and promote circulation.

35
Q

Rolling - Application

A

Fingers pulled towards the thumbs creating a roll of the tissue. Thumbs pushed forwards while finger travel backwards to roll tissue away from therapist.

36
Q

Rolling - Purpose

A

Increase motility and length to fibrous tissue.

To increase extensibility and strength of connective tissue.

37
Q

Kneading - Application

A

Proximal to distal.
When using both hands, alternate them. Compress tissue and move right hand clockwise and left counter clockwise.
When using thenar: no circular movement. Tissue pulled towards thenar and then rolled forward towards finger.

38
Q

Friction - Application

A

Small cross-section or circular motions are used to mobilize specific tissue.
Must be applied at 90° to direction of tissue.
No lubricant. Warn patient about discomfort.

39
Q

Friction - Purpose

A

Break adhesions or soften scar tissue to improve area mobility.

40
Q

Cupping/tapotement - Application

A

Hands are cupped, motion occurring from relaxed wrists to create a gentle slapping of the surface. Rapid rhythmic method.

41
Q

Cupping/tapotement - Purpose

A

Release lymph or fluid and mucous blockage or stimulate afferent nerves.

42
Q

Scar tissue massage

A

Improves alignment of tissue.
Circular, vertical or horizontal.
Effleurage can be applied to increase circulation.
Finger and thumb kneading to mobilize scar and surrounding tissue.

43
Q

Clinical Use of Massage - Headaches and Neck Pain - Tender Muscles/Areas

A

Might identify increased muscle tone and stringy areas.

Traps, supraspinatus, levator scapulae, rhomboids, scalenes, nuchal line of occiput.

44
Q

Clinical Use of Massage - Back Pain - Tender Areas/Muscles - Acute vs Chronic

A

Lumbar fascia, paraspinal muscles, painful nodules around iliac crest.
Massage on acute back pain aims to reduce muscle pain and spasm and increase circulation.
Massage on chronic back pain aims to reduce muscle pain and spasm and relieve stress symptoms.

45
Q

Deep Tissue Massage - Goals

A 
Aimed at deeper tissue structures of the muscle and fascia (connective tissue).
Helps to: 
- Loosen muscle tissue
- Release toxins from muscles
- Improve blood and oxygen circulation
46
Q

Myofascial Trigger Points (MTrP)

A

Common cause of muscle pain.
Discrete, hyperirritable nodule in a taut band of skeletal muscle which is palpable and tender during physical examination.

47
Q

Active Trigger Points

A

Associated with spontaneous pain. Referred pain pattern.

Always tender.

48
Q

Latent Trigger Points - what does it lead to?

A

Painful only on pressure, eliciting local pain at the site of the nodule.
Sleeping trigger point.
Leads to muscle dysfunction, muscle weakness, limited ROM, local twitch response (produced by snapping palpation).

49
Q

Trigger Point Theory

A

Muscle overuse during low intensity activities → sustained muscle contraction → Ischemia, hypoxia (local energy crisis due to lack of oxygen).

50
Q

Trigger Point Theory - Cinderella Hypothesis

A

Constantly activated muscle fibers which are metabolically overloaded. More susceptible to damage.

51
Q

Trigger Point Pressure Release

A

Muscle passively placed into mildly lengthened position.
Pressure applied slowly and progressively to the point of discomfort without pain. Pressure and stretch maintained until tension is released.

52
Q

Massage in Sports - Before/During/After

A

Before: Muscle warm up - accelerated movements (e.g. effleurage, petrissage, friction techniques).
During:
- Maintain peak performance (effleurage to remove toxin)
- Ease muscle tightness (petrissage, kneading)
After: Remove fatigue products (lactic acid, CO2), can reduce delayed onset muscle pain.

53
Q

Lymph Drainage Massage

A

Conservative treatment for lymphedema. Works best with others! (compression bandage, positioning, pneumatic pump)
Reduces swelling. Promotes movement of lymphatic fluid.
Slow and rhythmical movements with gentle pressure.

54
Q

Which techniques can be used for the upper arm?

A 
Supine- whole arm
- Effleurage along the arm and towards the
shoulder
- Effleurage with the forearm raised.
- Deep effleurage on the palm
- Kneading of the forearm
- Friction on the elbow area.
55
Q

Which techniques can be used for the shoulder area?

A
  • Effleurage on the posterolateral aspect of the upper arm
  • Effleurage on the anteromedial side
  • Biceps petrissage
  • Petrissage on the posterior muscles of the upper arm.
56
Q

Which techniques can be used on the thigh?

A 
In supine: 
- Light Effleurage/Deep effleurage of anterior and medial /lateral thigh
- Muscle wringing
- kneading of the anterior and lateral aspect.
In prone: posterolateral 
- Light effleurage
- Deep effleurage du poing
- Petrissage -wringing
57
Q

Which techniques can be used on the knee?

A

Finger/ thumb kneading around the patella, along the

joint line and over the collateral ligaments

58
Q

Which techniques can be used on the lower limb?

A 
In supine: 
- Fingertip effleurage around malleoli
- Effleurage du poing on the lower leg (tibia)
- Effleurage of calf (leg bent)
- single handed or thumb kneading of anterior tibialis
In prone: 
- Light Effleurage - V grip
- Petrissage of calf
- Petrissage of calf leg bent
59
Q

Which Effleurage techniques can be used on the spine?

A 
Light effleurage: 
- Longitudinal
- Reversed longitudinal
- Criss cross
Deep effleurage:
- Hands reinforcement
- Forearms
- Effleurage du poing
- Thumbs effleurage
60
Q

Which techniques can be used on the Lumbar spine?

A
  • Figure of 8
  • Deep effleurage with thumbs
  • Petrissage
  • Kneading with whole hand finger/ thumb along iliac crest
  • reinforced kneading
    Side lying:
  • Figure of 8
  • Effleurage du poing
61
Q

Which techniques can be used on the Thoracic spine?

A
  • Skin rolling
  • Friction of the paraspinal muscles
  • kneading
62
Q

Which techniques can be used on the neck?

A
  • Kneading with thenar
  • Kneading with thumbs
  • Wringing (petrissage) of trapezius
    Side lying:
  • Effleurage du poing

Key Skills in Physiotherapy - BPT05 (14 decks)

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