Soft Tissue Massage (stm) Flashcards
What is soft tissue massage?
Different manual techniques - designed to improve inter-tissue mobility and produce pain-free function.
What are some indications for STM?
- pain is a big indication
- muscle spasm
- edema
- reduced circulation
- scar tissue. We can realign scar tissue
- headaches
- decreased ROM/flexibility, and contractures
Affective touch…
Interpersonal touch mediates the release of neurochemicals. which can result in reduced physiological and behavioral reactivity to stressors and improved mood/affect
Contextual factors…
A positive therapeutic encounter is tied to clinical outcomes; the magnitude of a response is influenced by mood, expectation, and conditioning
Mechanical factors…
Gentle stretching of neurovascular structures and muscles induces a molecular response that helps diminish intraneural edema and expedite clearance of noxious biochemical by-products
Neurological factors…
Therapeutic stimulation of somatosensory nerves inhibits nociceptive processing and activate descending inhibitory mechanisms. This influences neuro-immune processes correlated with the experience of pain
How does STM help?
STM causes reduced cellular infiltration which helps reduce swelling and edema and flush out inflammation. This helps speed up recovery. Histologically, the faster you can get in and do soft tissue mobilization, the better the healing is and the more normal the tissue is. If you do it later, the tissue will have had some hypoxia which can cause secondary injury
What are the precautions for stm?
- Skin rashes/irritations
- Hypoesthesia/hyperesthesia
- Osteoporosis
- Pregnancy
- Extremely hairy areas
What are the contraindications for stm?
- Open wound, hematoma, deep bruising, burns, blisters
- Marked varicosities
- Gross edema with risk of skin tear
- Skin CA
- Septic arthritis
- Acute/chronic skin infections
- DVT
- Cellulitis
- Constant, severe pain or pain not relieved by rest
What are some treatment considerations?
- Clean, dry, and warm hands
- Comfortable positioning of PT and patient
- Lubricant-overcome friction and avoid skin irritation
- Some lubricants contain beeswax
Components to consider for every massage…
- Direction of the stroke
- Pressure
- Rate and rhythm
- Duration and frequency
- Changes in signs and symptoms
General massage is…
The whole body. We don’t really do this.
Local massage is…
A specific body part.
Focal massage is…
One specific spot like the biceps tendon.
When do you use effleurage?
It is often used in the beginning to get people used to touch. It can be regular or deep strokes.
What are the primary effects of effleurage?
- increase in the flow of venous blood
- stimulation of lymph flow
- Increase flow in veins and lymphatic vessels
- Increase mobility of the skin and subcutaneous tissues
- Dilation of superficial arterioles
- Stimulation of the large diameter mechanoreceptors in the skin
What direction do you perform effleurage in?
Always in the direction of venous and lymphatic flow. It is always towards the heart.
How much pressure do you give in effleurage?
Gradually increase the pressure throughout the stroke. However, it is not a super deep stroke.
What is the rate and rhythm of effleurage?
About 7 inches per second. Slight pause at the end of each stroke and/or near lymph glands. Slow. This pushes the fluid into the venous system.
When performing effleurage, do your hands ever leave their body?
No. You can use one hand or two hands, but your hands are always in contact with the patient’s body.
How is deep stroking effleurage different from effleurage?
- More pressure to produce a mechanical effect
- May help relieve pain, muscle spasm, and superficial scar tissue
- Stimulates circulation in deeper tissues
- Promotes relaxation which may help pain and muscle spasms
- Does not have to be with venous flow
