Neurological massage

Question 1

what is therapeutic massage

Answer 1

is the manipulation of the soft tissue of the body by a trained therapist as a component of a holistic intervention

Question 2

main types of massage used

Answer 2

swedish- includes effleurage and petrissage

Question 3

swedish massage

Answer 3

stroking, effleurage, petrissage- kneading, finger kneading, wringing, rolling, picking up
tapotement- hacking and pounding

Question 4

effects of massage- mechanical effect

Answer 4

mobilisation of tissue- skin and subcutaneous tissue, contractile/non-contractile tissue, scar or repair tissue
movement of fluid- oedema, lymph, blood, mucus

Question 5

effects of massage- physiological effects- circulatory and MSK system

Answer 5

circulatory- venous and lymphatic flow- shift toxins, and move oxygen into areas needed, shift CO2 you don’t want, skin redding
MSK- muscle tissue, connective tissue, move lactic acid and things building up in muscle

Question 6

effects of massage- physiological effects- other systems

Answer 6

nervous system- pain relief- pain gate theory and autonomic response- BP, HR, swelling
hormonal system and immunological system

Question 7

effects of massage- psychological effect

Answer 7

reduced anxiety, reduced muscle tension, reduced perceived pain, raised mood, improved development in children, improved relaxation, placebo effect

Question 8

a therapeutic relationship- is built on

Answer 8

respect, trust and confidentiality, good communication, client-centred care, understanding of power relationship

Question 9

a therapeutic relationship- considerations

Answer 9

client vulnerability, emotional responses to therapists, emotional responses to massage

Question 10

ethical considerations

Answer 10

informed consent, inappropriate behaviours, maintain clear communication, maintain boundaries- confidentiality and dual relationship, maintain privacy and dignity

Question 11

indications for use

Answer 11

soft tissue damage- muscle, connective tissue, skin, oedema-swelling, venous ulcers- less common now,adverse neural dynamics- high tone, spasticity, pain as a result of neural changes

Question 12

absolute contradictions

Answer 12

open wound, inadequate or compromised circulation (DVT or haemophilia), haemorrhage, early stages of healing, bacterial/ fungal infection, febrile condition, acute inflammation, active bone growth, skin conditions, undiagnosed cancer, active malignancy, over a foreign body

Question 13

undiagnosed cancer

Answer 13

intractable pain, generally feeling unwell, change in temperature, inflammation or heat in absence of trauma, unexplained weight change, any lump size, family history

Question 14

potential contraindications or precautions

Answer 14

malignant skin, fragile skin, collagenous weakening- steroid use/ diabetes/ RA, patients with heart, dermatomyositis- infection of muscles, vicinity of endocrine glands

Question 15

self preparation for massage

Answer 15

personal appearance (no jewellery, hair restrained, clean/soft/warm hand, short clean fingernails, a sense of rhythm, knowledge of techniques and rational, good postural awareness, ability to relax arms and hands, coordinated movement, ability for smooth weight transference in stance position

Question 16

environment preparation

Answer 16

quit, well headed/ ventilated area, free from obstacles, couch should be clean and covered, couch adjusted for therapists good posture,

Question 17

patient preperation

Answer 17

ensure appropriate exposure of the part of massage- including proximal lymph glands, ensure the patient is warm/ dignity, ensure patient comfort in positioning- relaxed and pain free, ensure area of massage is well supported

Question 18

massage- feel for

Answer 18

temperature, muscle tension, joint posture, pain, ticklishness

Question 19

massage medium

Answer 19

reduce friction- protects fragile or hairy skin, absorbs perspiration, enhances gliding effect, may have psychological or therapeutic effect

Question 20

effleurage purpose

Answer 20

aid venous and lymphatic return, aid tissue fluid interchange, aid removal of chemical irritants, improve tissue interface mobility, increase (deep)/decrease (light) muscle tone, passively stretch muscle fibres

Question 21

effleurage features

Answer 21

distal to proximal, towards lymph glands, whole hand or fingers or thumb, even pressure, intersperse other techniques, moulds to body contours, stroke completed over lymph glands with slight pause and over pressure

Question 22

petrissage purpose

Answer 22

aid venous/ lymphatic return, aid tissue fluid interchange, aid removal of chemical irritants, improve tissue interface mobility, increase mobility and length of fibrous tissue, increase extensibility and strength of connective tissue, provoke somatovisceral reflex effects

Question 23

petrissage types

Answer 23

kneading, box kneading, wringing, finger kneading

Question 24

petrissage features

Answer 24

double/ single handed; fingers/thumb, on superficial tissue, muscles or ligaments, compression of soft tissue first, then lifted, squeezed or rolled, taken to end feel, painful on sensitised tissue- avoid