Principles & Standards of Assessments and Treatments

Question 1

What are the principles of performing an optimal massage treatment?

Answer 1

Treat unaffected side (possibly compensating) first
General to specific to general
Superficial to deep to superficial
Proximal to distal to proximal
Peripheral to central to peripheral
Treat antagonist (if tension differences present)

Question 2

What are good principles of assessment?

Answer 2

• Have proper informed consent
• Hold myotomes for minimum 5 seconds
• Assess end-feel via overpressure
• Test unaffected side first
• Test unaffected movements/ROMs first
• ## Assess surrounding (both superior and inferior) joints in addition to the reportedly painful joint(s), continuing to assess until joints show no dysfunction (assuming not a player to overall dysfunction)

Question 3

What is the general procedure for scans (assuming the interview, posture, gait, and general observations are completed)?

Answer 3

ROMs
UMNLs
Nerve root testing (and differentation from peripheral nerve problem) - i.e. dermatomes, myotomes, reflexes
Dural movement testing

Question 4

What does a general upper and lower scan consist of?

Answer 4

Upper:
ROMs: cervical (4), thoracic (4), TMJ (2), glenohumeral (2), elbow (4), wrist (4), hand (2)
UMNL: Hoffman’s or Babinski’s or Oppenheim’s
Nerve roots: dermatomes C1-T1, myotomes C1-T1, reflexes C5/C6 and C7/C8
Dural movement: ULTT variations or all 4

Lower:
ROMs: lumbar (3), SIJ (5), acetabulofemoral (3), knee (2), ankle/foot (4)
UMNL: Hoffman’s or Babinski’s or Oppenheim’s
Nerve roots: dermatomes L1-S2, myotomes L2-S2, reflexes L3/L4 and L5/S1
Dural movement: slump test, Nachlas test, and/or SLR test (and variations applicable)

Question 5

What is the general process of an assessment of a particular joint?

Answer 5

Observation/Palpation
ROMs (+likely above & below)
Muscle testing
Orthopedic testing
Neuological testing

Question 6

If a client is taking medication for a particular condition, when should you NOT perform a treatment?

Answer 6

When he/she is in an unstable state (i.e. hasn’t taken his/her dose at the proper scheduled time for peak onset during treatment - or vice versa if you don’t want it to be active during treatment - is randomly off it on day or few days without doctor’s approval because they [temporarily] didn’t think they needed it anymore [=rebound], etc.)